Mood disorders: irritability in adolescent depression: 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: irritability in adolescent depression

Sample item

A 15-year-old has become sulky, short-tempered and withdrawn for two months, with falling grades, headaches and abdominal pains, and says he feels fine. By DSM-5, which statement applies?

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

The answer and the reasoning

B. In adolescents, irritable mood can replace depressed mood as a criterion

DSM-5 allows irritable mood in children and adolescents to count in place of depressed mood in a major depressive episode. Somatic complaints and school decline are common presentations, so depression is often missed.

Option by option

  • A. Irritability excludes a mood disorder

    Irritability is a recognised mood presentation, and does not exclude depression.

  • B. In adolescents, irritable mood can replace depressed mood as a criterion (correct)

    Correct. Irritability can satisfy the mood criterion in young people.

  • C. Depression cannot be diagnosed before 18 years

    Major depression is diagnosed in adolescents and even in children.

  • D. Somatic complaints exclude depression

    Somatic complaints often accompany depression in youth and do not exclude it.

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 B, In adolescents, irritable mood can replace depressed mood as a criterion. DSM-5 allows irritable mood in children and adolescents to count in place of depressed mood in a major depressive episode.

Why is "Irritability excludes a mood disorder" not the answer?

Irritability is a recognised mood presentation, and does not exclude depression.

Why is "Depression cannot be diagnosed before 18 years" not the answer?

Major depression is diagnosed in adolescents and even in children.

Why is "Somatic complaints exclude depression" not the answer?

Somatic complaints often accompany depression in youth and do not exclude it.

What concept does this question test?

It tests Mood disorders: irritability in adolescent depression in Psychiatry. Somatic complaints and school decline are common presentations, so depression is often missed.

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: irritability in adolescent depression?

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.