Key features of depression and its management in general practice.

 
"..I've been possessed by the devil"

Regarding this presentation, which of the following statements are true?
1. Omar's delusions are diagnostic of schizophrenia.
2. Psychotic depression occurs in around 10% of people with major depressive disorders.
3. Auditory hallucinations in this context suggest a diagnosis of schizophrenia.
4. Omar should be referred to a psychiatrist.
5. Suicidal ideation is an indication for referral to a psychiatrist.

3. Auditory hallucinations in this context suggest a diagnosis of schizophrenia.

Author's answer: False

A minority of depressed persons have fleeting auditory or visual hallucinations with extremely unpleasant content, and occasionally auditory hallucinations. There is no reason to believe that in this patient the feelings of somatic passivity and running commentary indicate a schizophrenic process.

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