All are required to diagnose major depression except?
What does the term 'Folie-à-deux' refer to?
Which of the following is the most classic example of a delusion?
The delusion that involves the belief that a familiar person has been replaced by someone else is known as?
According to DSM-5 criteria, symptoms of brief psychotic disorder must resolve within what time period to differentiate it from longer-term psychotic conditions like schizophreniform disorder?
Which of the following disorders is classified under somatic symptom and related disorders in the DSM-5?
What is the drug of choice for treating generalized anxiety disorder?
A student unable to deliver speech before an audience is suffering from?
Astasia-abasia is associated with which of the following conditions?
Which of the following symptoms is NOT included in the diagnostic criteria for DSM-IV-TR somatization disorder?
NEET-PG 2013 - Psychiatry NEET-PG Practice Questions and MCQs
Question 31: All are required to diagnose major depression except?
- A. Depressed mood
- B. Decreased concentration
- C. Nihilistic ideas (Correct Answer)
- D. Insomnia
Explanation: ***Nihilistic ideas*** - While nihilistic ideas (e.g., belief that life is meaningless or that nothing matters) can occur in severe depression, they are **not a mandatory diagnostic criterion** for major depressive disorder (MDD). - The diagnosis of MDD requires a specific number of core symptoms, and nihilistic ideation is not listed as one of them in diagnostic manuals like the DSM-5. *Depressed mood* - A **depressed mood** for most of the day, nearly every day, is one of the two **cardinal symptoms** required for a diagnosis of major depressive disorder. - The other cardinal symptom is anhedonia (loss of interest or pleasure). *Insomnia* - **Insomnia** (difficulty falling or staying asleep) or hypersomnia (sleeping excessively) is a common neurovegetative symptom of major depressive disorder and is one of the **nine diagnostic criteria**. - At least 5 of these 9 criteria must be present for a diagnosis, including at least one of the two cardinal symptoms. *Decreased concentration* - **Diminished ability to think or concentrate**, or indecisiveness, is another of the **nine diagnostic criteria** for major depressive disorder. - This cognitive symptom highlights the impact of depression on mental function beyond mood.
Question 32: What does the term 'Folie-à-deux' refer to?
- A. Delusion of persecution
- B. Sharing of delusion (Correct Answer)
- C. Delusion of double
- D. None of the options
Explanation: ***Sharing of delusion*** - **Folie-à-deux**, also known as **shared psychotic disorder**, describes a rare psychiatric syndrome in which a **delusional belief** is transmitted from one individual to another. - It typically occurs between two people in a close relationship, where one individual (the primary case) develops a delusion and the other person (the secondary case) subsequently adopts the same delusion. *Delusion of persecution* - A **delusion of persecution** is a specific type of delusion where an individual believes they are being harmed, harassed, or conspired against by others. - While it can be the content of a shared delusion in folie-à-deux, the term itself refers to the *type* of delusion, not the *sharing* mechanism. *Delusion of double* - "Delusion of double" is not a standard term for folie-à-deux. - This phrase might be confused with **delusional misidentification syndromes** (like Capgras syndrome where a person believes someone has been replaced by an identical impostor), but this is a different concept from shared psychotic disorder. *None of the options* - This option is incorrect because "sharing of delusion" accurately defines folie-à-deux.
Question 33: Which of the following is the most classic example of a delusion?
- A. Othello syndrome (Correct Answer)
- B. Pyromania
- C. Kleptomania
- D. De Clérambault's syndrome
Explanation: ***Othello syndrome*** - **Othello syndrome**, also known as **delusional jealousy**, is characterized by a *fixed, unfounded belief* that one's partner is being unfaithful. - This is a classic example of a **delusion** because it involves a **fixed, false belief** that is firmly held despite clear evidence to the contrary and is not amenable to logic or persuasion. - The syndrome demonstrates all core features of a delusion: **unshakeable conviction**, **imperviousness to contradictory evidence**, and **significant impact on behavior**. *De Clérambault's syndrome* - **De Clérambault's syndrome**, or **erotomania**, is a delusional disorder where an individual *believes another person, often of higher status, is in love with them*. - While this is also a classic example of a delusional disorder, **Othello syndrome** is more frequently cited in clinical teaching as the prototypical example of an isolated, circumscribed delusion. *Pyromania* - **Pyromania** is an **impulse control disorder** characterized by recurrent, deliberate fire-setting driven by tension or arousal. - It involves **behavioral impulsivity** and *not a fixed false belief*, thus it is not a delusion. *Kleptomania* - **Kleptomania** is another **impulse control disorder** characterized by recurrent failure to resist urges to steal objects not needed for personal use. - Like pyromania, it represents a **disorder of impulse control** rather than a disorder of thought content or belief system.
Question 34: The delusion that involves the belief that a familiar person has been replaced by someone else is known as?
