Which criterion states symptoms are not attributable to a substance or medical condition?

• A. Fatigue
• B. Not attributable to substances
• C. Recurrent thoughts of death
• D. Anhedonia

Answer: (B)

In diagnosing depressive disorders, clinicians must first confirm that the symptoms are not caused by a substance or another medical condition. This exclusion ensures we identify a primary mood disorder rather than symptoms secondary to drug effects or medical illness. The statement that fits this criterion says the symptoms are not attributable to substances or to another medical condition. If mood symptoms can be explained by substance use, withdrawal, or a medical illness (for example, thyroid disease or vitamin deficiency), the diagnosis must be reconsidered or the underlying cause treated first. The other terms listed—fatigue, recurrent thoughts of death, and anhedonia—are examples of depressive symptoms themselves, not statements about whether those symptoms can be attributed to a substance or medical condition.