PRIMARY CARE MANAGEMENT OF
ADOLESCENTS AND ADULTS GUIDE FINAL
2026 CERTIFICATION EVALUATION EXAM
QUESTIONS AND ANSWERS MASTER FILE
◉ MDD mood congruent with psychotic features Answer:
delusions/hallucinations related to depressive themes (guilt,
worthlessness)
◉ MDD with Mood incongruent psychotic features Answer: Bizzare
or unrelated psychotic symptoms
◉ MDD with catatonia Answer: mutism
stupor
posturing
rigidity
bizzare movements
**Can occur in severe depression, bipolar disorder, or schizophrenia.
Requires urgent treatment
,◉ MDD with peripartum onset Answer: Depression during
pregnancy or within 4 week postpartum
**Can include psychotic features, risk of postpartum psychosis
◉ MDD With seasonal Pattern (Seasonal Affective Disorder-SAD)
Answer: Depression occurs in seasonal pattern, typically in
fall/winter
**Related too light exposure, responds to light therapy
◉ Course specifiers for mood disorders Answer: Describes how the
disorder progresses overtime
In partial remission
In full remission
with rapid cycling (For Bipolar Disorder only)
◉ Mood disorders in partial remission Answer: symptoms are
present but do not meet full criteria for an episode
◉ Mood disorders in full remission Answer: No significant
symptoms for atleast 2 months
,◉ Mood disorders with rapid cycling Answer: For Bipolar Only
>=4 mood episodes per year (depressive, Manic, Hypomanic)
◉ Clinical importance of specifiers Answer: guides treatment
choices (ex: atpyical depression may respond to MAOIs, Melancholic
depression may respond to ECT)
Helps predict prognosis (ex: anxious distress=higher suicide risk)
Aids in differentiating MDD from Bipolar Disorder
◉ Premenstrual Dysphoric Disorder Answer: Severe form of
premenstrual syndrome (PMS) characterized by significant mood,
behavioral, and physical symptoms that occur in the luteal phase
and resolves shortly after menstruation begins
◉ Luteal phase Answer: week before menstruation
◉ Diagnostic Criteria for PMDD Answer: Symptoms must occur in
the majority of menstrual cycles
Must be present in the final week before menstruation
, Symptoms improve within a few days of period onset
Symptoms are minimal or absent in the week after menstruation
At Least 5 symptoms must be present, including at least one from
Section 1 and one from section 2
◉ Core Mood Symptoms of PMDD Answer: At least one of these is
required to make a diagnosis
Marked mood swings (sudden sadness, increased sensitivity to
rejection)
Irritability or anger (frequent conflicts)
Depressed mood ( feelings of hopelessness, self critical thoughts)
Anxiety or tension (feeling on edge)
◉ Addition symptoms of PMDD Answer: Need to reach a total of 5
symptoms, one symptom must be from this category
Decreased interest in usual activities (work, school, social life)
Difficulty concentrating
Fatigue or low energy
Changes in appetite (overeating, food cravings)
ADOLESCENTS AND ADULTS GUIDE FINAL
2026 CERTIFICATION EVALUATION EXAM
QUESTIONS AND ANSWERS MASTER FILE
◉ MDD mood congruent with psychotic features Answer:
delusions/hallucinations related to depressive themes (guilt,
worthlessness)
◉ MDD with Mood incongruent psychotic features Answer: Bizzare
or unrelated psychotic symptoms
◉ MDD with catatonia Answer: mutism
stupor
posturing
rigidity
bizzare movements
**Can occur in severe depression, bipolar disorder, or schizophrenia.
Requires urgent treatment
,◉ MDD with peripartum onset Answer: Depression during
pregnancy or within 4 week postpartum
**Can include psychotic features, risk of postpartum psychosis
◉ MDD With seasonal Pattern (Seasonal Affective Disorder-SAD)
Answer: Depression occurs in seasonal pattern, typically in
fall/winter
**Related too light exposure, responds to light therapy
◉ Course specifiers for mood disorders Answer: Describes how the
disorder progresses overtime
In partial remission
In full remission
with rapid cycling (For Bipolar Disorder only)
◉ Mood disorders in partial remission Answer: symptoms are
present but do not meet full criteria for an episode
◉ Mood disorders in full remission Answer: No significant
symptoms for atleast 2 months
,◉ Mood disorders with rapid cycling Answer: For Bipolar Only
>=4 mood episodes per year (depressive, Manic, Hypomanic)
◉ Clinical importance of specifiers Answer: guides treatment
choices (ex: atpyical depression may respond to MAOIs, Melancholic
depression may respond to ECT)
Helps predict prognosis (ex: anxious distress=higher suicide risk)
Aids in differentiating MDD from Bipolar Disorder
◉ Premenstrual Dysphoric Disorder Answer: Severe form of
premenstrual syndrome (PMS) characterized by significant mood,
behavioral, and physical symptoms that occur in the luteal phase
and resolves shortly after menstruation begins
◉ Luteal phase Answer: week before menstruation
◉ Diagnostic Criteria for PMDD Answer: Symptoms must occur in
the majority of menstrual cycles
Must be present in the final week before menstruation
, Symptoms improve within a few days of period onset
Symptoms are minimal or absent in the week after menstruation
At Least 5 symptoms must be present, including at least one from
Section 1 and one from section 2
◉ Core Mood Symptoms of PMDD Answer: At least one of these is
required to make a diagnosis
Marked mood swings (sudden sadness, increased sensitivity to
rejection)
Irritability or anger (frequent conflicts)
Depressed mood ( feelings of hopelessness, self critical thoughts)
Anxiety or tension (feeling on edge)
◉ Addition symptoms of PMDD Answer: Need to reach a total of 5
symptoms, one symptom must be from this category
Decreased interest in usual activities (work, school, social life)
Difficulty concentrating
Fatigue or low energy
Changes in appetite (overeating, food cravings)
