<prompt> A patient complaints of sadness of mood, increased letharg, early morning awakening, loss of interest and repos no will to live and hears voices asking her to kill self. What is the diagnosis?SchizophreniaMajor depressive disorder plus psychosisSchizoaffective disorderSchizotypal personality disorder  <response>: The symptoms of depression are there plus adding psychotic symptoms of hallucinations make it a diagnosis of MDD PLUS PSYCHOSIS. SymptomsOF DEPRESSION -SIGECAPSS S- Sadness of mood depressed mood persistent pervasive I- Loss of interest pleasure Anhedonia G- Guilt Feeling of wohlessness . E- Energy loss Fatigue C- Concentration loss, cognition negative thoughts A- Appetite loss gain with significant weight changes 5 change in 1 month P- Psychomotor Agitation Retardation S- Suicidal thoughts Note:Suicidal thoughts are fuher classified into 3: Death wishes patient feels death should come to me - GRADE 1 Suicidal wish patient says I wish I could commit suicide - GRADE 2 Suicidal intent patient says I would be killing myself - GRADE 3 S - Sleep abnormalities decreased increased Early morning insomnia getting up 2 hrs earlier than the usual waking time Reduced latency of REM sleep Sleep is usually decreased but it might be increased also. Criteria for defining depression according to DSM - 5 : From the above 9 symptoms 5 must be present at least 1 must be present out of first 2 for at least 2 weeks duration. 