Mood disorders: mixed features specifier: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Mood disorders: mixed features specifier

Sample item

A patient meeting criteria for a major depressive episode also has elevated mood, grandiosity and decreased need for sleep during the same weeks, though not enough for full mania. In DSM-5 this is coded as

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Major depressive episode with mixed features

DSM-5 replaced the mixed episode with a mixed features specifier that can be added to depressive or manic episodes when three or more opposite-pole symptoms are present. It signals a higher risk of later bipolar disorder and calls for caution with antidepressants. A bipolar II diagnosis needs a past hypomanic episode.

Option by option

  • A. Major depressive episode with mixed features (correct)

    Correct. Subthreshold opposite-pole symptoms within an episode form the mixed features specifier.

  • B. Bipolar II disorder

    Bipolar II needs a full hypomanic episode, not just a few symptoms within a depressive episode.

  • C. Cyclothymic disorder

    Cyclothymia needs two years of numerous subthreshold hypomanic and depressive periods.

  • D. Persistent depressive disorder

    Persistent depressive disorder is chronic low mood without these elevated symptoms.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Major depressive episode with mixed features. DSM-5 replaced the mixed episode with a mixed features specifier that can be added to depressive or manic episodes when three or more opposite-pole symptoms are present.

Why is "Bipolar II disorder" not the answer?

Bipolar II needs a full hypomanic episode, not just a few symptoms within a depressive episode.

Why is "Cyclothymic disorder" not the answer?

Cyclothymia needs two years of numerous subthreshold hypomanic and depressive periods.

Why is "Persistent depressive disorder" not the answer?

Persistent depressive disorder is chronic low mood without these elevated symptoms.

What concept does this question test?

It tests Mood disorders: mixed features specifier in Psychiatry. It signals a higher risk of later bipolar disorder and calls for caution with antidepressants. A bipolar II diagnosis needs a past hypomanic episode.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mood disorders: mixed features specifier?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.