Rosh Psychiatry Board Practice Exam

What is a defining feature of persistent depressive disorder?

1. Anger outbursts

2. Episodes of mania

3. Significant impairment in occupational functioning

4. Chronic low-grade depression

The correct answer is: Chronic low-grade depression

A defining feature of persistent depressive disorder, also known as dysthymia, is chronic low-grade depression. This condition involves a prolonged period of depressive symptoms that typically lasts for at least two years in adults (one year in children and adolescents). The symptoms may not be as severe as those seen in major depressive disorder, but they are still significant enough to impact the individual’s overall functioning and quality of life. Chronic low-grade depression characterizes persistent depressive disorder in that individuals often experience a consistent feeling of sadness or emptiness, coupled with other symptoms such as low energy, low self-esteem, and difficulty concentrating. This persistent state can significantly affect various life areas, including relationships and daily activities. In contrast, the other options do not accurately define persistent depressive disorder. For example, anger outbursts are more indicative of certain personality disorders or mood disorders but are not a core feature of this specific depressive condition. Similarly, episodes of mania are characteristic of bipolar disorder rather than persistent depressive disorder. Lastly, while significant impairment in occupational functioning may occur as a result of this condition, it is not a defining feature but rather a potential consequence of the ongoing low-grade depressive state.