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Quizzes > Health & Medicine

Alexis Experiences MDD Symptoms: Major Depressive Disorder Quiz

Quick, free major depressive disorder quiz to test your knowledge. Instant results.

Editorial: Review CompletedCreated By: Kathleen KowalskiUpdated Aug 28, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for a psychology quiz on major depressive disorder symptoms and DSM-5 terms on a coral background

This quiz helps you practice identifying major depressive disorder symptoms in Alexis and apply DSM-5 terms in context. For more practice across conditions, try our mood disorder quiz, compare presentations with a bipolar depression test, or explore seasonal patterns with a seasonal affective disorder test.

According to DSM-5 criteria, how many symptoms must be present for a diagnosis of major depressive disorder?
Five
Six
Seven
Four
DSM-5 requires at least five of the nine specified symptoms for at least two weeks to diagnose major depressive disorder. This threshold ensures that the symptom cluster is significant enough to cause impairment. The symptoms include mood disturbances, sleep and appetite changes, and cognitive impairments.
What is the minimum duration of symptoms required for a DSM-5 diagnosis of major depressive disorder?
Four weeks
One week
Six weeks
Two weeks
DSM-5 specifies that symptoms must persist for at least two weeks nearly every day. This time frame distinguishes transient mood changes from clinical depression. It ensures stability of symptoms before diagnosis.
Which of the following is considered a core symptom of major depressive disorder?
Anhedonia
Elevated mood
Hallucinations
Compulsive behaviors
Anhedonia, or markedly diminished interest or pleasure in all activities, is one of two core symptoms of major depressive disorder. The other core symptom is depressed mood. Recognizing anhedonia is essential for diagnosis according to DSM-5.
Which sleep disturbance is included in the DSM-5 criteria for major depressive disorder?
Restless legs
Sleepwalking
Insomnia or hypersomnia
Night terrors
DSM-5 includes insomnia (difficulty initiating or maintaining sleep) or hypersomnia (excessive sleep) as one of the nine symptoms. Both represent disruptions in sleep quality or quantity. This criterion highlights the interplay between mood and sleep.
Significant weight change or appetite disturbance in depression can be characterized by:
No change in appetite
Unintentional weight loss only
Either significant weight gain or loss
Unintentional weight gain only
DSM-5 criteria include significant weight loss when not dieting, weight gain, or decrease/increase in appetite. These changes reflect neurovegetative symptoms of depression. Both directions of change count toward the diagnostic threshold.
Which symptom involves psychomotor changes in major depressive disorder?
Nightmares
Psychomotor agitation or retardation
Compulsive rituals
Auditory hallucinations
DSM-5 includes psychomotor agitation (restlessness) or retardation (slowed movements) nearly every day. These symptoms indicate changes in motor function associated with depressive states. They are observable by others rather than self-reported.
Feelings of worthlessness or excessive guilt are part of depression because:
They are cognitive symptoms reflecting negative self-evaluation
They indicate psychotic features
They denote a personality disorder
They are only present in bipolar disorder
Excessive guilt or feelings of worthlessness reflect negative cognitions at a pathological level. DSM-5 lists these as a symptom of major depressive disorder when they are inappropriate and persistent. They contribute to overall impairment.
Which cognitive symptom is listed among the DSM-5 criteria for major depressive disorder?
Obsessive ideation
Delusional thinking
Racing thoughts
Difficulty concentrating
Difficulty concentrating or indecisiveness nearly every day is one of the nine DSM-5 criteria. It reflects impaired cognitive processing in depression. This symptom can severely affect daily functioning.
Suicidal ideation in the context of major depressive disorder includes:
Only actual attempts
Recurrent thoughts of death or suicide
Illicit substance use
Brief thoughts of death
DSM-5 lists recurrent thoughts of death, suicidal ideation without a specific plan, or a suicide attempt as a symptom. These thoughts indicate severity and risk in depression. Clinicians must assess for intent and plan.
Why must depressive symptoms cause clinically significant distress or impairment?
To ensure diagnosis reflects pathological dysfunction
To confirm substance use as a cause
To rule out normal grief reactions
It is optional in DSM-5
DSM-5 requires that symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning. This criterion differentiates normal mood variations from clinical disorders. It emphasizes the impact on daily life.
