Prognosis of schizophrenia is best, if:
An IQ of 40 corresponds to which level of intellectual disability?
Anxiety is best described as:
Frotteurism is:
Severe mental retardation is:
Erotomania is seen in:
Mental Health Care Act of India was passed in the year:
Type of schizophrenia with intellectual disability:
All are first rank symptoms of schizophrenia, except:
Quod hanc means:
NEET-PG 2013 - Psychiatry NEET-PG Practice Questions and MCQs
Question 71: Prognosis of schizophrenia is best, if:
- A. Acute onset (Correct Answer)
- B. Negative symptoms
- C. Insidious onset
- D. Family history is positive
Explanation: ***Acute onset*** - An **acute onset** of schizophrenia is associated with a better prognosis, as it often indicates a more favorable response to treatment and less pervasive deterioration of daily functioning. - This typically suggests that the individual had a relatively intact baseline level of functioning before the emergence of psychotic symptoms. *Negative symptoms* - The presence of prominent **negative symptoms** (e.g., avolition, anhedonia, alogia) is usually associated with a poorer prognosis in schizophrenia. - Negative symptoms are generally harder to treat and often lead to greater functional impairment and disability. *Insidious onset* - An **insidious onset** of schizophrenia, where symptoms develop gradually over time, is typically linked to a poorer prognosis. - This often implies more severe and persistent neurodevelopmental abnormalities and a less robust response to interventions. *Family history is positive* - A **positive family history** of schizophrenia indicates a higher genetic predisposition but does not directly predict the individual's prognosis. - While genetics play a role in susceptibility, the course and outcome of the illness are influenced by many other factors, including symptom presentation and treatment adherence.
Question 72: An IQ of 40 corresponds to which level of intellectual disability?
- A. Mild
- B. Profound
- C. Severe
- D. Moderate (Correct Answer)
Explanation: ***Moderate*** - An **IQ score between 35 and 49** is classified as moderate intellectual disability. - Individuals with moderate intellectual disability often require **supervision** but can develop some communication and self-care skills. *Mild* - **IQ scores between 50 and 69** are indicative of mild intellectual disability. - Individuals with mild intellectual disability can often achieve academic skills up to a **sixth-grade level** and live independently with support. *Profound* - **IQ scores below 20** signify profound intellectual disability. - Individuals with profound intellectual disability require **intensive support** for all activities of daily living and have minimal communication skills. *Severe* - **IQ scores between 20 and 34** fall into the severe intellectual disability category. - Individuals with severe intellectual disability have significant **impairments in adaptive functioning** and require substantial support for self-care and communication.
Question 73: Anxiety is best described as:
- A. A specific fear leading to avoidance behavior (Phobic disorder)
- B. A mental disorder with delusions or hallucinations (Psychosis)
- C. Enduring maladaptive personality traits (Personality disorder)
- D. Excessive worry and emotional distress without loss of reality (Anxiety disorder) (Correct Answer)
Explanation: ***Excessive worry and emotional distress without loss of reality (Anxiety disorder)*** - **Anxiety** is characterized by persistent, excessive worry and apprehension, often accompanied by emotional distress and physical symptoms, while the individual maintains contact with reality. - This definition distinguishes it from psychotic disorders where there is a **loss of reality**. *A specific fear leading to avoidance behavior (Phobic disorder)* - While phobic disorders are a type of **anxiety disorder**, they represent a specific subtype characterized by an intense, irrational fear of a particular object or situation. - The given description of anxiety is broader than just a **phobic disorder**. *A mental disorder with delusions or hallucinations (Psychosis)* - This describes **psychotic disorders**, where individuals experience a significant disruption in their perception of reality, marked by **delusions** (fixed false beliefs) and/or **hallucinations** (sensory experiences without external stimuli). - Anxiety, in its core definition, does not involve a **loss of reality**. *Enduring maladaptive personality traits (Personality disorder)* - **Personality disorders** are characterized by deeply ingrained, inflexible, and maladaptive patterns of perceiving, relating to, and thinking about the environment and oneself. - These patterns typically manifest across various situations and are stable over time, differing significantly from the definition of anxiety as a state of **worry and emotional distress**.
