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This syndrome is characterized by clinical symptoms of sickness behavior such as leaden paralysis of the limbs, hypersomnia, and hyperphagia/weight gain, while mood reactivity is unimpaired, i.e., mood brightens in response to positive events (according to DSM-5 criteria for MDD with atypical features), while still suffering from lack of concentration and higher levels of exhaustibility as in melancholic MDD [99]

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However, the comparability of such studies depends heavily on the definition of washout periods, follow-up windows, and pregnancy criteria (110)