Major depressive disorder must not be better explained by:
Personality traits
Short-lived sadness
A general medical condition or substance use
Mild stressors
DSM-5 specifies that symptoms must not be attributable to physiological effects of a substance or another medical condition. This rule-out criterion ensures accurate diagnosis. It prevents misdiagnosis due to medical or pharmacological causes.
Which of the following is NOT one of the nine DSM-5 symptoms for major depressive disorder?
Anhedonia
Euphoria
Psychomotor changes
Fatigue
Euphoria is characteristic of mania, not depression. The nine DSM-5 symptoms for major depressive disorder include depressed mood, anhedonia, weight changes, sleep disruption, psychomotor changes, fatigue, feelings of worthlessness, concentration problems, and suicidal ideation. Recognizing this prevents confusion between mood disorders.
Fatigue or loss of energy nearly every day is included because it reflects:
Poor cardiovascular fitness
Normal aging
A panic attack
A neurovegetative symptom of depression
Fatigue or loss of energy is a neurovegetative symptom indicating physiological involvement in depression. DSM-5 includes it as one of nine core symptoms. It can significantly impair daily activities.
Which combination would satisfy the two core symptoms required by DSM-5 for major depressive disorder?
Anhedonia and euphoria
Depressed mood and insomnia
Psychomotor agitation and guilt
Depressed mood and anhedonia
The two core symptoms are depressed mood and anhedonia. At least one of these must be present among the five required symptoms. Neither insomnia nor guilt alone are core without one of these two.
True or False: Temporary feelings of sadness after a stressful event count toward a diagnosis of major depressive disorder.
True
False
DSM-5 distinguishes between normal grief or transient sadness and major depressive disorder. Symptoms must persist and cause significant impairment for at least two weeks. Situational sadness alone is insufficient for diagnosis.
Which specifier describes depression with features of marked psychomotor retardation, profound anhedonia, and diurnal mood variation?
Mixed features
Melancholic features
Catatonic features
Atypical features
Melancholic features include loss of pleasure, lack of mood reactivity, profound anhedonia, diurnal mood variation, and psychomotor changes. These are specified in DSM-5 under major depressive disorder specifiers. They denote a more biological subtype.
The "with anxious distress" specifier for MDD includes symptoms such as:
Elevated mood
Excessive sleepiness
Delusions of grandeur
Feeling keyed up or tense
The anxious distress specifier requires at least two anxiety symptoms like feeling tense, restless, or difficulty concentrating because of worry. It indicates comorbid anxiety symptoms in depression. It is linked to poorer prognosis.
Which feature characterizes the 'atypical features' specifier in major depressive disorder?
Insomnia predominating
Mood-congruent hallucinations
Diurnal mood variation worse in evening
Mood reactivity and hypersomnia
Atypical features include mood reactivity (ability to feel better in response to positive events), hypersomnia, increased appetite or weight gain, leaden paralysis, and interpersonal rejection sensitivity. They contrast with melancholic features.
Peripartum onset specifier applies when depressive symptoms begin:
Only after menopause
After childbirth after six months
During pregnancy or within four weeks postpartum
Prior to menarche
Peripartum onset specifier is used when symptoms occur during pregnancy or within four weeks of delivery. It highlights the need for specialized screening and treatment in this population. Postpartum depression management differs from non-peripartum depression.
Seasonal pattern specifier is associated with depressions that:
Recur at characteristic times of year
Follow a chronic course with no remission
Occur only in summer
Are triggered by food intake
The seasonal pattern specifier applies when at least two major depressive episodes occur in a seasonal pattern over two years and remissions at other times. It often involves winter depression with hypersomnia and increased appetite. Light therapy is a common treatment.
In differentiating grief from major depressive disorder, which feature suggests MDD rather than normal bereavement?
Self-critical and pervasive worthlessness
Feelings of emptiness and loss
Transient waves of sadness linked to reminders
Maintained self-esteem
In normal bereavement, self-esteem is usually preserved and sadness comes in waves tied to reminders. In MDD, feelings of worthlessness and pervasive self-criticism are more constant. This cognitive distinction helps differentiate between the two.
Which rating scale is commonly used to assess severity of depression in clinical trials?
PANSS
GAD-7
YMRS
HAM-D (Hamilton Depression Rating Scale)
