Psychiatric Assessment and Diagnosis — MCQs

Psychiatric Assessment and Diagnosis Indian Medical PG Practice Questions and MCQs

Question 471: According to MHA 2017, what is the maximum duration for which a person can be kept for observation before admission?

A. 90 days
B. 24 hours (Correct Answer)
C. 30 days
D. 72 hours

Explanation: ***24 hours*** - According to **Section 99 of the Mental Healthcare Act, 2017**, a person can be kept under observation for a **maximum of 24 hours** before a decision on admission must be made. - This provision ensures timely assessment while protecting individual rights and preventing indefinite detention without proper admission procedures. - After 24 hours, the mental health professional must either initiate formal admission procedures or discharge the person. *72 hours* - This refers to **emergency admission under Section 98** of MHA 2017, not pre-admission observation. - Emergency admission allows a person to be admitted for up to **72 hours** without following the complete admission process in crisis situations. - This is different from the observation period which precedes the decision on whether admission is necessary. *30 days* - This duration is not specified in MHA 2017 for pre-admission observation. - Admission for treatment follows a different process with varying durations depending on the type of admission (independent or supported). *90 days* - This duration is not relevant to pre-admission observation under MHA 2017. - Extended treatment orders for admitted patients may span such durations, but these apply after formal admission, not during the observation phase.

Question 472: What is the current term used to describe the condition previously known as mental retardation according to the American Association on Intellectual and Developmental Disabilities?

A. Intellectual disability (Correct Answer)
B. Cognitive impairment
C. Developmental disability
D. Global developmental delay

Explanation: ***Correct Answer: Intellectual disability*** - The term **intellectual disability** is the current, preferred terminology adopted by both the American Association on Intellectual and Developmental Disabilities (AAIDD) and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) - This change from "mental retardation" reflects a move towards more **person-first language** and reduces the stigma associated with the outdated term - Key diagnostic features include deficits in intellectual functioning (IQ < 70) and adaptive functioning, with onset during the developmental period *Incorrect: Cognitive impairment* - **Cognitive impairment** is a broader term that encompasses various degrees of decline in cognitive functions, such as memory, attention, and executive function - It is not specifically limited to the developmental period and can occur due to various conditions like Alzheimer's disease or stroke - This term does not have the same diagnostic specificity as intellectual disability *Incorrect: Developmental disability* - **Developmental disability** is an umbrella term that includes a wide range of chronic conditions that occur during the developmental period - While intellectual disability is a type of developmental disability, the term itself is broader and includes conditions like **cerebral palsy** or **autism spectrum disorder** without necessarily implying intellectual deficits - Not all developmental disabilities involve intellectual impairment *Incorrect: Global developmental delay* - **Global developmental delay (GDD)** is a diagnosis given to children under the age of 5 when they show significant delays in two or more developmental domains (e.g., motor, language, cognitive, social skills) - While GDD can later be diagnosed as intellectual disability, it is a provisional diagnosis used in early childhood when a child's specific intellectual functioning cannot yet be reliably assessed - This is age-specific and not the official replacement term for mental retardation

Question 473: What does the term 'jamais vu' refer to?

A. A thought that feels familiar but is actually new
B. A situation that feels familiar but is actually new
C. The feeling of strangeness in a familiar situation (Correct Answer)
D. An illusion where one feels they have heard something before

Explanation: ***The feeling of strangeness in a familiar situation*** - **Jamais vu** describes the opposite of déjà vu; it is the experience of encountering something familiar—a person, place, or word—but feeling that it is **unfamiliar or strange**. - This phenomenon can sometimes be a symptom associated with certain neurological conditions like **temporal lobe epilepsy**. *A thought that feels familiar but is actually new* - This describes a sensation closer to **cryptomnesia** or a "false familiarity," where a new idea is mistakenly believed to be an original thought. - Jamais vu specifically relates to the **perception of external reality** or recognition of known entities, not the familiarity of internal thoughts. *A situation that feels familiar but is actually new* - This is the definition of **déjà vu**, not jamais vu. Déjà vu involves experiencing a new event or situation as if it has happened before. - **Déjà vu** translates to "already seen," directly contrasting with the "never seen" sensation of jamais vu. *An illusion where one feels they have heard something before* - This is a specific type of **déjà vu** known as **déjà entendu** ("already heard"). - Jamais vu involves the *loss of familiarity* with something known, rather than the *false familiarity* with something new.

