Major depressive disorder — MCCQE Part 1 MCQ
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Correct answer: A — Offer evidence-based psychotherapy and/or antidepressant treatment with follow-up and safety assessment
Offer evidence-based psychotherapy and/or antidepressant treatment with follow-up and safety assessment is the single best answer because the age, timing, examination findings and investigations in the vignette fit Major depressive disorder better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CANMAT depression guidelines, with attention to acuity, safety-netting and local provincial pathways.
Reference: CANMAT depression guidelines