Which specifier indicates depressive features?

• A. With melancholic features
• B. With atypical features
• C. With catatonia
• D. With peripartum onset

Answer: (A)

Melancholic features indicate a depressive pattern. This specifier signals a depressive episode with a biologically driven profile, typically featuring anhedonia (loss of pleasure), mood that is not reactive to positive events, and prominent vegetative symptoms such as early morning awakening, significant weight loss, excessive guilt, and psychomotor agitation or retardation. These distinctive features help differentiate this depressive subtype and influence prognosis and treatment choices, with melancholic depression often responding differently to certain antidepressants and to electroconvulsive therapy.

The other options describe timing or non-depressive patterns: atypical features involve mood reactivity plus symptoms like hypersomnia and increased appetite; catatonia refers to motor symptoms that can accompany severe mood disorders but isn’t itself a depressive-pattern specifier; peripartum onset denotes onset around childbirth, not a pattern of depressive symptoms.