Psychiatrymiddle twist
A 61-year-old man was admitted with severe depression and pervasive hopelessness after a near-fatal overdose. Twelve days after starting an antidepressant the nursing entries record that he is out of bed before breakfast, showers unprompted, eats in the dining room, moves about the ward briskly, joins in conversations and is no longer tearful. Interviewed by the intern the same afternoon, he still says his family would be better off without him and that nothing will ever change. Which one of the following changes should be documented as the one that most increases his risk?