Assessment and Screening for Major Depressive Episode

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According to the DSM-5, which of the following is NOT a symptom required for the diagnosis of major depressive disorder?

Significant weight changes

Recurrent thoughts of death

Feelings of worthlessness

Excessive worry (correct)

How long must the symptoms of depressed mood or anhedonia be present for a diagnosis of major depressive disorder?

At least 1 week

At least 4 weeks

At least 2 weeks (correct)

At least 3 weeks

Which of the following statements about the DSM-5 criteria for major depressive disorder is correct?

At least six symptoms must be present, regardless of depressed mood or anhedonia.

At least three symptoms must be present, including depressed mood and anhedonia.

At least four symptoms must be present, in addition to depressed mood or anhedonia. (correct)

At least five symptoms must be present, including depressed mood or anhedonia.

Which of the following statements about the DSM-5 criteria for major depressive disorder is NOT true?

Bereavement is still considered an exclusion criterion. Signup and view all the answers

Which of the following is a potential symptom of major depressive disorder according to the DSM-5?

Both insomnia and hypersomnia Signup and view all the answers

What is the primary reason for ruling out potential medical disorders before diagnosing major depressive disorder?

To ensure the symptoms are not caused by a medical condition Signup and view all the answers

What is a commonly used screening tool to assess the severity of a patient's depressive symptoms?

Montgomery-Asberg Depression Rating Scale (MADRS) Signup and view all the answers

What is one of the medical conditions that should be ruled out in the assessment for depressive disorders?

Hypothyroidism Signup and view all the answers

What is the main purpose of using screening tools for depressive disorders in primary care?

To measure outcomes of care Signup and view all the answers

Which self-report screening instrument assists in differentiating bipolar symptoms?

Mood Disorder Questionnaire (MDQ) Signup and view all the answers

Which tool can assess both depression and anxiety symptoms?

Hamilton Rating Scale (HAM-D; HAM-A) Signup and view all the answers

Why is it important to rule out medical conditions like hypothyroidism in the assessment of depressive disorders?

Hypothyroidism can mimic symptoms of depression. Signup and view all the answers

Which screening tool is a self-report instrument consisting of 17 questions to assist in differentiating bipolar disorder symptoms?

Mood Disorder Questionnaire (MDQ) Signup and view all the answers

What is one of the most common screening tools used in primary care for assessing depression?

Patient Health Questionnaire (PHQ-9) Signup and view all the answers

What distinguishes the Mood Disorder Questionnaire (MDQ) from other screening tools?

It helps differentiate bipolar disorder symptoms. Signup and view all the answers

Why are screening tools alone not diagnostic of depression?

They lack the context provided by a thorough medical evaluation. Signup and view all the answers

According to the passage, which medication is mentioned as potentially alleviating some PTSD symptoms?

Clonidine Signup and view all the answers

What is the primary recommendation for primary care providers regarding PTSD patients?

Refer to a mental health specialist Signup and view all the answers

According to the passage, what is the most effective way to decrease symptoms of depression?

Increasing daily activity Signup and view all the answers

What type of therapy, in addition to pharmacological treatment, has been found to be efficacious for anxiety disorders?

Cognitive behavioral therapy Signup and view all the answers

Which of the following is NOT mentioned in the passage as a potential treatment for PTSD?

Sertraline Signup and view all the answers

According to the passage, which of the following has been shown to reduce symptoms in multiple anxiety disorders?

Exercise Signup and view all the answers

Which neurotransmitters are specifically mentioned as potentially contributing to the core symptoms of depression?

Serotonin, dopamine, and norepinephrine Signup and view all the answers

Which brain regions are linked to the depressive symptom of depressed mood?

Amygdala and prefrontal cortex Signup and view all the answers

What is the focus of genetic testing in relation to the treatment of psychiatric disorders?

Distinguishing CYP450 polymorphisms affecting drug metabolism Signup and view all the answers

Which brain circuit is specifically mentioned as potentially contributing to the symptom of worry in generalized anxiety disorder (GAD)?

Corticostriato-thalamo-cortical (CSTC) loops Signup and view all the answers

Which neurotransmitter is specifically mentioned as being involved with sedatives like benzodiazepines and alcohol?

GABA Signup and view all the answers

Which brain region is mentioned as potentially contributing to the neurobiology of post-traumatic stress disorder (PTSD)?

Both hippocampus and amygdala Signup and view all the answers

What is the conclusion regarding the efficacy of genetic testing in relation to the treatment of depression with selective serotonin reuptake inhibitors (SSRIs)?

There is insufficient evidence to determine the efficacy of genetic testing with SSRIs Signup and view all the answers

Which brain region is specifically mentioned as potentially contributing to the neurobiology of obsessive-compulsive disorder (OCD)?

