For Major Depressive Episode, at least one of the symptoms must be depressed mood or anhedonia.

For Major Depressive Episode, at least one of the symptoms must be depressed mood or anhedonia.

• A. The presence of depressed mood or anhedonia is required
• B. The presence of mania is required
• C. The presence of psychosis is required
• D. The presence of sleep disturbance is required

Answer: (A)

The essential feature being tested is that a major depressive episode requires at least one of two core symptoms—depressed mood or anhedonia—to be present. In DSM-5, an MDE is diagnosed when five or more symptoms occur during the same 2-week period and represent a change from previous functioning, with at least one of the symptoms being depressed mood or markedly diminished interest or pleasure (anhedonia). Depressed mood means feeling sad, empty, or tearful most of the day, nearly every day. Anhedonia is a pronounced loss of interest or pleasure in nearly all activities most of the day, nearly every day. Other symptoms—sleep disturbance, appetite or weight changes, psychomotor changes, fatigue, feelings of worthlessness or excessive guilt, diminished ability to think or concentrate, and suicidal ideation—often accompany the episode but are not required on their own. Psychotic features or mania are not required for an MDE (psychosis can occur in severe cases but is not a criterion), and mania is not part of a depressive episode. Because the diagnosis hinges on the presence of depressed mood or anhedonia, that requirement is the correct one.

The essential feature being tested is that a major depressive episode requires at least one of two core symptoms—depressed mood or anhedonia—to be present. In DSM-5, an MDE is diagnosed when five or more symptoms occur during the same 2-week period and represent a change from previous functioning, with at least one of the symptoms being depressed mood or markedly diminished interest or pleasure (anhedonia). Depressed mood means feeling sad, empty, or tearful most of the day, nearly every day. Anhedonia is a pronounced loss of interest or pleasure in nearly all activities most of the day, nearly every day. Other symptoms—sleep disturbance, appetite or weight changes, psychomotor changes, fatigue, feelings of worthlessness or excessive guilt, diminished ability to think or concentrate, and suicidal ideation—often accompany the episode but are not required on their own. Psychotic features or mania are not required for an MDE (psychosis can occur in severe cases but is not a criterion), and mania is not part of a depressive episode. Because the diagnosis hinges on the presence of depressed mood or anhedonia, that requirement is the correct one.