What are the DSM-5-TR criteria for Major Depressive Disorder in youth?

• A. At least 5 of 9 symptoms for 2 weeks
• B. Three symptoms for one week
• C. Five symptoms for one week
• D. At least 5 of 9 symptoms for 2 weeks, including depressed mood or anhedonia, causing distress/impairment

Answer: (D)

The key idea is that diagnosing Major Depressive Disorder in youth hinges on a combination of symptom count, duration, and impact on functioning. To meet the criteria, there must be five or more of the nine possible symptoms occurring during the same two-week period, and at least one of those symptoms must be depressed mood or anhedonia (loss of interest or pleasure). In addition, these symptoms must cause clinically significant distress or impairment in functioning (social, school, family, etc.). In youth, irritability can sometimes substitute for depressed mood, but the requirement still centers on mood or anhedonia plus impairment. The option that specifies five or more symptoms for two weeks, including depressed mood or anhedonia, with distress/impairment, aligns with how the DSM-5-TR defines MDD in younger individuals. The other choices miss either the duration, the required number of symptoms, or the impairment criterion, which is why they aren’t correct.