When reading papers, I like to focus on the useful stuff - what we called "pearls" when we were students, interns,and residents.And for me,this study guide is full of pearls - here are a few that I can now use to nail my unsuspecting students. (Sorry, you’ll have to read the supplement to get the answers.)

When you get a partial response to an antidepressant, what’s the best plan: stay the course, raise the dose, stop and switch to a different type of drug, or augmentation (and what’s augmentation, anyway)?
Which screening test for depression should you use in your practice?*
Which antidepressant gives the best results for initial empirical therapy?*
Drugs give a better response after a few months than psychotherapy, right?*
The main reason that patients stop taking their SSRIs after a few months is side effects, right?*

*Careful, these are trick questions.

Well, I can’t give you all the pearls I picked up from the study guide - part of the fun is to open the oyster and find your own pearls. And since you are well on your way to recertification, you probably know all the answers anyway. But just in case, look inside the oyster for a few minutes and pick up some pearls.

Jack D. McCue, MD
Medical Director, Tuolumne General Hospital
Sonora, Calif
Clinical Professor of Medicine, UCSF

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