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Major depressive disorder in primary care — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareMajor depressive disorder in primary careUSMLE Step 3

A 45-year-old man has depressed mood, anhedonia, early morning awakening, poor concentration, and guilt for 7 weeks. He denies suicidal thoughts, mania, psychosis, and substance use. TSH is normal. Which of the following is the most appropriate next step in management?

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Correct answer: A — Start an SSRI and arrange follow-up

Uncomplicated outpatient major depression can be treated with an antidepressant, psychotherapy, or both, with follow-up to assess response and safety.

Reference: APA Depression Guideline; USPSTF Depression Screening Recommendation