AIIMS Nagpur NO- 2020
Mental Health Nursing
Easy
The following delusions are common in depression; EXCEPT:
Appeared in: AIIMS Nagpur NO- 2020
Explanation
- A delusion of grandeur is a false, fixed belief about one's own superiority, inflated power, wealth, or special identity.
- This type of delusion is characteristic of a manic or hypomanic episode, which is a key feature of Bipolar I and Bipolar II Disorders.
- It is considered 'mood-incongruent' for depression because its grandiose theme is the opposite of the low self-esteem, guilt, and hopelessness that define a depressive state.
- Therefore, it is the delusion that is not commonly associated with depression.
Why Other Options Were Wrong
- Option A: This is a common mood-congruent delusion in severe or psychotic depression. The individual has a fixed belief that they are financially ruined or will become destitute, which aligns with feelings of hopelessness and worthlessness.
- Option C: This delusion can occur in psychotic depression. The belief that one is being persecuted or punished often stems from profound feelings of guilt (e.g., 'I am a terrible person, so people are rightly trying to harm me').
- Option D: This is a classic, though severe, delusion associated with depression, also known as Cotard's syndrome. It involves the bleak and hopeless belief that one is dead, does not exist, or that the world is ending.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of delusions in mood disorders, specifically depression as background academic context rather than a clinical decision trigger.
- Accurately identifying the content of a patient's delusions is critical for differential diagnosis, particularly between major depressive disorder with psychotic features and bipolar disorder.
- A patient presenting with delusions of grandeur requires an immediate and thorough assessment for other signs of mania, such as decreased need for sleep, pressured speech, flight of ideas, and impulsive or risk-taking behaviors.
- Patient safety is a primary concern. A patient with persecutory delusions may feel threatened and act defensively, while a patient with nihilistic delusions is at a very high risk for suicide.
How to Approach the Question
- First, identify the core concept of the question, which is 'delusions' in the context of 'depression'.
- Pay close attention to the keyword 'EXCEPT'. This signals that you must find the option that does not belong or is the outlier.
- Recall the principle of 'mood congruence' in psychotic mood disorders. Delusions in depression typically have negative, self-deprecating themes (poverty, guilt, nihilism).
- Evaluate each option against this principle:
- Delusion of poverty: A negative theme, consistent with depression.
- Delusion of grandeur: A positive, inflated theme, inconsistent with depression.
Concept Tested & Keywords
- Concept Tested: Types of delusions in mood disorders, specifically depression.
- Stem keywords: delusions, depression
- Lead-in keywords: EXCEPT
- Negative lead-in flag: This is a negative-lead-in question, asking you to identify the option that does NOT fit the condition (depression).
Question ID
Qwc5y_266x2rUlmLc529DM
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 3803-3805, 3808-3810
Practise the full AIIMS Nagpur NO- 2020
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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