A nurse is conducting a mental health assessment on a client. The client reports feeling extremely fatigued, having difficulty concentrating, and having thoughts of worthlessness. The nurse recognizes these as:

Choice A rationale:

The correct answer. A positive family history of mood disorders is a well-established risk factor for developing major depressive disorder (MDD). Genetic factors play a significant role in predisposing individuals to MDD, making it more likely to develop if there's a family history of mood disorders.

Choice B rationale:

Optimistic personality traits are not considered risk factors for developing major depressive disorder (MDD). In fact, having an optimistic personality might serve as a protective factor against developing MDD.

Choice C rationale:

The correct answer. Young age is a risk factor for developing MDD. Adolescents and young adults are particularly susceptible to the onset of depressive disorders due to hormonal changes, emotional challenges, and life transitions during this developmental stage.

Choice D rationale:

High socioeconomic status is not a consistent risk factor for developing major depressive disorder (MDD). While individuals from various socioeconomic backgrounds can develop MDD, the factors contributing to its development are more complex and not solely dependent on socioeconomic status.

Choice E rationale:

The correct answer. Chronic medical conditions are risk factors for developing major depressive disorder (MDD). The stress, emotional toll, and physiological effects of living with a chronic illness can contribute to the onset or exacerbation of depressive symptoms.

Choice A rationale:

Symptoms of major depressive disorder (MDD) are characterized by causing significant distress, not mild distress. The distress associated with MDD is usually severe and impairs daily functioning.

Choice B rationale:

While insomnia is a common symptom of major depressive disorder (MDD), it is not necessary for the diagnosis. Other symptoms, such as changes in appetite, psychomotor agitation or retardation, fatigue, and diminished interest or pleasure, can also contribute to the diagnosis.

Choice C rationale:

The correct answer. Symptoms of major depressive disorder (MDD) must not be due to a medical condition. It's crucial to rule out medical conditions that can mimic depressive symptoms, such as hypothyroidism or certain neurological disorders.

Choice D rationale:

The presence of a manic or hypomanic episode would indicate a diagnosis of bipolar disorder, not major depressive disorder (MDD). Bipolar disorder involves distinct periods of both elevated mood and depressive episodes.

Choice E rationale:

The correct answer. To meet the diagnostic criteria for major depressive disorder (MDD) according to DSM-5, an individual must experience five or more symptoms of depression during a continuous two-week period. These symptoms must include either depressed mood or loss of interest/pleasure. The scenario did not specify all the symptoms, but the persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia described align with the criteria.