Which option is not listed as a symptom of Major Depressive Episode?

• A. Psychomotor agitation
• B. Fatigue
• C. Chest pain
• D. Recurrent thoughts of death

Answer: (C)

Major depressive episodes are diagnosed based on a combination of mood symptoms and associated physical and cognitive signs, not on isolated somatic complaints. Specifically, DSM-5 requires a depressed mood or anhedonia plus at least four other symptoms over a two-week period, such as fatigue or loss of energy, psychomotor agitation or retardation, difficulty concentrating, feelings of worthlessness or excessive guilt, sleep disturbances, appetite or weight changes, and recurrent thoughts of death or suicidal ideation. Chest pain is not among these diagnostic criteria, though it can occur as a somatic symptom from other conditions or anxiety. So chest pain is not listed as a symptom of a Major Depressive Episode, whereas fatigue, psychomotor changes, and recurrent thoughts of death are.