Which mood disorder episode is defined by five or more symptoms over a two-week period with depressed mood or anhedonia?

• A. Major Depressive Episode
• B. Hypomanic Episode
• C. Manic Episode
• D. Unspecified Schizophrenia Spectrum & Other Psychotic Disorder

Answer: (A)

Major depressive episodes are diagnosed when five or more symptoms occur during the same two-week period, and at least one of those symptoms is depressed mood or anhedonia (loss of interest or pleasure). This combination—multiple symptoms within a concise two-week window, with either persistent sadness or a marked reduction in interest—defines the depressive episode in contrast to other mood states. The full set of possible symptoms typically includes depressed mood or anhedonia plus changes in weight or appetite, sleep disturbances, psychomotor changes, fatigue, feelings of worthlessness or excessive guilt, diminished ability to think or concentrate, and recurrent thoughts of death or suicide. These must cause clinically significant distress or impairment in functioning, and cannot be better explained by another condition or substance.

This differs from a hypomanic or manic episode, which centers on elevated or irritable mood with increased energy and activity, not a persistent depressive presentation. An unspecified schizophrenia-spectrum or other psychotic disorder is driven by psychotic symptoms such as delusions or hallucinations, and is not defined primarily by this constellation of mood symptoms over a two-week period.