The Hamilton Depression Rating Scale (HAM-D) is a clinician-administered tool widely used to assess the severity of depressive symptoms. It covers mood, guilt, suicide, insomnia, anxiety, and weight loss. It is considered the gold standard in many research settings.
Which neurochemical change is most associated with major depressive disorder?
Excess GABA in limbic structures
Increased dopamine in the nucleus accumbens
Reduced serotonin and norepinephrine signaling
Elevated glutamate in the prefrontal cortex
Major depressive disorder is linked to reduced serotonergic and noradrenergic transmission. Many antidepressants target these systems to restore balance. The monoamine hypothesis remains influential in understanding depression.
Which risk factor increases the likelihood of developing major depressive disorder?
Regular exercise
Strong social support
Family history of depression
High socioeconomic status
A family history of depression is a well-established risk factor due to genetic and environmental contributions. First-degree relatives of depressed individuals have higher risk. This informs assessment and prevention strategies.
Which medication class is first-line for treating major depressive disorder?
Benzodiazepines
Antipsychotics
Selective serotonin reuptake inhibitors
Monoamine oxidase inhibitors
Selective serotonin reuptake inhibitors (SSRIs) are first-line treatments due to efficacy and tolerability. They increase serotonin availability by blocking reuptake. They have a favorable side-effect profile compared with older agents.
Which therapeutic approach is evidence-based for major depressive disorder?
Psychoanalysis
Electroconvulsive shock therapy only
Cognitive-behavioral therapy
Hypnotherapy
Cognitive-behavioral therapy (CBT) has strong empirical support for treating depression. It targets maladaptive thoughts and behaviors. It is recommended in guidelines alongside pharmacotherapy.
Which age group has the highest incidence of major depressive disorder?
Middle-aged adults
Adults over 65
Children under 12
Adolescents and young adults
Epidemiological studies show that adolescents and young adults have peak incidence of first-onset depression. Factors include social stressors and developmental changes. Early identification in this group is critical.
Which comorbid condition is most frequently observed with major depressive disorder?
Schizophrenia
Autism spectrum disorder
Attention-deficit/hyperactivity disorder
Generalized anxiety disorder
Generalized anxiety disorder commonly co-occurs with major depressive disorder. The overlap in symptoms and shared risk factors leads to high comorbidity. This comorbidity often worsens prognosis and complicates treatment.
The DSM-5 mixed features specifier for depression includes:
Psychotic features only during mania
Only catatonic signs
Subthreshold hypomanic symptoms during a depressive episode
Full manic episode during depression
The mixed features specifier applies when several hypomanic symptoms occur during a depressive episode without meeting full criteria for mania. It recognizes overlapping mood states that affect treatment choice. Identification can guide mood stabilizer use.
Which neuroimaging finding is most consistently associated with major depressive disorder?
Reduced prefrontal cortex activity
Increased hippocampal volume
Enlarged ventricles
Hyperactivity of the cerebellum
Functional imaging studies show hypoactivity in the dorsolateral prefrontal cortex in depressed patients. This region is involved in executive function and mood regulation. Reduced activity correlates with cognitive and emotional impairments.
Which genetic factor has been implicated in susceptibility to major depressive disorder?
COMT Val158Met variant only
APOE ?4 allele
Serotonin transporter gene promoter polymorphism (5-HTTLPR)
Huntingtin gene CAG repeats
The 5-HTTLPR polymorphism in the serotonin transporter gene has been linked to depression risk, especially under stress. It influences serotonin reuptake efficiency. Studies show gene - environment interactions affecting onset.
Which inflammatory marker is often elevated in patients with major depressive disorder?
Albumin
C-reactive protein (CRP)
Thyroid-stimulating hormone
Proinsulin
Elevated C-reactive protein (CRP) levels have been observed in many depressed individuals, reflecting systemic inflammation. This supports the inflammatory hypothesis of depression. Anti-inflammatory treatments are under investigation.
Which brain-derived neurotrophic factor (BDNF) change is associated with major depressive disorder?
Exclusive BDNF receptor upregulation
Decreased hippocampal BDNF expression
Constant BDNF expression
Increased peripheral BDNF levels
Depressed patients often have lower hippocampal BDNF expression, which is linked to impaired neurogenesis and synaptic plasticity. Antidepressants increase BDNF levels over time. This neurotrophic model explains structural changes in depression.
