What is the minimum number of symptoms required for a Major Depressive Disorder diagnosis in youth, and for how long must they persist?

• A. Five symptoms out of nine for two weeks, including either depressed mood or anhedonia
• B. Three symptoms for one week
• C. Seven symptoms for three weeks
• D. Any two symptoms for one week

Answer: (A)

The main idea is that a Major Depressive Disorder diagnosis in youth requires a threshold of symptoms and a minimum duration. Specifically, at least five of the nine core depressive symptoms must be present during the same two-week period, and at least one of those symptoms must be depressed mood or a loss of interest/pleasure (anhedonia). In children and adolescents, depressed mood can present as irritability, but the requirement to have at least five symptoms in a two-week window remains. The symptoms must cause clinically significant distress or impairment in functioning. Because the minimum is five symptoms over two weeks, options suggesting only three or seven symptoms, or a shorter duration like one week, don’t meet the diagnostic threshold. The two-week timeframe is essential to distinguish a depressive episode from brief mood changes.