NR547 FINAL EXAM STUDY GUIDE
Based on Kaplan & Sadock’s Synopsis of Psychiatry (12th ed.)
🔹 WEEK FIVE – MOOD DISORDERS
1. Hamilton Rating Scale for Depression (HAM-D)
(Kaplan & Sadock, HAM-D table)
Components (17-item version most common):
Depressed mood
Feelings of guilt
Suicide
Insomnia (early, middle, late)
Work and activities
Psychomotor retardation or agitation
Anxiety (psychic & somatic)
Somatic symptoms
Weight loss
Insight
Scoring:
0–7: Normal
8–13: Mild depression
14–18: Moderate depression
19–22: Severe depression
≥23: Very severe depression
2. Geriatric Depression Scale (GDS)
Purpose: Screens depression in older adults (minimizes somatic bias)
Components:
Yes/No questions
Focus on mood, energy, life satisfaction, helplessness
Scoring (15-item version):
0–4: Normal
5–8: Mild depression
9–11: Moderate depression
12–15: Severe depression
3. PHQ-9
Components (DSM-based):
, 1. Anhedonia
2. Depressed mood
3. Sleep disturbance
4. Fatigue
5. Appetite/weight changes
6. Guilt/worthlessness
7. Concentration difficulty
8. Psychomotor changes
9. Suicidal ideation
Scoring:
0–4: Minimal
5–9: Mild
10–14: Moderate
15–19: Moderately severe
20–27: Severe
4. Mood Disorder Questionnaire (MDQ)
Purpose: Screens for bipolar disorder
Components:
≥13 yes/no manic symptoms
Symptoms occurring at same time
Caused moderate or serious problems
Positive screen:
≥7 symptoms
Occurring together
Functional impairment present
⚠️
MDQ does NOT grade depression severity
5. Normal Lab Values (Exam-Relevant)
Test Normal Range
TSH 0.5–5.0 mIU/L
Men: 13.5–17.5 g/dL
Hemoglobin
Women: 12–16 g/dL
Lithium (maintenance) 0.6–1.2 mEq/L
Valproate (Depakote) 50–125 mcg/mL
6. Major Depressive Disorder – Specifiers
(Kaplan & Sadock + DSM-5-TR)
With anxious distress
, With mixed features
With melancholic features
With atypical features
With mood-congruent psychotic features
With mood-incongruent psychotic features
With catatonia
With peripartum onset
With seasonal pattern
7. Premenstrual Dysphoric Disorder (PMDD)
Criteria:
Symptoms in final week before menses
Improve within days after onset
Minimal post-menses
Symptoms (≥5):
Mood lability
Irritability/anger
Depressed mood
Anxiety
Decreased interest
Fatigue
Appetite changes
Sleep disturbance
Feeling overwhelmed
Physical symptoms
8. Persistent Depressive Disorder (Dysthymia)
≥2 years (adults)
≥1 year (children/adolescents)
No symptom-free period >2 months
9. Antidepressant Augmentation Strategies
(Kaplan & Sadock Ch. 21.2)
Add lithium
Add atypical antipsychotic
Add thyroid hormone (T3)
Combine antidepressants (e.g., SSRI + bupropion)
10. Tricyclic Antidepressants (TCAs)
Examples:
Based on Kaplan & Sadock’s Synopsis of Psychiatry (12th ed.)
🔹 WEEK FIVE – MOOD DISORDERS
1. Hamilton Rating Scale for Depression (HAM-D)
(Kaplan & Sadock, HAM-D table)
Components (17-item version most common):
Depressed mood
Feelings of guilt
Suicide
Insomnia (early, middle, late)
Work and activities
Psychomotor retardation or agitation
Anxiety (psychic & somatic)
Somatic symptoms
Weight loss
Insight
Scoring:
0–7: Normal
8–13: Mild depression
14–18: Moderate depression
19–22: Severe depression
≥23: Very severe depression
2. Geriatric Depression Scale (GDS)
Purpose: Screens depression in older adults (minimizes somatic bias)
Components:
Yes/No questions
Focus on mood, energy, life satisfaction, helplessness
Scoring (15-item version):
0–4: Normal
5–8: Mild depression
9–11: Moderate depression
12–15: Severe depression
3. PHQ-9
Components (DSM-based):
, 1. Anhedonia
2. Depressed mood
3. Sleep disturbance
4. Fatigue
5. Appetite/weight changes
6. Guilt/worthlessness
7. Concentration difficulty
8. Psychomotor changes
9. Suicidal ideation
Scoring:
0–4: Minimal
5–9: Mild
10–14: Moderate
15–19: Moderately severe
20–27: Severe
4. Mood Disorder Questionnaire (MDQ)
Purpose: Screens for bipolar disorder
Components:
≥13 yes/no manic symptoms
Symptoms occurring at same time
Caused moderate or serious problems
Positive screen:
≥7 symptoms
Occurring together
Functional impairment present
⚠️
MDQ does NOT grade depression severity
5. Normal Lab Values (Exam-Relevant)
Test Normal Range
TSH 0.5–5.0 mIU/L
Men: 13.5–17.5 g/dL
Hemoglobin
Women: 12–16 g/dL
Lithium (maintenance) 0.6–1.2 mEq/L
Valproate (Depakote) 50–125 mcg/mL
6. Major Depressive Disorder – Specifiers
(Kaplan & Sadock + DSM-5-TR)
With anxious distress
, With mixed features
With melancholic features
With atypical features
With mood-congruent psychotic features
With mood-incongruent psychotic features
With catatonia
With peripartum onset
With seasonal pattern
7. Premenstrual Dysphoric Disorder (PMDD)
Criteria:
Symptoms in final week before menses
Improve within days after onset
Minimal post-menses
Symptoms (≥5):
Mood lability
Irritability/anger
Depressed mood
Anxiety
Decreased interest
Fatigue
Appetite changes
Sleep disturbance
Feeling overwhelmed
Physical symptoms
8. Persistent Depressive Disorder (Dysthymia)
≥2 years (adults)
≥1 year (children/adolescents)
No symptom-free period >2 months
9. Antidepressant Augmentation Strategies
(Kaplan & Sadock Ch. 21.2)
Add lithium
Add atypical antipsychotic
Add thyroid hormone (T3)
Combine antidepressants (e.g., SSRI + bupropion)
10. Tricyclic Antidepressants (TCAs)
Examples:
