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PANCE® is a registered trademark of the National Commission on Certification of Physician Assistants (NCCPA). This application is an independent study resource and is not affiliated with, sponsored by, or endorsed by the NCCPA.

For educational use only. Content is AI-generated, may contain errors, and is not medical advice — always verify against current primary sources and faculty guidance before clinical use.

HomePsychiatry/BehavioralMajor Depressive Disorder
💭

Major Depressive Disorder

Psychiatry/Behavioral · ~7% of blueprint
🔬Pathophysiology
Multifactorial — monoamine (serotonin/norepinephrine/dopamine) dysregulation, GABA/glutamate and neuroendocrine changes, genetics.
🩺Signs & Symptoms
≥2 weeks of depressed mood/anhedonia plus SIGECAPS (sleep, interest, guilt, energy, concentration, appetite, psychomotor, suicidality).
🎯Gold Standard Diagnosis
Clinical (DSM-5): ≥5 of 9 symptoms for ≥2 weeks, including mood or anhedonia (PHQ-9 to screen).
💊First-line Treatment
SSRIs first-line + psychotherapy (CBT); reassess if no improvement by 4 weeks.
Drug cardsSertralineFluoxetine
High-Yield Pearl

Screen with PHQ-9; SSRIs are first-line — assess suicidality and allow weeks for effect.

Sources

Reviewed September 2026
  1. CANMAT 2023 Update on Clinical Guidelines for Management of Major Depressive Disorder in Adults — CANMAT, 2024
  2. StatPearls: Major Depressive Disorder (NBK559078) — StatPearls Publishing / NCBI Bookshelf, 2026
  3. StatPearls: Bipolar Disorder (NBK558998) - carries the DSM-5 major-depressive-episode criteria — StatPearls Publishing / NCBI Bookshelf, 2026

Checked against the guideline or standard reference the exam keys to. If it has moved, use Report an error below.

More Psychiatry/Behavioral conditions

  • Bipolar I Disorder
  • Generalized Anxiety Disorder
All Psychiatry/Behavioral