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Psychiatry · USMLE Step 1

USMLE Psychiatry: Mood Disorders

Major depressive disorder and bipolar spectrum disorder diagnostic criteria and distinguishing features tested on USMLE Step 1.

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Major depressive disorder requires a constellation of symptoms present for at least ____.
2 weeks
How many of the nine DSM symptom categories (SIGECAPS plus depressed mood) must be present, at minimum, to diagnose MDD?
5 or more, and at least one must be depressed mood or anhedonia
What does the SIGECAPS mnemonic list for major depressive disorder symptoms?
Sleep change, Interest loss (anhedonia), Guilt/worthlessness, Energy loss, Concentration problems, Appetite change, Psychomotor change, Suicidal ideation (plus depressed mood)
What is anhedonia?
Loss of interest or pleasure in activities previously found enjoyable
What is the minimum duration of depressive symptoms required to diagnose persistent depressive disorder (dysthymia) in adults?
2 years
In children and adolescents, what is the minimum duration required to diagnose persistent depressive disorder?
1 year
What term describes a major depressive episode occurring on top of pre-existing persistent depressive disorder?
Double depression
A major depressive episode qualifies for the peripartum onset specifier if it occurs during pregnancy or within how many weeks after delivery?
4 weeks
Postpartum blues typically peaks around day 3 to 5 and resolves by when?
Within about 2 weeks after delivery
Postpartum psychosis is a psychiatric emergency primarily because of increased risk of what?
Harm to the infant or the mother (infanticide or suicide risk)
What mood feature defines atypical depression?
Mood reactivity (mood brightens in response to positive events)
What sleep pattern is characteristic of atypical depression?
Hypersomnia (sleeping excessively)
What appetite change is characteristic of atypical depression?
Hyperphagia with weight gain
What term describes the heavy, leaden sensation in the limbs seen in atypical depression?
Leaden paralysis
What sleep disturbance is characteristic of melancholic depression?
Early morning awakening (terminal insomnia)

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