What are the DSM-5 criteria for a Major Depressive Episode in adults?

• A. At least five of nine symptoms (depressed mood, anhedonia, sleep disturbance, appetite/weight change, psychomotor changes, fatigue, worthlessness/guilt, diminished concentration, recurrent thoughts of death) for at least 2 weeks, causing distress or impairment.
• B. Three symptoms for one week.
• C. Two symptoms for three weeks.
• D. Five symptoms only if psychotic features present.

Answer: (A)

Major depressive episode requires a specific threshold of symptoms over a defined time, with real impact on functioning. In adults, you look for five or more of a particular set of symptoms that occur during the same two-week period. Crucially, at least one of those symptoms must be depressed mood or a loss of interest or pleasure (anhedonia). The full list covers emotional, cognitive, physical, and behavioral signs: depressed mood, anhedonia, sleep problems, changes in appetite or weight, psychomotor changes, fatigue, feelings of worthlessness or excessive guilt, diminished concentration or indecisiveness, and recurrent thoughts of death or suicidal ideation. These symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Psychotic features, if present, are a specifier rather than a requirement.

So the option reflecting at least five of the nine symptoms for a two-week period, with the symptoms causing distress or impairment, aligns exactly with these criteria. The other choices fail because they shorten the duration, reduce the number of symptoms, or incorrectly treat psychotic features as required rather than as a possible specifier.