Question 474: In which condition is sex reassignment surgery typically performed?

A. Premature ejaculation
B. Erectile dysfunction
C. Orgasmic dysfunction
D. Gender dysphoria (Correct Answer)

Explanation: ***Gender dysphoria*** - **Sex reassignment surgery** is primarily performed as part of the treatment for **gender dysphoria**, a condition where there is a marked incongruence between an individual's experienced/expressed gender and their assigned sex. - The surgery aims to align the individual's physical appearance with their **gender identity**, alleviating distress and improving quality of life. *Premature ejaculation* - This condition involves consistent or recurrent ejaculation with minimal sexual stimulation before, during, or shortly after penetration and before the person wishes it. - Treatment typically includes behavioral therapies, medication (e.g., SSRIs), and psychological counseling, not surgical intervention. *Erectile dysfunction* - **Erectile dysfunction** is the inability to achieve or maintain an erection firm enough for satisfactory sexual intercourse. - Treatments range from lifestyle changes and oral medications (e.g., PDE5 inhibitors) to vacuum devices, penile injections, and in some cases, penile implants, but not sex reassignment surgery. *Orgasmic dysfunction* - This condition refers to persistent or recurrent delay in, or absence of, orgasm following a normal phase of sexual excitement. - Management often involves psychological counseling, addressing underlying medical conditions, or adjusting medications; it does not involve sex reassignment surgery.

Question 475: What is an illusion?

A. Perception without stimuli
B. Abnormal perception by a sensory misinterpretation of actual stimulus (Correct Answer)
C. Fear of closed spaces
D. A false unshaken belief not keeping one's sociocultural background

Explanation: ***Abnormal perception by a sensory misinterpretation of actual stimulus*** - An **illusion** involves the misinterpretation of an **actual external stimulus**, where the perception of that stimulus is distorted. - This means an object or event is present, but it is perceived incorrectly, for example, mistaking a shadow for an animal. *Perception without stimuli* - This describes a **hallucination**, which is a perception in the absence of an external stimulus, such as hearing voices when no one is speaking. - Hallucinations are fundamentally different from illusions because they do not rely on an existing sensory input to be misperceived. *Fear of closed spaces* - This refers to **claustrophobia**, which is a specific phobia characterized by an intense and irrational fear of confined spaces. - Claustrophobia is an anxiety disorder, not a type of perceptual disturbance. *A false unshaken belief not keeping one's sociocultural background* - This defines a **delusion**, which is a fixed, false belief that is not amenable to change in light of conflicting evidence and is not in line with an individual's cultural or religious background. - Delusions are disorders of thought content, whereas illusions are disorders of perception.

Question 476: Which condition is characterized by ejaculation that occurs sooner than desired, typically within one minute of vaginal penetration, and causes distress to the individual or partner?

A. Erectile dysfunction
B. Premature ejaculation (Correct Answer)
C. Retrograde ejaculation
D. Antegrade ejaculation

Explanation: ***Premature ejaculation*** - It is defined by ejaculation that **occurs sooner than desired**, typically within **one minute of vaginal penetration**, and causes significant distress. - This condition can be lifelong or acquired, and often impacts **sexual satisfaction** and **relationship quality**. *Erectile dysfunction* - This condition involves the **inability to achieve or maintain an erection** firm enough for satisfactory sexual intercourse. - While both can affect sexual function, **erectile dysfunction** is about erection quality, not the timing of ejaculation. *Retrograde ejaculation* - This occurs when semen, instead of exiting the penis, **travels backward into the bladder** during orgasm. - It results in a **"dry" orgasm** or very little semen expelled, but does not primarily relate to the timing of ejaculation. *Antegrade ejaculation* - This term describes **normal ejaculation**, where semen is expelled forward through the urethra and out of the penis. - It is the **physiological opposite** of retrograde ejaculation and does not describe a dysfunctional timing of ejaculation.

