What is the term for a persistent preoccupation with serious illness despite having no or only mild symptoms?
Which of the following is a first-line treatment for bipolar affective (manic-depressive) disorder:
Erotomania is seen in:
Type of schizophrenia with intellectual disability:
NEET-PG 2012 - Psychiatry NEET-PG Practice Questions and MCQs
Question 21: What is the term for a persistent preoccupation with serious illness despite having no or only mild symptoms?
- A. Somatic symptom disorder
- B. Conversion disorder
- C. Body dysmorphic disorder
- D. Illness anxiety disorder (Correct Answer)
Explanation: ***Illness anxiety disorder*** - This condition is characterized by a **preoccupation with having or acquiring a serious illness** despite having few or no somatic symptoms. - Individuals with illness anxiety disorder engage in **excessive health-related behaviors** (e.g., repeated checking) or maladaptive avoidance (e.g., avoiding doctor appointments). *Somatic symptom disorder* - Involves **distressing somatic symptoms** that result in significant disruption of daily life, with excessive thoughts or behaviors related to the symptoms. - The focus is on the **symptoms themselves**, rather than the fear of a specific undiagnosed illness. *Conversion disorder* - Features neurological symptoms (e.g., weakness, paralysis, seizures) that are **incompatible with recognized neurological or medical conditions**. - There is a **lack of voluntary control** over the symptoms, and they are not intentionally feigned. *Body dysmorphic disorder* - Characterized by a **preoccupation with perceived flaws** or defects in physical appearance that are not observable or appear slight to others. - This preoccupation leads to **repetitive behaviors** (e.g., mirror checking) or mental acts (e.g., comparing oneself to others).
Question 22: Which of the following is a first-line treatment for bipolar affective (manic-depressive) disorder:
- A. Chlorpromazine
- B. Haloperidol
- C. Diazepam
- D. Lithium carbonate (Correct Answer)
Explanation: **Lithium carbonate** - **Lithium** is a well-established and highly effective **mood stabilizer**, considered a first-line treatment for managing both **manic** and **depressive episodes** in bipolar disorder. - It helps prevent recurrent episodes and reduces the severity of mood swings, acting as a prophylactic agent. *Chlorpromazine* - **Chlorpromazine** is a **first-generation antipsychotic** that is primarily used to treat **schizophrenia** and other psychotic disorders. - While it can be used acutely to manage severe manic agitation, it is not a first-line agent for the long-term mood stabilization characteristic of bipolar disorder. *Haloperidol* - **Haloperidol** is another **first-generation antipsychotic** often used for acute treatment of **psychotic symptoms** or severe agitation, including in mania. - It is not a primary long-term mood stabilizer for bipolar disorder due to its side effect profile and lack of efficacy in preventing future mood episodes compared to lithium. *Diazepam* - **Diazepam** is a **benzodiazepine** primarily used for treating **anxiety**, muscle spasms, and acute seizures. - While it can help manage acute agitation and insomnia during a manic episode, it does not have mood-stabilizing properties and is not a long-term treatment for bipolar disorder.
Question 23: 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 24: 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.