Prefrontal cortex Signup and view all the answers

Which neurotransmitter is specifically mentioned as potentially contributing to the neurobiology of panic and phobias?

GABA Signup and view all the answers

Which brain region is specifically mentioned as potentially contributing to the symptom of fatigue in depression?

Prefrontal cortex and nucleus accumbens Signup and view all the answers

Which of the following is NOT a common symptom of a panic attack?

Confusion Signup and view all the answers

What is the minimum number of symptoms required to meet the criteria for Panic Disorder (PD)?

4 Signup and view all the answers

Which of the following is a common differential diagnosis for Panic Disorder?

Hyperthyroidism Signup and view all the answers

What is the purpose of the HAM-A rating scale in the assessment of Panic Disorder?

To monitor symptom improvement Signup and view all the answers

Which of the following is a key characteristic of Generalized Anxiety Disorder (GAD)?

Excessive worry that is difficult to control Signup and view all the answers

What is the purpose of the Yale-Brown Obsessive-Compulsive Scale (YBOCS) in the assessment of Obsessive-Compulsive Disorder (OCD)?

Both b and c Signup and view all the answers

What is a key change in the criteria for PTSD in the DSM-5?

The inclusion of children younger than age 6 and adolescents Signup and view all the answers

Which of the following is a common screening tool for PTSD?

PTSD Checklist for DSM-5 (PCL-5) Signup and view all the answers

What is a key difference between the symptoms of depression and anxiety disorders?

Early morning awakening or fragmented sleep Signup and view all the answers

What is a common compulsive behavior associated with Obsessive-Compulsive Disorder (OCD)?

Checking behavior Signup and view all the answers

What is the purpose of using screening tools for traumatic events?

To determine if the disorder is present Signup and view all the answers

How many sources of information are recommended when screening for trauma?

2 sources Signup and view all the answers

What is the purpose of the TESI tool?

To assess the experience of traumatic events Signup and view all the answers

What is a key risk factor for suicide?

Prior suicide attempts Signup and view all the answers

What is a key protective factor against suicide?

Feeling responsible for children or pets Signup and view all the answers

What is the purpose of the SAFE-T suicide assessment?

To identify risk factors and protective factors for suicide Signup and view all the answers

What is the classic monoamine theory of depression?

Depression is caused by a deficiency of various neurotransmitters and/or abnormalities in monoamine receptors Signup and view all the answers

Which of the following is NOT a key step in the SAFE-T suicide assessment?

Determine the Patient's Diagnosis Signup and view all the answers

What is the purpose of understanding the neurobiology of depression and anxiety disorders?

To choose the most appropriate pharmacological treatment Signup and view all the answers

What is the recommended approach for using screening tools for depression, anxiety, and suicide?

Use the screening tools as a guide to appropriate treatment decisions Signup and view all the answers

What was the key finding from the STAR*D study regarding the treatment of major depressive disorder?

Remission could be achieved in 25-35% of patients after 14 weeks of treatment with citalopram. Signup and view all the answers

According to the passage, which of the following is a key recommendation from the STAR*D study and other guidelines for the treatment of major depressive disorder?

Titrate antidepressant doses to the maximum tolerated level, rather than the minimum effective dose. Signup and view all the answers

Based on the information provided, which of the following antidepressants has been shown to be effective in the treatment of panic disorder?

Venlafaxine Signup and view all the answers

What is the first-line treatment recommendation for post-traumatic stress disorder (PTSD) according to the passage?

SSRIs such as sertraline and paroxetine Signup and view all the answers

Which of the following is a key finding from the STAR*D study regarding the treatment of major depressive disorder?

There was no statistically significant difference in remission rates between augmentation and switching strategies. Signup and view all the answers

What is the main focus of the evidence-based algorithms and guidelines discussed in the passage for the treatment of major depressive disorder?

Treating to remission and using other medication options if the initial antidepressant is not effective. Signup and view all the answers

According to the passage, what is the key difference in long-term prognosis between patients who achieve remission and those who achieve a partial response to antidepressant treatment for major depressive disorder?

Patients who achieve remission have a better long-term prognosis. Signup and view all the answers

Which of the following antidepressant classes was found to be effective in the treatment of generalized anxiety disorder (GAD) according to the passage?

Serotonin-norepinephrine reuptake inhibitors Signup and view all the answers

What is the key takeaway from the evidence-based algorithm presented in Figure 30-2 regarding the general approach to the treatment of anxiety disorders?

Antidepressants are the recommended first-line pharmacological treatment for anxiety disorders. Signup and view all the answers