Which neurotransmitter abnormality is implicated in seasonal affective disorder subtype of depression?
Serotonin deficiency during winter months
GABA surplus in spring
Dopamine hyperactivity in fall
Excessive norepinephrine in summer
Seasonal affective disorder (SAD) has been linked to reduced serotonin transporter function and lower serotonin availability during winter. Light therapy improves symptoms by influencing serotonergic pathways. This distinguishes SAD from nonseasonal depression.
Which psychotic feature specifier is used when hallucinations occur exclusively in the context of MDD?
Mood-incongruent psychotic features
Schizoaffective features
Mood-congruent psychotic features
Mixed psychotic features
Mood-congruent psychotic features align with depressive themes such as guilt or sin. DSM-5 distinguishes mood-congruent from mood-incongruent psychotic features. This affects prognosis and treatment planning.
What is the typical gender ratio in lifetime prevalence of major depressive disorder?
Equal prevalence across genders
2:1 female to male
3:1 male to female
1:1 male to female
Epidemiological data indicate that women are about twice as likely as men to experience major depressive disorder in their lifetime. This difference may reflect biological, hormonal, and psychosocial factors. Recognition of this ratio aids in screening and intervention.
Which chronic medical condition is most commonly comorbid with major depressive disorder?
Celiac disease
Multiple sclerosis
Type 2 diabetes mellitus
Rheumatoid arthritis
Type 2 diabetes mellitus frequently co-occurs with depression, with bidirectional influence on prognosis. Depression can worsen glycemic control and vice versa. Integrated care approaches are recommended.
Which factor distinguishes treatment-resistant depression?
Early remission with therapy
Only one symptomatic episode
Failure to respond to at least two adequate antidepressant trials
Rapid response to SSRI
Treatment-resistant depression is defined by lack of adequate response to at least two different antidepressant trials at therapeutic doses. It often requires alternative strategies like augmentation or neurostimulation. Clear definition guides research and management.
Which symptom pattern is characteristic of psychotic depression?
Only catatonic symptoms
Delusions incongruent with mood
Subthreshold hypomania
Mood-congruent delusions or hallucinations
Psychotic depression includes mood-congruent delusions or hallucinations that align with depressive themes. Mood-incongruent psychotic features are less common and may suggest schizoaffective disorder. Accurate identification influences use of antipsychotics.
Which neuroendocrine abnormality is frequently observed in major depressive disorder?
Elevated cortisol due to HPA axis dysregulation
Hypothyroidism
Low insulin levels
High growth hormone
Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis with elevated cortisol levels is commonly found in depression. Chronic stress can perpetuate this dysregulation. It may contribute to symptoms and comorbidities.
Persistent depressive disorder (dysthymia) differs from major depressive disorder primarily in:
Greater severity of symptoms
Presence of psychotic features
Onset only in childhood
Chronicity of low-grade symptoms for at least two years
Persistent depressive disorder involves depressed mood for most of the day for at least two years with less severe but more chronic symptoms than MDD. Patients may experience intermittent major depressive episodes. Chronicity is the defining factor.
Mood-incongruent psychotic features in depression suggest:
Exclusion from DSM-5 diagnosis
Only occurs in bipolar I
Possible schizoaffective or psychotic disorder
Improved prognosis
Mood-incongruent psychotic features do not align with depressive themes and may indicate a more complex psychotic disorder such as schizoaffective disorder. They are included in DSM-5 but warrant careful differential. Their presence can worsen prognosis.
Which neuroanatomical change is most consistently found in chronic major depressive disorder?
Increased amygdala volume
Enlarged prefrontal cortex
Hypertrophy of basal ganglia
Reduced hippocampal volume
Chronic depression is associated with reduced hippocampal volume, likely due to stress-induced neurotoxicity and reduced neurogenesis. This finding is replicated across neuroimaging studies. It correlates with memory deficits.
Which treatment is FDA-approved for treatment-resistant depression?
Electroconvulsive therapy
Standard SSRI
Bupropion monotherapy
Ketamine infusion therapy
Electroconvulsive therapy (ECT) is FDA-approved and considered the gold standard for treatment-resistant depression due to rapid response and high efficacy. Other interventions like ketamine are emerging but not universally approved. ECT use is guided by severity and history.
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Study Outcomes

