Major depressive disorder
Table:
Major depressive disorder
Other names	Clinical depression, major depression, unipolar depression, unipolar disorder, recurrent depression

Vincent van Gogh's 1890 painting
Sorrowing old man ('At Eternity's Gate')
Specialty	Psychiatry
Symptoms	Low mood, low self-esteem, loss of interest in normally enjoyable activities, low energy, pain without a clear cause[1]
Complications	Self-harm, suicide[2]
Usual onset	20s–30s[3][4]
Duration	> 2 weeks[1]
Causes	Genetic, environmental, and psychological factors[1]
Risk factors	Family history, major life changes, certain medications, chronic health problems, substance abuse[1][3]
Differential diagnosis	Bipolar disorder, ADHD, sadness[3]
Treatment	Counseling, antidepressant medication, electroconvulsive therapy, exercise[5][1]
Frequency	216 million (2015)[6]

With reference to the table, decide if the statement is entailed, neutral, or refuted by the data. Output only the JSON object {"answer": "YOUR ANSWER"}.

Assertion: Major depressive disorder can be cured with a change in environment.

answer: refuted