Mood disorders: psychotic depression treatment: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Mood disorders: psychotic depression treatment

Sample item

A 58-year-old woman with severe depression, delusions of guilt and refusal of food is losing weight rapidly. Which is the most effective treatment option?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. ECT

Psychotic depression responds poorly to antidepressant alone and best to ECT or to an antidepressant combined with an antipsychotic. ECT is preferred when there is food refusal, high suicide risk or rapid deterioration. Response rates are the highest among all available treatments.

Option by option

  • A. ECT (correct)

    Correct. ECT is the treatment of choice with psychotic features and food refusal.

  • B. Supportive counselling alone

    Counselling alone is inadequate for severe psychotic depression.

  • C. Benzodiazepine monotherapy

    Benzodiazepines may calm the patient but do not treat psychotic depression.

  • D. Low-dose SSRI alone

    A low-dose SSRI alone is inadequate for psychotic depression and slow in a dangerous situation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, ECT. Psychotic depression responds poorly to antidepressant alone and best to ECT or to an antidepressant combined with an antipsychotic.

Why is "Supportive counselling alone" not the answer?

Counselling alone is inadequate for severe psychotic depression.

Why is "Benzodiazepine monotherapy" not the answer?

Benzodiazepines may calm the patient but do not treat psychotic depression.

Why is "Low-dose SSRI alone" not the answer?

A low-dose SSRI alone is inadequate for psychotic depression and slow in a dangerous situation.

What concept does this question test?

It tests Mood disorders: psychotic depression treatment in Psychiatry. ECT is preferred when there is food refusal, high suicide risk or rapid deterioration. Response rates are the highest among all available treatments.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mood disorders: psychotic depression treatment?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.