Answer targeted questions : PSY-Q

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Aggression

Antianxiety

Antidepressants

Antipsychotics

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Augmentation agents

Bipolar and related disorders

BRAIN / NNCI

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Depressive disorders

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Environmental - Risk/Protective Factors

Feeding and eating disorders

Gender Dysphoria

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Neurodevelopmental

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Obsessive-compulsive and related disorders

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Other mental disorders

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Psychogenomics

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sedative-hypnotics

Sexual dysfunctions

Sleep-wake disorders

Somatic symptom and related disorders (may include pain syndromes)

Substance-related and addictive disorders

Suicidality

Trauma and stressor-related disorders

Question : 1 / 258

All Medical Assistance in Dying laws include “Irremediability” as one of the primary eligibility criteria. What statement is true with respect to “irremediability” as applied to major depressive disorder (MDD)? 

“Irremediable depression” is considered to be synonymous with the “treatment-resistant” modifier for MDD found in DSM-5-TR 
A score of 11 or greater on the Maudsley Staging Method for Treatment Resistance in Depression is the most commonly accepted definition of “irremediability” in MDD 
"Irremediability” in MDD is only determined for patients aged over 65 
There is general consensus that ECT should be tried before irremediability of MDD can be established

While it is challenging to define irremediable psychiatric suffering in the context of MAID requests, experienced psychiatrists generally assess the number of failed treatments (including ones with the most likelihood of efficacy vs depression, e.g. ECT). Challenges include assessing the quality of past treatments (e.g. psychotherapy) and managing ‘treatment fatigue’ and treatment refusal.

Publication reference : Van Veen S, Ruissen AM et al. Irremediable psychiatric suffering in the context of medical assistance in dying: a qualitative study. CMAJ 2022; 194: E485-E491.
Reference URL: https://pubmed.ncbi.nlm.nih.gov/35273025/

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