- A. Capgras syndrome (Correct Answer)
- B. Cotard syndrome
- C. Othello syndrome
- D. Fregoli syndrome
Explanation: ***Capgras syndrome*** - This **delusional misidentification syndrome** is characterized by the belief that a familiar person (e.g., a spouse, child, or parent) has been replaced by an identical imposter. - It often occurs in individuals with **schizophrenia**, **dementia**, or following **brain injury**. *Cotard syndrome* - This syndrome involves a nihilistic delusion where the individual believes they are **dead**, do not exist, or have lost their organs or blood. - It is often associated with severe **depression**, psychosis, or neurological disorders. *Othello syndrome* - Also known as **delusional jealousy**, this involves the unfounded belief that one's partner is being unfaithful. - It is a **primary delusional disorder** but can also be seen in conditions like alcohol dependence or neurodegenerative diseases. *Fregoli syndrome* - This is another **delusional misidentification syndrome** where the person believes that different people are actually the same person in disguise. - It is the opposite of Capgras syndrome and may occur in **schizophrenia** or **organic brain disorders**.
Question 35: According to DSM-5 criteria, symptoms of brief psychotic disorder must resolve within what time period to differentiate it from longer-term psychotic conditions like schizophreniform disorder?
- A. 1 week
- B. 3 weeks
- C. 2 weeks
- D. 1 month (Correct Answer)
Explanation: ***1 month*** - According to **DSM-5 criteria**, brief psychotic disorder is characterized by symptoms lasting more than **1 day** but less than **1 month**. - If psychotic symptoms persist for **1 month or longer**, it indicates a different diagnosis, such as schizophreniform disorder or schizophrenia, requiring further evaluation. *1 week* - While psychotic symptoms may be present for 1 week in brief psychotic disorder, this duration is within the disorder's diagnostic window but not its defining upper limit. - The key differentiator for brief psychotic disorder is that symptoms resolve within **1 month**. *2 weeks* - Similar to 1 week, 2 weeks is a duration that can occur within brief psychotic disorder, but it does not represent the minimum duration that distinguishes it from longer-term conditions. - The crucial threshold for duration in brief psychotic disorder is **less than 1 month**. *3 weeks* - Three weeks also falls within the diagnostic duration for brief psychotic disorder. - The essential criteria specify that psychotic symptoms must last **less than 1 month** to be classified as brief psychotic disorder.
Question 36: Which of the following disorders is classified under somatic symptom and related disorders in the DSM-5?
- A. Post-Traumatic Stress Disorder (PTSD)
- B. Phobic disorders (e.g., social anxiety disorder)
- C. Conversion disorder (functional neurological symptom disorder) (Correct Answer)
- D. Obsessive-Compulsive Disorder (OCD)
Explanation: ***Conversion disorder (functional neurological symptom disorder)*** - **Conversion disorder** is characterized by neurological symptoms (e.g., paralysis, blindness) that are **incompatible with recognized neurological or medical conditions**, yet are not intentionally produced. - It falls under **somatic symptom and related disorders** because the primary features are physical symptoms causing distress or functional impairment, rather than being malingered or feigned. *Phobic disorders (e.g., social anxiety disorder)* - **Phobic disorders** are classified under **anxiety disorders** in the DSM-5, not somatic symptom and related disorders. - They are primarily characterized by **intense, irrational fears** of specific objects or situations, leading to avoidance rather than prominent physical symptoms without a medical cause. *Post-Traumatic Stress Disorder (PTSD)* - **PTSD** is classified under **trauma- and stressor-related disorders** in the DSM-5, distinguished by symptoms developing after exposure to a traumatic event. - Its core features include **intrusive memories, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity**, rather than unexplained physical symptoms. *Obsessive-Compulsive Disorder (OCD)* - **OCD** is classified under **obsessive-compulsive and related disorders** in the DSM-5. - It is primarily characterized by the presence of **obsessions (recurrent, intrusive thoughts)** and/or **compulsions (repetitive behaviors or mental acts)**, which are distinct from somatic symptoms.
Question 37: What is the drug of choice for treating generalized anxiety disorder?
- A. Alprazolam
- B. Buspirone (Correct Answer)
- C. Phenytoin
- D. β-blocker
Explanation: ***Buspirone*** - **Buspirone** is a non-benzodiazepine anxiolytic that is effective for generalized anxiety disorder (GAD) and has a lower risk of dependence and sedation compared to benzodiazepines. - It acts as a partial agonist at **5-HT1A serotonin receptors**, which contributes to its anxiolytic effects without affecting GABAergic systems. *β-blocker* - **β-blockers** are primarily used to manage the **physical symptoms of anxiety**, such as palpitations and tremors, often in performance anxiety, rather than the core cognitive and emotional symptoms of GAD. - They do not address the underlying psychological aspects of generalized anxiety. *Alprazolam* - **Alprazolam** is a **benzodiazepine** that provides rapid relief of anxiety symptoms but carries a significant risk of **dependence, withdrawal, and sedation**, making it less suitable for long-term treatment of GAD. - Due to these risks, benzodiazepines are typically reserved for short-term use or acute anxiety management rather than as a first-line treatment for chronic GAD. *Phenytoin* - **Phenytoin** is an **antiepileptic drug** primarily used to treat seizures and does not have a recognized role in the management of generalized anxiety disorder. - Its mechanism of action involves stabilizing neuronal membranes and is unrelated to the neurochemical pathways targeted in anxiety disorders.
