Introduction to Psychiatry Practice Questions

Q: Who proposed the concept of 'la belle indifférence'?

Freud. **Explanation:** The correct answer is **Freud**. The term **'la belle indifférence'** (the beautiful indifference) was popularized by **Sigmund Freud** to describe a specific clinical feature of **Conversion Disorder** (Functional Neurological Symptom Disorder). It refers to a paradoxical state where a patient shows a surprising lack of concern or anxiety regarding their severe physical symptoms (e.g., sudden paralysis or blindness), which have no organic cause and are rooted in psychological conflict. **Analysis of Options:** * **A. Seligman:** Martin Seligman is known for the theory of **'Learned Helplessness,'** which is a foundational model for understanding the etiology of Depression. * **B. Lorenz:** Konrad Lorenz was an ethologist famous for his work on **'Imprinting'** and attachment behaviors in animals. * **C. Freud (Correct):** As the father of psychoanalysis, Freud linked 'la belle indifférence' to the "primary gain" of conversion—where the physical symptom reduces the patient's internal anxiety. * **D. Bleuler:** Eugen Bleuler is renowned for naming **Schizophrenia** and defining its core symptoms, known as the **'4 As'** (Ambivalence, Autism, Affective flattening, and Association looseness). **NEET-PG High-Yield Pearls:** * **Conversion Disorder:** Now classified in DSM-5 as Functional Neurological Symptom Disorder. * **Primary Gain:** Internal relief from anxiety by converting psychological conflict into a physical symptom. * **Secondary Gain:** External benefits derived from being sick (e.g., attention, avoiding work). * **Clinical Note:** While classically associated with conversion disorder, 'la belle indifférence' is neither pathognomonic nor present in all cases; it can occasionally be seen in patients with organic brain lesions.

Q: What is the greatest psychiatric burden in society?

Depression. **Explanation:** **Depression (Major Depressive Disorder)** is the correct answer because it consistently ranks as the leading cause of psychiatric disability and the greatest contributor to the global burden of disease among mental disorders. According to the World Health Organization (WHO) and the Global Burden of Disease studies, depression is a primary driver of **Years Lived with Disability (YLDs)**. Its high prevalence (affecting over 5% of the global population), early age of onset, and significant impact on social and occupational functioning make it the greatest psychiatric burden. **Analysis of Incorrect Options:** * **Schizophrenia:** While it is one of the most severe and chronic mental illnesses, its relatively low prevalence (approx. 1%) means its total societal burden is less than that of depression. * **Obsessive-compulsive disorder (OCD):** Although highly distressing and often chronic, OCD has a lower lifetime prevalence and a smaller overall impact on global health metrics compared to mood disorders. * **Alcohol abuse:** Substance use disorders contribute significantly to morbidity and mortality (especially in men), but depression remains the leading cause of non-fatal health loss globally. **Clinical Pearls for NEET-PG:** * **Most common psychiatric disorder in the community:** Anxiety disorders (as a group), but **Depression** is the leading cause of disability. * **Most common psychiatric disorder in clinical practice:** Depression. * **Daly (Disability-Adjusted Life Year):** Depression is the leading cause of DALYs among all mental and substance use disorders. * **Gender Predominance:** Depression is twice as common in females as in males.

Q: Which of the following is NOT a defense mechanism?

Transference. **Explanation:** The core of this question lies in distinguishing between **Defense Mechanisms** and **Psychodynamic Phenomena**. **Why Transference is the Correct Answer:** Transference is not a defense mechanism; it is a **phenomenon** occurring during psychotherapy where a patient unconsciously redirects (transfers) feelings, desires, and expectations from significant figures in their past (like parents) onto the therapist. While it is a vital tool for psychoanalysis, it does not function as a psychological strategy to protect the ego from anxiety. **Analysis of Incorrect Options (Defense Mechanisms):** * **A. Repression:** A primary **immature/neurotic** defense mechanism where the ego pushes threatening thoughts or painful impulses into the unconscious mind (e.g., "forgetting" a traumatic event). * **C. Projection:** An **immature** defense mechanism where an individual attributes their own unacknowledged, unacceptable feelings or impulses to others (e.g., a person who is angry at their spouse accuses the spouse of being angry at them). * **D. Anticipation:** A **mature** defense mechanism where an individual realistically plans for future inner discomfort or stressful situations (e.g., preparing for a difficult exam to reduce anxiety). **High-Yield Clinical Pearls for NEET-PG:** * **Classification:** Defense mechanisms are categorized by Vaillant into four levels: Pathological (e.g., Denial), Immature (e.g., Projection), Neurotic (e.g., Repression, Reaction Formation), and Mature (e.g., Sublimation, Altruism, Suppression, Humor, Anticipation). * **Repression vs. Suppression:** Repression is **unconscious** (involuntary), whereas Suppression is the only **conscious** (voluntary) defense mechanism. * **Counter-transference:** This is the therapist’s unconscious emotional response to the patient, which must be managed to maintain professional boundaries.

Question 1

Which statement correctly describes classical conditioning?

Accepted Answer

Conditioned stimulus triggers a conditioned response after learning

Answer

Association between conditioned stimulus and conditioned response

Answer

Association between unconditioned stimulus and unconditioned response

Answer

Unconditioned stimulus produces conditioned response after learning

Question 2

Who proposed the concept of 'la belle indifférence'?

Accepted Answer

Freud

Answer

Seligman

Answer

Lorenz

Answer

Bleuler

Question 3

What is the greatest psychiatric burden in society?

Accepted Answer

Depression

Answer

Schizophrenia

Answer

Obsessive-compulsive disorder (OCD)

Answer

Alcohol abuse

Question 4

Which of the following is NOT a defense mechanism?

Accepted Answer

Transference

Answer

Repression

Answer

Projection

Answer

Anticipation

Question 5

What does GAS refer to?

Accepted Answer

The pathway of stress (autonomic nervous system) when aroused by a stressful situation

Answer

Homeostasis

Answer

Adaptation to new situations

Answer

The pattern of physiological response to stress

Introduction to Psychiatry — MCQs

Introduction to Psychiatry — MCQs

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