Who coined the term 'psychiatry'?
Which type of delusion is primarily associated with Cotard's syndrome?
Waxy flexibility is a feature of ?
Visual hallucinations are typically seen in all of the following conditions except?
Which of the following can cause delirium?
Psychoanalysis was started by?
Which of the following is NOT a diagnostic criterion for drug dependence?
Which of the following is true regarding the treatment of cocaine withdrawal symptoms?
Which of the following is considered a poor prognostic factor for schizophrenia?
In stupor catatonia, all are seen except -
NEET-PG 2013 - Psychiatry NEET-PG Practice Questions and MCQs
Question 21: Who coined the term 'psychiatry'?
- A. Moral
- B. Bleuler
- C. Pinel
- D. Johann Reil (Correct Answer)
Explanation: ***Johann Reil*** - The term "**psychiatry**" (Psychiatrie) was coined by the German physician **Johann Christian Reil** in **1808**. - Reil introduced the term in his work to advocate for a more **humane and medical approach** to mental illness, moving away from purely custodial care. *Moral* - While Reil's efforts were part of a broader movement towards **moral treatment** of the mentally ill, "moral" itself is not the specific context in which the term was coined. - **Moral treatment** emphasized humane care, occupational therapy, and a therapeutic environment, contributing to the development of psychiatry but not coining the word. *Bleuler* - **Eugen Bleuler** is known for coining the term "**schizophrenia**" in the early 20th century. - He significantly contributed to the understanding of psychotic disorders but did not coin the broader term "psychiatry." *Pinel* - **Philippe Pinel** was a French physician who was an instrumental figure in the **humanitarian reform** of mental asylum care in the late 18th century. - He is famous for **unshackling patients** at Bicêtre and Salpêtrière asylums, but he did not coin the term "psychiatry."
Question 22: Which type of delusion is primarily associated with Cotard's syndrome?
- A. Persecutory delusions
- B. Religious delusions
- C. Nihilistic delusions (Correct Answer)
- D. Hypochondriacal delusions
Explanation: ***Nihilistic delusions*** - **Cotard's syndrome** is characterized by beliefs of **non-existence**, such as the patient being dead, not existing, or having lost their organs, which are typical of **nihilistic delusions**. - These delusions can also extend to the belief that the world or parts of it no longer exist. *Persecutory delusions* - These involve the belief that one is being **harassed, tricked, spied upon, or conspired against**, which is not the primary feature of Cotard's syndrome. - While they can co-occur with other psychiatric conditions, **persecutory themes** are distinct from the non-existence themes of Cotard's. *Religious delusions* - These delusions focus on **religious or spiritual themes**, such as believing one is a prophet or has a special relationship with a deity. - They are not a core component of Cotard's syndrome, which centers on themes of **death and non-existence**. *Hypochondriacal delusions* - These involve a preoccupation with the belief that one has a **serious, undiagnosed medical condition**, despite medical reassurance. - While Cotard's syndrome can involve bodily concerns, the belief in **non-existence of organs** or death goes beyond typical hypochondriacal fears of illness.
Question 23: Waxy flexibility is a feature of ?
- A. Catatonia (Correct Answer)
- B. Echolalia
- C. Stereotypy
- D. Mannerisms
Explanation: ***Catatonia*** - **Waxy flexibility** (or catalepsy) is a classic symptom of **catatonia**, where an individual's limbs can be **placed in any position by the examiner and remain in that position for an extended period**, as if molded from wax. - It reflects a severe psychomotor disturbance, often seen in conditions like **schizophrenia** or **mood disorders** with catatonic features. *Echolalia* - **Echolalia** refers to the **involuntary repetition of another person's spoken words**, typically without understanding. - It is a symptom of thought disorder or communication difficulties, not a state of motor rigidity. *Stereotypy* - **Stereotypy** involves **repetitive, seemingly purposeless movements or utterances** (e.g., body rocking, hand flapping). - While repetitive, it does not involve maintaining a fixed posture imposed by another, as seen in waxy flexibility. *Mannerisms* - **Mannerisms** are **habitual, idiosyncratic gestures or behaviors** that may appear odd but are often voluntary and goal-directed (e.g., an exaggerated bow before speaking). - They are distinct from the involuntary, often rigid, posturing characteristic of waxy flexibility.
Question 24: Visual hallucinations are typically seen in all of the following conditions except?
