Step 1

Behavioral 16

A 23-year-old man presents to his psychiatrist for treatment-resistant depression. He reports decreased mood, decreased energy, feelings of guilt, and suicidal ideation the past 2 weeks. Past medical history is significant for major depressive disorder (MDD), which has previously been treated with adequate trials of various selective serotonin reuptake inhibitors (SSRIs). He states previous treatment “worked for a while, but eventually stopped working.” Prior to this current episode, his most recent depressive symptoms occurred 6 months ago. He does not use any illicit substances, and screening laboratory tests are unremarkable. He recently saw a commercial advertising a new antidepressant and asks how adding this new drug would affect his chances of a future MDD relapse. The data from a randomized controlled trial in which this drug was used as an adjunctive treatment demonstrated that 15 percent of patients relapsed within 1 year, compared to 30 percent of patients in the placebo group.

Which of the following statements is the most appropriate answer to the patient's question?

  • A) For every 7 patients who take the new drug, MDD relapse will be prevented in one patient
  • B) More data must be collected before the physician may answer the patient’s question
  • C) The chance of another MDD relapse if the patient takes the new drug is 15%
  • D) The chance of another MDD relapse if the patient takes the new drug is 30%
  • E) The risk of another MDD relapse is halved by adding the new drug to his current regimen


Tyler Natof


Dr. Ted O'Connell