Introduction to Psychiatry — MCQs

Introduction to Psychiatry Indian Medical PG Practice Questions and MCQs

Question 141: 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."

Question 142: 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 - This act replaced the outdated **Mental Health Act 1987** and focuses on protecting the rights of persons with mental illness while ensuring quality care.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 143: Penile buccal coitus is:

A. Sadism
B. Fetishism
C. Fellatio (Correct Answer)
D. Cunnilingus

Explanation: ***Fellatio*** - **Fellatio** specifically refers to oral sex involving stimulation of the penis with the mouth. - The term "buccal coitus" in the context of penile stimulation directly describes the act of fellatio. *Sadism* - **Sadism** is a paraphilia characterized by deriving sexual pleasure from inflicting pain, humiliation, or suffering on others. - It does not describe a specific sexual act involving penile buccal coitus, but rather the motivation behind certain acts. *Fetishism* - **Fetishism** involves sexual attraction to non-genital body parts or inanimate objects. - While oral sex can be a preference, it is not inherently a fetish unless the focus is exclusively or predominantly on the mouth or penis as an isolated object, rather than interpersonal sexual activity. *Cunnilingus* - **Cunnilingus** is a form of oral sex involving stimulation of the vulva or clitoris. - This term describes oral sex directed at female genitalia, not the penis.

Question 144: On voluntary admission, the maximum number of days a person can be admitted as per mental health care act is:

A. 30 days (Correct Answer)
B. 48 hours
C. 60 days
D. 90 days

Explanation: ***30 days*** - As per the **Mental Healthcare Act, 2017**, under **Section 89 (Independent Admission)**, a person can be admitted independently for a **maximum period of 30 days**. - After 30 days, the person must either be discharged or the admission must be converted to voluntary or involuntary admission with appropriate procedures. - This provision allows for independent treatment-seeking without requiring a caregiver's involvement initially. *48 hours* - **48 hours** is not related to voluntary or independent admission duration. - This timeframe relates to the period within which a voluntary patient must be discharged after they request to leave (unless there are grounds for involuntary admission). *60 days* - **60 days** is not specified in the Mental Healthcare Act, 2017 for any category of admission. - This is neither the duration for voluntary, independent, nor involuntary admission procedures. *90 days* - **90 days** is not the correct maximum period for voluntary or independent admission. - While voluntary admission can continue indefinitely with ongoing consent, **independent admission** specifically has a **30-day limit** as per Section 89 of the Act.

Question 145: SPIKES protocol is used for:

A. RCT
B. Triage
C. Communication with patients/attendants regarding bad news (Correct Answer)
D. Writing death certificate

Explanation: ***Communication with patients/attendants regarding bad news*** - The **SPIKES protocol** provides a structured framework for delivering difficult or "bad" news sensitively and effectively to patients and their families. - It ensures that the communication is **patient-centered**, empathetic, and allows for understanding and emotional support. *RCT* - **Randomized Controlled Trials (RCTs)** are study designs used to evaluate the efficacy and safety of medical interventions. - They involve randomizing participants to different treatment groups and are not related to breaking bad news. *Triage* - **Triage** is the process of prioritizing patients based on the severity of their condition, typically used in emergency settings. - Its purpose is to allocate resources efficiently and save lives, not to guide difficult conversations. *Writing death certificate* - **Writing a death certificate** is a legal and administrative task that involves documenting the cause and circumstances of a person's death. - While it follows a death, the SPIKES protocol is for the *process of conveying* difficult news, such as a terminal diagnosis or death, rather than the administrative task afterward.

Question 146: All are provisions of WHO mental health Gap Action Programme (mhGAP), except:

A. Communication regarding care
B. Human rights
C. Screening family members (Correct Answer)
D. Social support

Explanation: ***Screening family members*** - The **WHO mhGAP** primarily focuses on scaling up care for **priority mental, neurological, and substance use disorders** in low- and middle-income countries. It does not explicitly include the provision of routine screening of family members of affected individuals. - While family support is crucial, direct screening of asymptomatic family members for psychiatric disorders is not a core component of the program's defined interventions for service delivery. *Communication regarding care* - **Effective communication** is a fundamental aspect of the **WHO mhGAP** to ensure patients and their families understand their condition and treatment plan. - It emphasizes **patient-centered care** and informed decision-making, which rely heavily on clear and empathetic communication from healthcare providers. *Human rights* - **Human rights** are a foundational principle of the **WHO mhGAP**, ensuring that individuals with mental disorders receive care without discrimination and with respect for their dignity and autonomy. - The program advocates for policies and practices that protect the rights of people with mental health conditions. [1] *Social support* - **Social support** is a crucial component promoted by the **WHO mhGAP**, recognizing its role in recovery and well-being for individuals with mental health conditions. - The program encourages interventions that strengthen social ties and community integration to reduce isolation and improve outcomes.

