Which specifier indicates atypical depressive symptoms?

• A. With melancholic features
• B. With mood-congruent psychotic features
• C. With atypical features
• D. With seasonal pattern

Answer: (C)

Atypical features is the specifier that denotes an atypical presentation of depression. This pattern is characterized by mood reactivity (the mood can brighten in response to positive events) along with features such as increased appetite or weight gain, hypersomnia, leaden paralysis (heavy arms or legs), and a heightened sensitivity to interpersonal rejection. These traits set atypical depression apart from other specifiers.

Melancholic features, by contrast, involve a nearly complete lack of mood reactivity, profound anhedonia, early morning awakening, significant weight loss, and psychomotor changes. Mood-congruent psychotic features refer to psychotic symptoms that align with the mood state (delusions or hallucinations), and seasonal pattern describes depressive episodes that recur in specific seasons, usually fall or winter.