Question 38: A student unable to deliver speech before an audience is suffering from?
- A. Social anxiety disorder (Correct Answer)
- B. Fear of open spaces
- C. Fear of enclosed spaces
- D. Obsessive Compulsive Disorder
Explanation: ***Social anxiety disorder*** - This condition involves an intense, persistent fear of social situations, particularly those where one might be scrutinized or judged by others. - Public speaking is a classic scenario that can trigger significant distress and avoidance in individuals with **social anxiety disorder**. *Fear of open spaces* - This symptom describes **agoraphobia**, which is an anxiety disorder characterized by fear and avoidance of situations or places that might cause panic, helplessness, or embarrassment, often due to a perceived inability to escape. - While it can sometimes involve fear of public gatherings, its core is about escape/safety from open, unfamiliar, or overwhelming spaces, not specifically about performance. *Fear of enclosed spaces* - This refers to **claustrophobia**, which is an anxiety disorder characterized by an irrational fear of confined spaces. - It does not involve the fear of speaking or performance before an audience. *Obsessive Compulsive Disorder* - **OCD** is characterized by recurrent and persistent thoughts (obsessions) and/or repetitive behaviors or mental acts (compulsions) performed to reduce anxiety. - It does not typically manifest as an inability to deliver a speech before an audience unless the obsessions or compulsions directly interfere with such an activity, which is not the primary mechanism of this symptom.
Question 39: Astasia-abasia is associated with which of the following conditions?
- A. Post-Traumatic Stress Disorder
- B. Depressive Disorder
- C. Bipolar Mood Disorder
- D. Functional Neurological Symptom Disorder (Correct Answer)
Explanation: ***Functional Neurological Symptom Disorder*** - **Astasia-abasia**, which refers to an inability to stand (astasia) and walk (abasia) despite normal motor function when examined in bed, is a classical presentation of **Functional Neurological Symptom Disorder** (formerly conversion disorder). - This disorder involves neurological symptoms that are incompatible with recognized medical conditions and often linked to **psychological stressors**. - The gait disturbance is bizarre and inconsistent with any known neurological pattern. *Post-Traumatic Stress Disorder* - Characterized by re-experiencing a **traumatic event**, avoidance behaviors, negative alterations in cognitions and mood, and hyperarousal. - While it can manifest with physical symptoms, **astasia-abasia** is not a primary or characteristic feature. *Depressive Disorder* - Primarily involves persistent **sadness**, loss of interest or pleasure, changes in appetite or sleep, and feelings of worthlessness or guilt. - Although physical symptoms like fatigue and psychomotor retardation can occur, **astasia-abasia** is not a typical presentation. *Bipolar Mood Disorder* - Distinguished by episodes of both **mania** (or hypomania) and **depression**. - Symptoms are predominantly mood-related, including extreme shifts in energy, activity levels, and concentration, not specific neurological deficits like astasia-abasia.
Question 40: Which of the following symptoms is NOT included in the diagnostic criteria for DSM-IV-TR somatization disorder?
- A. Sexual symptom
- B. Pain symptom
- C. GI symptom
- D. Visual symptoms (Correct Answer)
Explanation: ***Visual symptoms*** - **Visual symptoms** is NOT a separate diagnostic category in DSM-IV-TR somatization disorder criteria. - While visual symptoms (such as **double vision** or **blindness**) ARE part of the diagnostic criteria, they fall under the **pseudoneurological symptom** category, not as a distinct standalone category. - The DSM-IV-TR required **one pseudoneurological symptom** (which could include visual, motor, sensory symptoms, or seizures), but did not list "visual symptoms" as one of the four main symptom categories. *Sexual symptom* - The DSM-IV-TR diagnostic criteria for somatization disorder explicitly included **sexual symptoms** as one of the four main categories. - At least **one sexual symptom** was required (such as sexual indifference, erectile dysfunction, irregular menses, or painful intercourse). *Pain symptom* - The DSM-IV-TR criteria included **pain symptoms** as one of the four main categories. - The criteria required **four pain symptoms** occurring in at least four different sites or functions (e.g., head, abdomen, back, joints, chest). *GI symptom* - The DSM-IV-TR criteria included **gastrointestinal symptoms** as one of the four main categories. - At least **two gastrointestinal symptoms** were required (such as nausea, bloating, vomiting other than during pregnancy, or diarrhea). **Key Point:** The four DSM-IV-TR symptom categories for somatization disorder were: (1) Pain, (2) Gastrointestinal, (3) Sexual, and (4) Pseudoneurological—NOT "visual symptoms" as a separate category.