Question 74: Frotteurism is:
- A. Sexual practice involving three people
- B. Sexual pleasure in watching people getting undressed
- C. Sexual gratification by rubbing against a non-consenting person (Correct Answer)
- D. Sexual pleasure obtained by witnessing urination
Explanation: ***Sexual gratification by rubbing against a non-consenting person*** - **Frotteurism** is a paraphilia characterized by recurrent, intense sexual urges or behaviors involving touching and rubbing against a non-consenting person, typically in crowded public places. - The individual usually achieves **sexual arousal** and gratification from this physical contact. *Sexual practice involving three people* - This describes a **threesome** or **ménage à trois**, which is a sexual activity involving three individuals, but it does not specifically define frotteurism. - Frotteurism is defined by the non-consensual nature of rubbing against another, not the number of participants. *Sexual pleasure in watching people getting undressed* - This describes **voyeurism**, which is obtaining sexual arousal from observing unsuspecting individuals who are naked, disrobing, or engaging in sexual activity. - Frotteurism involves physical contact, whereas voyeurism is primarily observational. *Sexual pleasure obtained by witnessing urination* - This is a specific type of **urophilia**, a paraphilia involving sexual arousal from urine or urination. - This is distinct from frotteurism, which involves non-consensual physical contact with another person.
Question 75: Severe mental retardation is:
- A. <20
- B. 35-50
- C. 20-35 (Correct Answer)
- D. 50-70
Explanation: ***20-35*** - A **score between 20-35** indicates **severe mental retardation**, where individuals typically have very limited communication skills and require extensive support in daily living activities. - This range is associated with significant cognitive impairment that often necessitates full-time supervision. *<20* - An **IQ score below 20** signifies **profound mental retardation**, indicating extremely limited intellectual functioning and severe developmental delays. - Individuals in this category generally have very minimal capacity for self-care or communication. *35-50* - This IQ range reflects **moderate mental retardation**, where individuals can often develop some basic communication and self-care skills, but still require significant support. - They may live semi-independently with supervision, but struggle with academic and complex social tasks. *50-70* - An **IQ score between 50-70** is classified as **mild mental retardation**, which is the most common form. - Individuals often achieve academic skills up to a 6th-grade level and can live independently with appropriate support.
Question 76: Erotomania is seen in:
- A. Obsessive compulsive disorder
- B. Delusional disorder (Correct Answer)
- C. Bipolar mania
- D. Mania without psychotic features
Explanation: ***Delusional disorder*** - Erotomania (De Clérambault's syndrome) is **classically a subtype of delusional disorder** known as **erotomanic type** in DSM-5. - Characterized by a **non-bizarre delusion** that another person, usually of higher social status, is in love with the individual. - The delusion persists despite clear evidence to the contrary and is the **primary psychiatric diagnosis** for erotomania. - Patients may engage in behaviors like following, attempting contact, or surveillance of the object of their delusion. *Bipolar mania* - While **psychotic features can occur** in severe manic episodes, they typically involve **grandiose delusions** about one's own abilities, power, wealth, or special identity. - Erotomania is **not a characteristic or common psychotic feature** of bipolar mania. - Manic psychosis more commonly presents with mood-congruent grandiose delusions rather than erotomanic delusions. *Obsessive compulsive disorder* - Characterized by **obsessions** (intrusive, unwanted thoughts) and **compulsions** (repetitive behaviors performed to reduce anxiety). - These thoughts are **ego-dystonic** and recognized as excessive or irrational by the patient. - Erotomania is a **fixed delusional belief** without insight, fundamentally different from OCD phenomenology. *Mania without psychotic features* - By definition involves elevated mood, increased energy, and decreased need for sleep **without delusions or hallucinations**. - Erotomania is a **delusional belief**, indicating presence of psychotic features. - This diagnosis would exclude any presentation with erotomanic delusions.
Question 77: Mental Health Care Act of India was passed in the year:
- A. 1948
- B. 2007
- C. 1987
- D. 2017 (Correct Answer)
Explanation: ***2017*** - The **Mental Health Care Act of India** was specifically enacted in **2017**, introducing a comprehensive rights-based approach to mental healthcare. - This act replaced the outdated **Mental Health Act 1987** and focuses on protecting the rights of persons with mental illness while ensuring quality care. *1948* - This year marks the **Universal Declaration of Human Rights** globally, but no mental health legislation was enacted in India. - India's mental health framework was still governed by the colonial-era **Indian Lunacy Act of 1912** during this period. *2007* - No significant mental health legislation was passed in India during this year. - The **Mental Health Act 1987** remained in effect, and the new Mental Health Care Act was still a decade away. *1987* - The **Mental Health Act 1987** (without "Care" in the title) was passed in this year, not the Mental Health Care Act. - This act provided the legal framework for mental health services but lacked the comprehensive **rights-based approach** later introduced in 2017.
