下列哪些症狀是重度憂鬱症（MDD）的特徵？（選所有適合的）
Which of the following symptoms are characteristic of major depressive disorder? (Select all that apply.)
- AAnhedonia✓ 正解快感缺乏
- BIncreased energy and flight of ideas精力增加與意念飛躍
- CSignificant weight loss or gain✓ 正解體重顯著減輕或增加
- DInsomnia or hypersomnia✓ 正解失眠或嗜睡
- EFeelings of worthlessness or excessive guilt✓ 正解無價值感或過度罪惡感
核心概念是 DSM-5 對重度憂鬱症的診斷標準。MDD 的核心症狀包括情緒低落與興趣缺失（Anhedonia）。為什麼正確答案對？因為憂鬱症不僅影響情緒，還會引發生理改變（體重、睡眠）。選項 C 描述了食慾與體重的顯著改變，D 描述了睡眠障礙（失眠或睡太多），E 則是認知方面的負面思維。臨床思路上，護理師應全面評估病人的情緒、生理與認知狀況。安全優先原則要求特別關注「無價值感」，因為這常與自殺意念相關。選項 B 是躁狂症（Mania）的特徵，與憂鬱症相反，故排除。
The core concept relates to the DSM-5 criteria for major depressive disorder. The hallmark symptoms of MDD include depressed mood and loss of interest (anhedonia). Why are the correct options correct? Depression affects not only mood but also produces physiologic changes (weight, sleep). Option C describes significant changes in appetite and weight, D describes sleep disturbance (insomnia or hypersomnia), and E captures negative thinking in the cognitive domain. Clinically, the nurse should comprehensively assess the client's emotional, physiologic, and cognitive status. The principle of prioritizing safety requires particular attention to feelings of worthlessness, as they are often associated with suicidal ideation. Option B describes features of mania, which are the opposite of depression, and is therefore excluded.
在美國，憂鬱症被廣泛視為一種「生物化學失衡」，病人對診斷的接受度較高。在台灣，受限於病恥感（Stigma），病人常以「軀體化症狀」（如頭痛、胸悶、胃痛）來表達憂鬱，護理師需從身體主訴中挖掘潛在的心理問題。