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Major depressive disorder — USMLE Step 3 MCQ

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EasyPsychiatry (outpatient management)Major depressive disorderUSMLE Step 3

A 36-year-old woman has 2 months of depressed mood, anhedonia, insomnia, low energy, impaired concentration, and guilt. She denies manic symptoms, psychosis, substance use, and suicidal intent. PHQ-9 indicates moderate depression. Which of the following is the most appropriate next step in management?

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Correct answer: C — Start psychotherapy and/or an SSRI after shared decision-making

Moderate major depression can be treated with evidence-based psychotherapy, antidepressant medication, or both after safety and bipolar screening.

Reference: American Psychiatric Association Clinical Practice Guidelines: https://www.psychiatry.org/psychiatrists/practice/clinical-practice-guidelines