A nurse at a primary care clinic is collecting data on a client for manifestations of depression. Which of the following client statements should the nurse identify as being consistent with depression?

A. "Do you think of yourself as more of an introvert? That makes a difference with how you socialize." Social withdrawal in schizophrenia is not related to personality traits like introversion. It is often an early symptom of the disorder, preceding more pronounced psychotic features. Focusing on introversion may mislead the client and overlook the underlying pathology.
B. "Before symptoms of schizophrenia begin, people often isolate themselves. This is an early warning." Social withdrawal is a common early sign of schizophrenia, occurring during the prodromal phase. Individuals may withdraw due to subtle cognitive changes, emotional blunting, or emerging paranoid thoughts. Recognizing these early symptoms can aid in early intervention and treatment.
C. "Were you avoiding your friend so that you could hear the voices more clearly?" This statement assumes the client was already experiencing auditory hallucinations, which is not always the case. Social isolation often predates the onset of hallucinations and delusions, making this explanation inaccurate. It may also come across as dismissive rather than informative.
D. "That is very interesting, We are not sure why people start to isolate themselves." While the exact cause of social withdrawal in schizophrenia is not fully understood, research indicates it is an early warning sign. Providing vague or uncertain information may leave the client feeling confused rather than supported in understanding their condition.

A. "Avoid looking at other clients on the unit." Distractions reduce the quality of communication and make the client feel undervalued. Focusing on the client demonstrates attentiveness and encourages open dialogue. Looking at others while a client speaks may suggest disinterest. Giving full attention strengthens therapeutic relationships and supports effective listening.
B. "Interrupt the client's statement to clarify thoughts or ideas." Interrupting can disrupt the client’s thoughts and make them feel unheard. Active listening requires patience, allowing the client to speak fully before responding. Clarifications should be made after they finish to ensure understanding. Frequent interruptions may hinder trust and open communication.
C. "Show emotion when a client is disclosing sensitive information." While empathy is important, excessive emotional reactions can shift focus away from the client. A calm and composed demeanor helps maintain a supportive environment. Overreacting may make the client feel uncomfortable or hesitant to share. Active listening involves offering validation without overwhelming emotional responses.
D. "Keep direct eye contact to a minimum." Eye contact conveys attentiveness and respect, helping to establish rapport. Avoiding eye contact may make the client feel ignored or dismissed. However, excessive staring can be intimidating, so a balanced approach is best. Appropriate eye contact fosters trust and enhances communication.