Question 78: Type of schizophrenia with intellectual disability:
- A. Catatonic schizophrenia
- B. Pfropf schizophrenia (Correct Answer)
- C. Paranoid schizophrenia
- D. Hebephrenic schizophrenia
Explanation: ***Pfropf schizophrenia*** - **Pfropf schizophrenia** is a historical term specifically used to describe a form of schizophrenia that develops in individuals with **pre-existing intellectual disability** (formerly termed mental retardation). - The term "Pfropf" is derived from German, meaning "grafted" or "engrafted," referring to schizophrenia being "grafted onto" pre-existing intellectual disability. - This term distinguishes it from other types of schizophrenia where intellectual disability is not a primary defining characteristic. - While this classification is largely historical (modern DSM-5 has removed schizophrenia subtypes), it remains relevant for older examination questions. *Catatonic schizophrenia* - Characterized primarily by prominent **psychomotor disturbances**, which can include stupor, catalepsy, waxy flexibility, mutism, and negativism. - While intellectual disability might coexist, it is not a defining feature of the catatonic subtype itself. *Paranoid schizophrenia* - Marked by the prominence of **delusions**, typically persecutory or grandiose, and **auditory hallucinations**. - Intellectual disability is not a core diagnostic criterion or a defining characteristic of this subtype. *Hebephrenic schizophrenia* - Also known as **disorganized schizophrenia**, this type is characterized by marked **disorganization of thought processes**, flat or inappropriate affect, and bizarre behavior. - While it often presents early and can lead to significant functional impairment, intellectual disability is not a defining feature; rather, the primary disturbance is in thought and emotion.
Question 79: All are first rank symptoms of schizophrenia, except:
- A. Audible thoughts
- B. Thought broadcasting
- C. Voice arguing or discussing or both
- D. Perplexity (Correct Answer)
Explanation: ***Perplexity*** - **Perplexity** is a state of severe confusion, bewilderment, or puzzlement, which can be seen in various psychiatric conditions but is not specifically classified as a **first-rank symptom of schizophrenia** by Kurt Schneider. - While it may be present in schizophrenia, it is a non-specific symptom, meaning it can occur in conditions other than schizophrenia. *Audible thoughts* - **Audible thoughts** (Gedankenlautwerden in German) refers to the patient hearing their own thoughts spoken aloud, often as if by another voice. - This is considered a **first-rank symptom** as described by Kurt Schneider, highly indicative of schizophrenia. *Thought broadcasting* - **Thought broadcasting** is the delusional belief that one's thoughts are escaping from their mind and are somehow accessible to others. - This symptom is also a **first-rank symptom** of schizophrenia according to Schneider's criteria. *Voice arguing or discussing or both* - **Voices arguing or discussing** are a specific type of auditory hallucination where two or more voices are perceived to be talking to each other, often about the patient. - This phenomenon is considered a classic **first-rank symptom** of schizophrenia.
Question 80: Quod hanc means:
- A. Impotent due to psychological factors
- B. Impotent due to physical factors
- C. Impotent in specific situations
- D. Impotent towards a particular woman (Correct Answer)
Explanation: ***Impotent towards a particular woman*** - The Latin phrase "**Quod hanc**" translates to "towards this woman." - In a medical or medico-legal context, particularly when discussing impotence or fertility, it refers to a situation where a man is **impotent only in relation to a specific woman** or partner, but not with others. [1] *Impotent due to psychological factors* - While psychological factors can cause situational impotence, "Quod hanc" specifically describes an impotence directed **"towards this woman,"** rather than broadly psychological. - This option is broader than the precise meaning of the Latin phrase, which highlights the **specificity of the partner**. *Impotent due to physical factors* - "Quod hanc" has no direct implication about the underlying cause being physical; it solely points to the **target of the impotence**. - Physical impotence would generally mean an inability to achieve erection with **any partner**, which contradicts the specific nature implied by "hanc." *Impotent in specific situations* - This is a general term for **situational impotence**, which could include performance anxiety or stress. [1] - "Quod hanc" is a **more specific sub-category** of situational impotence, precisely indicating that the impotence is directed at "this woman."