Classical triad of symptoms of depression includes all except ?

Ans. is 'c' i.e., Distractibility Clinical features of depression The classical triad of depression is depressed mood, psychomotor retardation, and slowed-down thinking. Mood : Mood is characteriztically low and sad. There is loss of interest and pleasure in almost all activities, which result in social withdrawal, avolition,occupational dysfunction. In severe cases there may be anhedonia (inability to experience pleasure). Thoughts (Thinking) : - Pesimistic thoughts conerning the patients past, present and future occur which results in Hopelessness, Helplessness, and wohlessness. Other thought problems may be guilt-feeling, Loss of self esteem, Suicidal ideas, Delusion of nihlism (World has come to an end, Intestines has been rotated away, No brain in head), Hypochondriacal delusions . Other delusions that may occur in elderly include paranoid or persecutory delusion, and delusional jealousy. Psychomotor activity : - There is psychomotor retardation --> Movements are sluggish & laboured, lack of initiative & energy, Easy fatiguability. In severe form, the patient becomes stuporous (depressive stupor). In older patient there may be agitation and restlessness. Cognition : - There is poor concentration, which may lead the patient to think (mistakenly) that the memory is also impaired (However, memory is normal). In old patients depression may present similar to dementia, i.e., Pseudodementia. Somatic symptoms & biological disturbances : - Multiple physical symptoms are common in elderly patient. Symptoms include heaviness of head, generalized ache & pain, Loss of sexual drive and amenorrhea, severe disturbance in biological function is called somatic syndrome (melancholia). Somatic syndrome (melanocholia) is characterized by :- Decrease in appetite or weight Early morning awakening, at least 2 hours before usual time. Diurnal variation, depession is worse in morning Loss of interest and loss of reactivity to pleasurable stimuli, and loss of pleasure in all activities. Psychomotor agitation or retardation. Excessive or inappropriate guilt. 6. Psychotic symptoms (Psychotic depression) : - Occur in 15-20% of patients. Symptoms include 2"a person auditory hallucinations, delusions, grossly inappropriate behavior. These symptoms may be mood congruent (e.g., nihilistic delusions, delusions of povey or guilt) which are understandable in the light of depressed mood or can be mood incongruent (e.g., delusion of control) which are not directly related to depressive mood. Psychotic depression usually occur later in life and is associated with severe depression.