Question 1 of 162

A 34-year-old woman presents with 4 weeks of persistently low mood. She reports she no longer enjoys running or seeing friends, sleeps only 3-4 hours per night with early-morning awakening, has lost 4 kg without dieting, feels exhausted, and struggles to concentrate at work. She describes feeling worthless and has fleeting thoughts that her family would be better off without her, but denies any plan or intent. She has no history of an elevated or expansive mood episode. Her TSH and metabolic panel are normal, and she takes no medications. Which of the following best establishes the diagnosis of major depressive disorder in this patient?

• A.The presence of at least 5 of 9 characteristic symptoms, including depressed mood or anhedonia, for at least 2 weeks
• B.Depressed mood present for the majority of days over at least 2 years
• C.At least 3 symptoms of depression occurring exclusively in the luteal phase
• D.A distinct period of depressed mood accompanied by a prior manic episode
• E.Depressed mood plus documented hypothyroidism as the underlying cause