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

Major Depressive Disorder (MDD) is characterized by a specific set of symptoms that affect mood, cognition, and physical functioning.
Hopelessness is a key cognitive feature, reflecting a negative outlook on the future and is a critical indicator of suicide risk.
Behaviour variation, specifically psychomotor agitation (restlessness) or retardation (slowing down), is a core observable sign of depression.
Decreased appetite is a classic neurovegetative symptom, often leading to significant weight loss. An increase in appetite can also occur but is less typical.
The correct option combines these three core features of MDD.

Option B: This option incorrectly includes 'Panic attack' (d) as a core feature of MDD. While comorbidity with panic disorder exists, panic attacks are not a diagnostic criterion for depression itself.
Option C: This option incorrectly includes 'Panic attack' (d). Panic attacks are characteristic of anxiety disorders, not primarily mood disorders like MDD.
Option D: This option incorrectly includes 'Panic attack' (d). The diagnosis of MDD relies on symptoms like depressed mood, anhedonia, and changes in sleep, appetite, and energy, not panic attacks.

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.
A thorough assessment for all core symptoms of depression is crucial for accurate diagnosis and treatment planning.
The presence of hopelessness is a major red flag for suicidal ideation. Nurses must conduct a suicide risk assessment whenever a patient expresses feelings of hopelessness.
What if? If a patient presents with panic attacks but no persistent low mood or anhedonia, the primary diagnosis would likely be an anxiety disorder (like Panic Disorder), not MDD. The treatment approach would then focus on managing anxiety and panic symptoms first.

How to Approach the Question

First, read the question to identify the core concept: clinical features of Major Depressive Disorder (MDD).
Next, analyze each individual feature listed (a, b, c, d) and determine if it is a recognized symptom of MDD.
Recall or use a mnemonic like SIGECAPS to systematically check the symptoms. S-Sleep, I-Interest, G-Guilt, E-Energy, C-Concentration, A-Appetite, P-Psychomotor, S-Suicidal thoughts.
Evaluate each feature: 'Hopelessness' fits under 'S' (Suicidal thoughts/hopelessness). 'Behaviour variation' fits under 'P' (Psychomotor). 'Decreased appetite' fits under 'A' (Appetite). 'Panic attack' is not part of SIGECAPS.
Eliminate any feature that is not a core symptom of MDD. In this case, 'Panic attack' (d) is the outlier.
Finally, select the option that includes all the correct features and excludes the incorrect one. The only option without 'd' is 'a, b, c'.

Concept Tested & Keywords

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E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 1 (pp 26-289 of 579) p. 214-216

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1214-1216

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.