  1. Identify Major Depressive Disorder Symptoms -

    Analyze Alexis's behavior to determine which DSM-5 criteria are met when alexis experiences the symptoms of major depressive disorder.

  2. Explain DSM-5 Abbreviation -

    Break down each letter in the phrase "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" to understand what the letters in the abbreviation DSM-5 stand for.

  3. Differentiate Anxiety Responses -

    Assess scenarios to distinguish between normal fear and situations where yuri experiences excessive distressing and persistent fear characteristic of anxiety disorders.

  4. Assess Obsessive-Compulsive Behaviors -

    Identify repetitive actions and thought patterns due to dominique's obsessive compulsive disorder, and understand their impact on daily functioning.

  5. Recognize Dissociative Identity Patterns -

    Evaluate presentation criteria for dissociative identity disorder when donna exhibits two separate personalities and differentiate it from other disorders.

Cheat Sheet

  1. Mnemonic "SIG E CAPS" for Major Depressive Disorder -

    Use the acronym SIG E CAPS (Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal) to remember the core criteria of how Alexis experiences the symptoms of major depressive disorder. This tool from the American Psychiatric Association streamlines DSM-5 diagnostic recall. Practice mapping each letter to sample case vignettes within two-week symptom duration.

  2. Key Features of Anxiety Disorders -

    Recall that Yuri experiences excessive distressing and persistent fear, a hallmark of specific anxiety disorders in DSM-5. Differentiating between generalized anxiety, panic attacks, and specific phobias helps you classify symptoms accurately. Use the "FAT PAC-T" mnemonic (Fear, Avoidance, Time”linked duration, Physiological arousal, Application to specific triggers, Chronic for six months, Two times per week) for quick review.

  3. Breaking Down DSM-5 Abbreviation -

    Remember that the letters in the abbreviation DSM-5 stand for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, published by the APA. It's the authoritative classification system for mental health diagnoses worldwide. Familiarize yourself with its multiaxial system update and crosswalk tables from journals like the Journal of the American Academy of Psychiatry and the Law for exam readiness.

  4. Understanding Dissociative Identity Disorder -

    Note that Donna exhibits two separate personalities, fitting the DSM-5 criteria for dissociative identity disorder (DID). Core features include identity fragmentation and memory gaps, not better explained by cultural or religious practices. Use the "I DID" shorthand (Identity fragmentation, Dissociative amnesia, Internal voices, Distress/impairment) to lock in these diagnostic essentials.

  5. Obsessive”Compulsive Disorder Essentials -

    Observe how due to Dominique's obsessive compulsive disorder, repetitive intrusive thoughts (obsessions) drive her compulsions like hand washing. The DSM-5 specifies that these behaviors are time”consuming and cause significant distress. Practice exposure and response prevention (ERP) case examples from peer”reviewed sources such as the Journal of Behavior Therapy and Experimental Psychiatry.

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