NR 547 QUESTIONS AND ANSWERS LATEST UPDATE
HAM-D (Hamilton Depression Rating Scale)
Screening tool that used 17 to 24 items (depending on version) measuring severity of
depression. It assesses symptoms like mood, insomnia, agitation, anxiety, weight loss,
and somatic symptoms.
HAM-D Scoring
0-7: Normal; 8-13: Mild depression; 14-18: Moderate depression; 19-22: Severe
depression; ≥23: Very severe depression.
Geriatric Depression Scale (GDS)
30-item or 15-item version with yes/no responses. It assesses mood, interest in
activities, energy, and overall depressive symptoms.
GDS Scoring
0-9: Normal; 10-19: Mild depression; 20-30: Severe depression.
PHQ-9 (Patient Health Questionnaire-9)
9 items based on DSM-5 criteria for depression. It assesses frequency of symptoms
over the last 2 weeks (0 = not at all, 3 = nearly every day).
PHQ-9 Scoring
1-4: Minimal depression; 5-9: Mild depression; 10-14: Moderate depression; 15-19:
Moderately severe depression; 20-27: Severe depression.
Mood Disorder Questionnaire (MDQ)
13 yes/no questions to screen for Bipolar Disorder. It assesses manic symptoms like
mood elevation, hyperactivity, grandiosity, and decreased need for sleep.
MDQ Scoring
Positive screen: ≥7 symptoms present, occurring in the same episode, with moderate-
to-severe impairment.
Normal Lab Values
TSH: 0.4-4.5 mIU/L; Hemoglobin: Males: 13.8-17.2 g/dL; Females: 12.1-15.1 g/dL;
Lithium: 0.6-1.2 mEq/L (Therapeutic range); Depakote (Valproic Acid): 50-100 mcg/mL
(Therapeutic range).
Major Depressive Disorder (MDD) Specifiers
, With anxious distress; With mixed features; With melancholic features; With atypical
features; With psychotic features; With peripartum onset; With seasonal pattern.
Premenstrual Dysphoric Disorder (PMDD)
≥5 symptoms in the week before menses, improving within days of onset. Symptoms
include mood swings, irritability, depression, anxiety, anhedonia, and physical
symptoms (bloating, breast tenderness).
Persistent Depressive Disorder (Dysthymia)
Depressed mood for ≥2 years (≥1 year in children/adolescents); Presence of at least 2
symptoms: appetite changes, sleep changes, fatigue, low self-esteem, poor
concentration, hopelessness.
Atypical antipsychotics
Examples include aripiprazole and quetiapine.
Lithium
A mood stabilizer used in bipolar disorder.
Buspirone
An anxiolytic medication used to treat anxiety.
Thyroid hormone (T3)
Used as an augmenting agent in depression treatment.
Bupropion
An antidepressant that can be used to augment treatment.
Mirtazapine
An antidepressant that can be used to augment treatment.
Tricyclic Antidepressants (TCAs)
Examples include amitriptyline, nortriptyline, and imipramine.
Anticholinergic effects
Side effects include dry mouth, constipation, and urinary retention.
Sedation
A common side effect of tricyclic antidepressants.
Orthostatic hypotension
A side effect characterized by a drop in blood pressure upon standing.
Cardiotoxicity
HAM-D (Hamilton Depression Rating Scale)
Screening tool that used 17 to 24 items (depending on version) measuring severity of
depression. It assesses symptoms like mood, insomnia, agitation, anxiety, weight loss,
and somatic symptoms.
HAM-D Scoring
0-7: Normal; 8-13: Mild depression; 14-18: Moderate depression; 19-22: Severe
depression; ≥23: Very severe depression.
Geriatric Depression Scale (GDS)
30-item or 15-item version with yes/no responses. It assesses mood, interest in
activities, energy, and overall depressive symptoms.
GDS Scoring
0-9: Normal; 10-19: Mild depression; 20-30: Severe depression.
PHQ-9 (Patient Health Questionnaire-9)
9 items based on DSM-5 criteria for depression. It assesses frequency of symptoms
over the last 2 weeks (0 = not at all, 3 = nearly every day).
PHQ-9 Scoring
1-4: Minimal depression; 5-9: Mild depression; 10-14: Moderate depression; 15-19:
Moderately severe depression; 20-27: Severe depression.
Mood Disorder Questionnaire (MDQ)
13 yes/no questions to screen for Bipolar Disorder. It assesses manic symptoms like
mood elevation, hyperactivity, grandiosity, and decreased need for sleep.
MDQ Scoring
Positive screen: ≥7 symptoms present, occurring in the same episode, with moderate-
to-severe impairment.
Normal Lab Values
TSH: 0.4-4.5 mIU/L; Hemoglobin: Males: 13.8-17.2 g/dL; Females: 12.1-15.1 g/dL;
Lithium: 0.6-1.2 mEq/L (Therapeutic range); Depakote (Valproic Acid): 50-100 mcg/mL
(Therapeutic range).
Major Depressive Disorder (MDD) Specifiers
, With anxious distress; With mixed features; With melancholic features; With atypical
features; With psychotic features; With peripartum onset; With seasonal pattern.
Premenstrual Dysphoric Disorder (PMDD)
≥5 symptoms in the week before menses, improving within days of onset. Symptoms
include mood swings, irritability, depression, anxiety, anhedonia, and physical
symptoms (bloating, breast tenderness).
Persistent Depressive Disorder (Dysthymia)
Depressed mood for ≥2 years (≥1 year in children/adolescents); Presence of at least 2
symptoms: appetite changes, sleep changes, fatigue, low self-esteem, poor
concentration, hopelessness.
Atypical antipsychotics
Examples include aripiprazole and quetiapine.
Lithium
A mood stabilizer used in bipolar disorder.
Buspirone
An anxiolytic medication used to treat anxiety.
Thyroid hormone (T3)
Used as an augmenting agent in depression treatment.
Bupropion
An antidepressant that can be used to augment treatment.
Mirtazapine
An antidepressant that can be used to augment treatment.
Tricyclic Antidepressants (TCAs)
Examples include amitriptyline, nortriptyline, and imipramine.
Anticholinergic effects
Side effects include dry mouth, constipation, and urinary retention.
Sedation
A common side effect of tricyclic antidepressants.
Orthostatic hypotension
A side effect characterized by a drop in blood pressure upon standing.
Cardiotoxicity