- A. Schizophrenia
- B. Alcohol withdrawal
- C. Delirium
- D. Depression (Correct Answer)
Explanation: **Depression** - While other forms of hallucinations can occur in severe depression with psychotic features (e.g., auditory), **visual hallucinations are rare**. - **Mood-congruent delusions** are more common in psychotic depression than visual hallucinations. *Delirium* - **Visual hallucinations** are a hallmark symptom of delirium, often described as polymorphic and vivid. - They are typically accompanied by **fluctuating consciousness** and cognitive impairment. *Schizophrenia* - Although **auditory hallucinations** are more common, visual hallucinations can occur in schizophrenia, particularly in advanced or severe cases. - These hallucinations are often well-formed, frequent, and can be **persecutory** or **bizarre** in nature. *Alcohol withdrawal* - **Alcohol withdrawal delirium** (delirium tremens) is characterized by prominent **visual hallucinations**, tactile hallucinations, and autonomic instability. - These hallucinations can be terrifying and are due to **CNS hyperexcitability**.
Question 25: Which of the following can cause delirium?
- A. Hypoxia
- B. Barbiturates
- C. Alcohol withdrawal
- D. All of the options (Correct Answer)
Explanation: ***All of the options*** - **Delirium** is an acute, fluctuating disturbance in attention and cognition, often with altered consciousness, and can be caused by a wide range of factors. - **Hypoxia**, **barbiturate** use, and **alcohol withdrawal** are all well-established causes of delirium. *Hypoxia* - **Cerebral hypoxia**, or insufficient oxygen supply to the brain, directly impairs neuronal function, leading to acute confusion and altered mental status characteristic of delirium. - Conditions like severe respiratory failure, heart failure, or anemia can precipitate hypoxia and subsequent delirium. *Barbiturates* - **Barbiturates** are central nervous system depressants that can cause sedation, confusion, and cognitive impairment, especially in overdose or in susceptible individuals. - While they typically induce sedation, paradoxical excitement or severe cognitive dysfunction consistent with delirium can occur. *Alcohol withdrawal* - **Alcohol withdrawal** can lead to a severe form of delirium known as *delirium tremens*, characterized by extreme confusion, hallucinations, tremors, and autonomic instability. - The rapid cessation of chronic alcohol intake disrupts neurochemical balance, leading to hyperexcitability and delirium.
Question 26: Psychoanalysis was started by?
- A. Eugen Bleuler
- B. Sigmund Freud (Correct Answer)
- C. Carl Jung
- D. Erik Erikson
Explanation: ***Sigmund Freud*** - **Sigmund Freud** is widely recognized as the founder of **psychoanalysis**. - He developed theories on the **unconscious mind**, **psychosexual development**, and the use of techniques like **free association** and dream analysis. *Eugen Bleuler* - **Eugen Bleuler** was a Swiss psychiatrist who coined the term "**schizophrenia**." - While influential in psychiatry, his work was primarily focused on **descriptive psychopathology**, not the founding of psychoanalysis. *Carl Jung* - **Carl Jung** was a student of Freud who later diverged to develop his own school of thought called **analytical psychology**. - His contributions include concepts like the **collective unconscious**, archetypes, and psychological types. *Erik Erikson* - **Erik Erikson** was a developmental psychologist and psychoanalyst known for his theory of **psychosocial development**. - He expanded on Freud's work by focusing on the influence of social factors and the **lifespan stages** on personality development.
Question 27: Which of the following is NOT a diagnostic criterion for drug dependence?
- A. Taking substance in larger amounts than intended
- B. Tolerance
- C. Withdrawal symptoms
- D. Early completion of tasks (Correct Answer)
Explanation: ***Early completion of tasks*** - This is not a recognized diagnostic criterion for **drug dependence (substance use disorder)** according to standardized diagnostic manuals like the DSM-5. - While it might reflect an individual's productivity or efficiency, it has no direct link to the compulsive drug-seeking and use behaviors characteristic of dependence. *Tolerance* - **Tolerance** is a core criterion, defined as a need for markedly increased amounts of the substance to achieve intoxication or desired effect, or a markedly diminished effect with continued use of the same amount of the substance. - This indicates a physiological adaptation to the presence of the drug. *Withdrawal symptoms* - **Withdrawal symptoms** refer to the characteristic physiological and psychological symptoms that occur when a person stops or reduces their use of a substance after prolonged or heavy use. - The presence of a withdrawal syndrome or taking the substance (or a closely related one) to relieve or avoid withdrawal symptoms is a key diagnostic indicator. *Taking substance in larger amounts than intended* - This criterion reflects the **impaired control** over substance use, where the individual uses the substance more often or in larger quantities than they initially intended. - It demonstrates a loss of conscious regulation over drug intake, which is a hallmark of substance dependence.
