AIIMS Nagpur NO- 2020
Mental Health Nursing
Medium
The following delusions are common in depression; EXCEPT:
Appeared in: AIIMS Nagpur NO- 2020
Explanation
- Delusion of grandeur is a false, fixed belief in one's own superiority, inflated power, wealth, or special identity.
- This type of delusion is a classic symptom of a manic episode, which is a key feature of Bipolar Disorder.
- It is considered 'mood-incongruent' for depression because its theme of superiority is the opposite of the typical depressive themes of worthlessness, guilt, and hopelessness.
Why Other Options Were Wrong
- Option A: This is incorrect because the delusion of poverty is a common mood-congruent delusion in severe depression, where the person falsely believes they are financially ruined or will be.
- Option C: This is incorrect because delusions of persecution can occur in psychotic depression. In this context, the belief of being persecuted often stems from profound feelings of guilt, i.e., the person believes they deserve to be punished.
- Option D: This is incorrect because nihilistic delusions (also known as Cotard's syndrome) are a classic, though severe, type of delusion seen in depression. It involves the 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.
- Recognizing the specific content of a patient's delusion is a critical nursing skill for the differential diagnosis 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 a decreased need for sleep, pressured speech, and impulsive or risk-taking behaviors, to ensure patient safety.
- What if? If a patient believed they were responsible for a natural disaster, this would be a 'delusion of guilt,' which IS a mood-congruent delusion common in depression, and thus would also be an incorrect answer for this 'EXCEPT' question.
How to Approach the Question
- First, identify the core concept of the question, which is the types of delusions associated with depression.
- Note the critical keyword 'EXCEPT'. This tells you to look for the option that is the outlier or does not belong with the others in the context of depression.
- Recall the principle of 'mood-congruent' delusions in depression. These delusions typically have negative themes that match the patient's low mood, such as worthlessness, guilt, poverty, or non-existence.
- Evaluate each option against this principle: 'Poverty', 'persecution', and 'nihilism' are all negative in theme.
- Identify that 'grandeur' involves a theme of inflated self-worth and superiority, which is the opposite of a depressive mood.
- Conclude that the delusion of grandeur is the exception and therefore the correct answer.
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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