According to the DSM-5, a diagnosis of Major Depressive Disorder requires at least how many symptoms, for at least how long?
A: 3 symptoms for at least 1 week
B: 5 symptoms for at least 2 weeks
C: 4 symptoms for at least 1 month
D: 6 symptoms for at least 2 weeks
Correct: 5 symptoms for at least 2 weeks
MDD requires 5 or more of 9 specified symptoms during the same 2-week period, representing a change from previous functioning. At least one symptom must be either depressed mood or loss of interest/pleasure (anhedonia). Other symptoms include changes in weight/appetite, sleep disturbance, psychomotor changes, fatigue, feelings of worthlessness or guilt, difficulty concentrating, and recurrent thoughts of death.
Beck's cognitive triad describes the negative thought patterns in depression as involving negative views of:
A: The past, the present, and the future
B: The self, the world, and the future
C: The self, others, and the environment
D: Relationships, work, and physical health
Correct: The self, the world, and the future
Aaron Beck's cognitive model of depression centres on a "cognitive triad" of negative automatic thoughts: a negative view of the self (e.g., "I am worthless"), a negative view of the world (e.g., "Everything is unfair"), and a negative view of the future (e.g., "Things will never improve"). These thoughts are underpinned by deeper cognitive schemas developed through early experience. This model forms the theoretical basis for Cognitive Behavioural Therapy (CBT).
Bipolar I disorder requires at least one manic episode, whereas Bipolar II disorder is defined by hypomanic episodes and major depressive episodes, without full mania.
Answer: True
This distinction is clinically important. Bipolar I requires at least one manic episode (lasting ≥7 days or requiring hospitalisation) with or without depressive episodes. Bipolar II requires at least one hypomanic episode (lasting ≥4 consecutive days, less severe than mania) and at least one major depressive episode — but crucially, no full manic episodes. Misdiagnosing Bipolar II as unipolar depression is common and clinically significant, as antidepressants alone can precipitate hypomania.
The monoamine hypothesis of depression proposes that depression results from:
A: Overactivity of the HPA axis leading to cortisol excess
B: Deficiency in monoamine neurotransmitters, particularly serotonin, noradrenaline, and dopamine
C: Structural abnormalities in the prefrontal cortex
D: Dysregulation of glutamate receptor activity
Correct: Deficiency in monoamine neurotransmitters, particularly serotonin, noradrenaline, and dopamine
The monoamine hypothesis, influential from the 1960s onwards, proposes that depression is caused by reduced availability of monoamine neurotransmitters — especially serotonin, noradrenaline, and dopamine. This hypothesis was supported by the observation that drugs depleting monoamines could cause depressive symptoms, and that antidepressants (MAOIs, TCAs, SSRIs, SNRIs) increase monoamine availability. However, the hypothesis is now considered an oversimplification — antidepressants act quickly on monoamines but take weeks to relieve symptoms, suggesting more complex downstream effects.
Seligman's learned helplessness model of depression was developed from experiments in which:
A: Rats were deprived of social contact from birth
B: Dogs exposed to unavoidable electric shocks later failed to escape when escape was possible
C: Humans given unsolvable problems showed reduced motivation on later solvable tasks
D: Both B and C
Correct: Both B and C
Seligman's learned helplessness model emerged from animal experiments showing that dogs exposed to inescapable shocks became passive and failed to escape later when escape was possible. This was extended to humans — people given unsolvable tasks similarly showed motivational and performance deficits. Seligman proposed that depression involves learning that outcomes are uncontrollable, leading to passivity, negative affect, and cognitive deficits that mirror depressive symptoms.
Lithium is used as a mood stabiliser in bipolar disorder and has been shown to reduce the risk of suicide.
Answer: True
Lithium is the gold-standard mood stabiliser for bipolar disorder, effective in reducing both manic and depressive episodes and preventing relapse. A substantial body of evidence, including meta-analyses, shows that long-term lithium treatment is associated with a significant reduction in suicidal behaviour compared to other treatments. Its antisuicidal effect is thought to be partially independent of its mood-stabilising properties, possibly involving serotonergic mechanisms.
Which psychological therapy has the strongest evidence base for preventing relapse in recurrent depression?
A: Psychodynamic psychotherapy
B: Mindfulness-Based Cognitive Therapy (MBCT)
C: Interpersonal therapy (IPT)
D: Acceptance and Commitment Therapy (ACT)
Correct: Mindfulness-Based Cognitive Therapy (MBCT)
MBCT, developed by Segal, Williams, and Teasdale, combines mindfulness meditation with elements of CBT. It was specifically designed to prevent relapse in recurrent depression. Multiple RCTs show it reduces relapse rates by approximately 40–50% in patients with three or more previous episodes, and NICE guidelines recommend it for this population. It works by helping patients recognise and disengage from the ruminative thought patterns that can trigger a depressive episode.
The diathesis-stress model of depression proposes that:
A: Stress is the sole cause of depression in genetically vulnerable individuals
B: A pre-existing vulnerability interacts with stressful life events to precipitate disorder
C: Biological and psychological factors operate independently to cause depression
D: Early childhood stress permanently alters brain structure, inevitably causing adult depression
Correct: A pre-existing vulnerability interacts with stressful life events to precipitate disorder
The diathesis-stress model proposes that mental disorders arise from an interaction between a pre-existing vulnerability (diathesis — which may be genetic, biological, or psychological) and environmental stressors. A person with a high diathesis may develop depression under moderate stress, while someone with a low diathesis requires much greater stress. This framework has been influential in understanding why not everyone exposed to adversity develops a mental disorder.
Mood Disorders
According to the DSM-5, a diagnosis of Major Depressive Disorder requires at least how many symptoms, for at least how long?
About this quiz
Mood disorders — including major depressive disorder, persistent depressive disorder, and bipolar disorder — are among the most disabling conditions worldwide. Depression alone affects over 280 million people globally and is a leading cause of disability.
This quiz covers the diagnostic criteria for major depressive disorder and bipolar spectrum conditions, the key biological, psychological, and social theories of their aetiology, and the evidence base for pharmacological and psychological treatments.