Question 28: Which of the following is true regarding the treatment of cocaine withdrawal symptoms?
- A. Fluoxetine
- B. Antidepressants
- C. No specific drug (Correct Answer)
- D. Benzodiazepines
Explanation: ***No specific drug*** - Currently, there is **no FDA-approved pharmacotherapy** for the treatment of cocaine withdrawal symptoms or for preventing relapse in cocaine dependence. - Management primarily focuses on **supportive care**, **psychotherapy** (cognitive behavioral therapy, contingency management), and addressing **co-occurring mental health disorders**. - Unlike alcohol or opioid withdrawal, cocaine withdrawal is not life-threatening and does not require specific medication. *Fluoxetine* - Fluoxetine is a **selective serotonin reuptake inhibitor (SSRI)** primarily used to treat depression and anxiety disorders. - While depression can be a symptom of cocaine withdrawal, fluoxetine has **not been shown to be effective** for reducing cocaine use or treating cocaine withdrawal specifically. - Multiple clinical trials have failed to demonstrate benefit for cocaine dependence treatment. *Antidepressants* - While various antidepressants (including desipramine, bupropion) have been investigated, there is **no strong evidence** to support their routine use as primary treatment for cocaine withdrawal or dependence. - Their effectiveness in this context is **limited and inconsistent** across studies. - They may be used to treat **co-occurring depressive disorders** but not as primary cocaine withdrawal treatment. *Benzodiazepines* - Benzodiazepines are primarily used to manage **acute anxiety and seizures** during withdrawal from GABAergic substances like **alcohol and sedatives**. - They are generally **not recommended** for cocaine withdrawal as cocaine withdrawal does not cause seizures or dangerous autonomic instability. - May be used only for **severe agitation** or **co-occurring alcohol withdrawal**, but carry their own dependence potential and do not address cocaine withdrawal itself.
Question 29: Which of the following is considered a poor prognostic factor for schizophrenia?
- A. Presence of depression
- B. Presence of stressor
- C. Early onset (Correct Answer)
- D. Female sex
Explanation: ***Early onset*** - An **earlier age of onset** (e.g., childhood or early adolescence) for schizophrenia is consistently associated with a **worse long-term prognosis**, including more severe symptoms, greater functional impairment, and a lower likelihood of full recovery. - This is thought to be due to the greater developmental disruption caused by the illness when it begins at a younger age. *Presence of depression* - While depression is common in schizophrenia, it is generally considered to be a **treatable co-occurring condition** rather than a primary poor prognostic factor for the core psychotic disorder itself. - Effective treatment for depression can actually **improve overall quality of life** and adherence to antipsychotic medication. *Presence of stressor* - The presence of a significant psychosocial stressor at the onset of schizophrenia is often associated with a **better prognosis**, as it suggests a more reactive and potentially remitting course. - This indicates that the illness might be more environmentally triggered and less intrinsically severe. *Female sex* - **Female sex** is typically associated with a **somewhat better prognosis** in schizophrenia, with a later age of onset and potentially less severe symptoms compared to males. - This may be influenced by hormonal factors and differences in social support networks.
Question 30: In stupor catatonia, all are seen except -
- A. Mutism
- B. Akinesia
- C. Catalepsy
- D. Agitation (Correct Answer)
Explanation: ***Agitation*** - **Stuporous catatonia** is characterized by a significant reduction or absence of motor activity and responsiveness, making **agitation**—increased motor activity—an unlikely feature. - In such a state, the patient is typically rigid, immobile, and unresponsive to external stimuli, which is the antithesis of agitation. *Catalepsy* - **Catalepsy** refers to a trance-like state with a loss of voluntary motion and active posturing, where the limbs maintain any position in which they are placed (waxy flexibility). - This is a hallmark feature of **catatonic stupor**, indicating a profound disturbance in motor control. *Mutism* - **Mutism** is the absence or profound reduction of speech, which is a common and defining feature of **catatonic stupor**. - Patients in a stuporous state typically do not speak or respond verbally to questions or commands. *Akinesia* - **Akinesia** is the absence of movement, or pronounced difficulty in initiating voluntary movements, which is a key component of **catatonic stupor**. - Patients exhibit severe motor retardation, often appearing frozen or rigid.