Which specifier is used when psychotic features are mood-congruent?

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

Answer: (A)

Psychotic features in mood disorders are categorized by whether the psychosis mirrors the mood state. When delusions or hallucinations fit the mood—for example, depressive themes like guilt or nihilism, or manic themes like grandiosity—they’re described as mood-congruent psychotic features. This specifier is used because it signals that the psychosis is tied to the affective episode, which affects treatment considerations and prognosis. If the psychotic symptoms are not aligned with the mood, the appropriate specifier is mood-incongruent psychotic features. The other specifiers shown refer to different depressive presentations (melancholic features) or to the pattern of mood episodes over time (seasonal pattern) and do not describe the alignment of psychotic symptoms with mood. So the correct choice is the one that states “with mood-congruent psychotic features.”