Which statement best reflects the DSM-5-TR criteria for Major Depressive Disorder (MDD)?

• A. At least five symptoms present during a two-week period, including either depressed mood or anhedonia, plus other symptoms such as weight change, sleep disturbance, psychomotor changes, fatigue, feelings of worthlessness or guilt, diminished ability to concentrate, or recurrent thoughts of death.
• B. Exactly two symptoms over one week.
• C. Only depressed mood is required.
• D. Psychotic features must be present.

Answer: (C)

The key idea is that Major Depressive Disorder is diagnosed when a person has a significant cluster of symptoms over a two-week period, with at least one of the core symptoms being either a persistently depressed mood or a loss of interest or pleasure (anhedonia). In total, you need five or more symptoms from a specified list, including either depressed mood or anhedonia, such as changes in weight or appetite, sleep disturbance, psychomotor changes, fatigue, feelings of worthlessness or guilt, difficulty concentrating, or recurrent thoughts of death. These symptoms must cause clinically significant distress or impairment in daily functioning and cannot be better explained by another medical condition or substance, nor better accounted for by another mental disorder.

So the correct understanding is that diagnosing MDD requires a minimum of five symptoms over a two-week span, with at least one being depressed mood or anhedonia, plus the impact on functioning and exclusion of other causes. The statement that only depressed mood is required is incorrect, and having just two symptoms over one week is insufficient, as is the notion that psychotic features must be present (they can occur, but they are not required and would be a specifier).