A clinical feature of patient with major depression includes?
a. Hopelessness
b. Behaviour variation
c. Decreased appetite
d. Panic attack

Appeared in: AIIMS Raipur - 2017 (shift-2)

Explanation

Hopelessness is a core cognitive symptom of MDD, reflecting a negative expectation of the future and self, and is a key indicator of suicide risk.
Behavioral variation in MDD manifests as observable psychomotor changes, either retardation (slowing of movement and thought) or agitation (restlessness).
Decreased appetite is a classic neurovegetative symptom of depression, often leading to unintentional weight loss.
These three symptoms (hopelessness, behavioral changes, appetite changes) are part of the established diagnostic criteria for MDD, as outlined in the DSM-5 and represented by the SIGECAPS mnemonic.

Option B: This option incorrectly includes 'd' (Panic attack). Panic attacks are not a core diagnostic criterion for Major Depressive Disorder.
Option C: This option incorrectly includes 'd' (Panic attack). While patients with MDD can experience panic attacks as a comorbidity, it is not a defining feature of the disorder itself.
Option D: This option incorrectly includes 'd' (Panic attack). The primary features of MDD relate to mood, cognition, and neurovegetative functions, not discrete episodes of intense fear.

Visual 1: Infographic: The SIGECAPS mnemonic for Major Depressive Disorder, with icons for Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, and Suicidality to aid memory.
Visual 2: Chart: A comparison chart differentiating the core symptoms of Major Depressive Disorder from those of Generalized Anxiety Disorder and Panic Disorder.

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical Features of Major Depressive Disorder (MDD) to guide bedside assessment, documentation, and the next nursing action.
Nurses play a vital role in assessing for symptoms of depression during routine patient interactions. Recognizing clusters of symptoms like low mood, anhedonia, and appetite changes is crucial for early identification.
The presence of hopelessness is a critical red flag for suicide risk. Any expression of hopelessness by a patient must trigger an immediate and thorough suicide risk assessment and implementation of safety protocols.
Monitoring for changes in appetite and weight is an important nursing intervention, as significant changes can impact a patient's physical health and recovery.

How to Approach the Question

First, identify the core concept of the question, which is the 'clinical features of major depression'.
Recall the standard diagnostic criteria for Major Depressive Disorder (MDD). A useful tool for this is the SIGECAPS mnemonic (Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidality).
Evaluate each of the four listed symptoms (a, b, c, d) against these criteria.
Determine that 'Hopelessness' (related to Guilt/Suicidality), 'Behaviour variation' (Psychomotor changes), and 'Decreased appetite' (Appetite change) are all part of the SIGECAPS criteria.
Recognize that 'Panic attack' is the defining feature of a separate illness, Panic Disorder, and is not a core symptom of MDD.
Choose the option that correctly groups the MDD symptoms (a, b, and c) and excludes the symptom from a different disorder (d).

Concept Tested & Keywords

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Practise the full AIIMS Raipur - 2017 (shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.