Question 147: As per Mental Healthcare Act, an individual with a known psychotic disorder on treatment and is not a minor, can decide the caretaker and the course of treatment. This is called:

A. Future directive
B. Treatment directive
C. Advance directive (Correct Answer)
D. Mental will

Explanation: ***Advance directive*** - An **advance directive** allows individuals with mental illness who are not minors to make decisions about their future care, including appointing a caretaker and outlining treatment preferences, while they are still capable. - This legal document ensures that a person's wishes regarding their mental health treatment are respected even if they later lose the capacity to make those decisions. *Future directive* - While "future directive" might seem semantically similar, it is not the specific legal or medical term used in the context of the **Mental Healthcare Act** for outlining future treatment choices. - This term is less precise and does not carry the same legal weight or established definition as "advance directive." *Treatment directive* - "Treatment directive" specifically refers to choices about treatment, but it doesn't encompass the full scope of appointing a **caretaker** or the broader legal framework of an advance directive under the act. - It's a more general term that might be used to describe instructions for current or future treatment, but it's not the legally recognized term for comprehensive pre-planned care in mental health. *Mental will* - "Mental will" is not a recognized legal or medical term under the **Mental Healthcare Act** or generally in healthcare planning. - The concept of a "will" typically applies to the distribution of property after death, not to ongoing healthcare decisions or the appointment of caretakers for mental health.

Question 148: mhGAP program includes all of the following disorders except?

A. Schizophrenia
B. Depression
C. Childhood mental disorder
D. Personality Disorders (Correct Answer)

Explanation: ***Personality Disorders*** - The **mhGAP program** (Mental Health Gap Action Programme) focuses on scaling up services for common, severe mental, neurological, and substance use disorders in low- and middle-income countries. - **Personality disorders** are generally not included in the core conditions addressed by the mhGAP program due to their complex and chronic nature, requiring specialized and long-term management that may be beyond the scope of primary care settings targeted by mhGAP. *Schizophrenia* - **Schizophrenia** is one of the priority conditions addressed by the mhGAP program, recognizing its severity and significant impact on individuals and communities. - The program provides guidelines for the recognition, management, and long-term care of schizophrenia at the primary healthcare level. *Depression* - **Depression** is a core focus of the mhGAP program, given its high prevalence and treatability in primary care settings. - mhGAP provides clear guidelines for the identification, basic management, and follow-up of individuals with depression. *Childhood mental disorder* - **Childhood mental disorders**, such as conduct disorder, attention-deficit/hyperactivity disorder (ADHD), and developmental disabilities, are also included as priority conditions within the mhGAP program. - The program aims to improve the detection and basic management of these conditions in children and adolescents, promoting early intervention.

Question 149: Which defense mechanism involves unconsciously eliminating feelings associated with a stressful event?

A. Rationalization
B. Reaction formation
C. Projection
D. Repression (Correct Answer)

Explanation: ***Repression*** - **Repression** is an unconscious defense mechanism where unacceptable thoughts, feelings, or memories are pushed out of conscious awareness. - It involves the involuntary blocking of threatening impulses or traumatic experiences from consciousness to protect the ego from distress. *Reaction formation* - This defense mechanism involves replacing an unacceptable impulse with its **opposite acceptable impulse**. - For example, showing excessive friendliness towards someone you intensely dislike. *Rationalization* - **Rationalization** involves creating logical, but false, explanations for one's actions, feelings, or thoughts. - It is used to justify behaviors that might otherwise be considered unacceptable or irrational. *Projection* - **Projection** is a defense mechanism where an individual attributes their own unacceptable thoughts or feelings to another person. - For instance, accusing someone else of being angry when you are in fact feeling angry yourself.

Question 150: What is the current preferred term for the condition previously known as mental retardation?

A. Feeble Mindedness
B. Madness
C. Intellectual disability (Correct Answer)
D. Mentally unstable

Explanation: ***Correct: Intellectual disability*** - This term was adopted to replace "mental retardation" due to its less stigmatizing nature and its focus on **cognitive and adaptive functioning** - It emphasizes the need for supports and services to help individuals achieve their potential, rather than simply labeling a deficit - Officially adopted in **DSM-5 (2013)** and mandated by **Rosa's Law (2010)** in federal terminology *Incorrect: Feeble Mindedness* - This is an **outdated and derogatory term** that was used historically to describe individuals with cognitive impairments - Its use has been discontinued due to its negative and dehumanizing connotations *Incorrect: Madness* - This term typically refers to severe **mental illness** or **psychosis**, not intellectual impairment - It is an informal and often stigmatizing term that is not used in clinical or diagnostic contexts for intellectual functioning *Incorrect: Mentally unstable* - This term is often used to describe individuals experiencing **fluctuations in mood**, **behavior**, or **thought processes**, usually associated with mental health conditions - It does not specifically refer to global cognitive deficits or intellectual functioning

Practice by Chapter

History of Psychiatry

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Classification Systems in Psychiatry

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Psychiatric Assessment and Interview

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Mental Status Examination

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Psychiatric Rating Scales

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Formulation and Diagnosis

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Ethics in Psychiatry

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Legal Aspects of Psychiatric Practice

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Psychiatric Epidemiology

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Cultural Psychiatry

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Stigma and Mental Illness

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Public Mental Health

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