Question 477: Loosening of association is an example of

A. Concrete thinking
B. Formal thought disorder (Correct Answer)
C. Schneider's first symptoms
D. Perseveration

Explanation: ***Formal thought disorder*** - **Loosening of association** is a classic symptom of **formal thought disorder**, where thoughts become disconnected, fragmented, or illogical. - It reflects a disturbance in the **structure and flow of thought**, leading to disorganized speech. *Schneider's first symptoms* - **Schneider's first-rank symptoms** are specific psychotic experiences (e.g., thought insertion, auditory hallucinations commenting on actions) that are highly suggestive of schizophrenia but do not include loosening of association as a primary symptom. - While sometimes seen in schizophrenia, loosening of association is a broader concept of thought disorganization rather than a first-rank symptom itself. *Perseveration* - **Perseveration** involves the **inappropriate repetition of words, phrases, or ideas**, even when the topic has changed. - While a form of thought disorder, it is distinct from the general disconnectedness seen in loosening of association. *Concrete thinking* - **Concrete thinking** is the **inability to comprehend abstract concepts or metaphors**, interpreting them literally. - This is a disorder of **thought content or style**, but not directly related to the disorganized flow of thought characterized by loosening of association.

Question 478: What is the IQ range associated with borderline intellectual functioning?

A. 0 - 20
B. 70 - 80 (Correct Answer)
C. 50 - 69
D. 20 - 49

Explanation: ***70 - 80*** - The IQ range of **70-80** (or sometimes 70-85, depending on the classification system) is typically defined as **borderline intellectual functioning**. - Individuals in this range may have some difficulties with **adaptive skills** and academic performance, but they do not meet the criteria for intellectual disability. *50 - 69* - An IQ range of **50-69** is generally classified as **mild intellectual disability**. - Individuals in this range often require significant support to achieve academic and occupational independence. *20 - 49* - An IQ range of **20-49** is categorized as **moderate intellectual disability**. - People in this range typically need substantial support in daily living activities and adaptive functioning. *0 - 20* - An IQ range of **0-20** (or sometimes 0-19) indicates **severe or profound intellectual disability**. - Individuals with IQs in this range require full-time care and supervision due to significant impairments in adaptive functioning.

Question 479: According to Wechsler intelligence scale scoring, what is the average IQ of a normal child?

A. 100 (Correct Answer)
B. 50
C. 75
D. 111

Explanation: ***100*** - The **Wechsler intelligence scales** are designed with a mean (average) IQ score of **100** for the general population. - This represents the average cognitive ability, with a standard deviation of 15 points. *50* - An IQ score of **50** on the Wechsler scales falls within the range typically indicative of **intellectual disability**. - This score is significantly below the average and suggests substantial cognitive impairment. *75* - An IQ score of **75** is generally considered to be in the **borderline range** of intellectual functioning. - While not typical for intellectual disability, it is still below the average range. *111* - An IQ score of **111** is above the average score of **100** but is not the defining average itself. - This score falls within the **high average** or **bright normal** range of intellectual functioning.

Question 480: Which term describes the sexual gratification obtained from enemas?

A. Exhibitionism
B. Frotteurism
C. Klismaphilia (Correct Answer)
D. Fetishism

Explanation: ***Klismaphilia*** - This term specifically refers to a **paraphilia** where an individual experiences **sexual arousal or gratification from enemas**. - It involves the use of enemas for purposes beyond their medical indication, for sexual pleasure. *Exhibitionism* - This paraphilia involves experiencing **sexual arousal from exposing one's genitals to an unsuspecting stranger**. - The gratification comes from the shock or surprise of the observer, not from enemas. *Fetishism* - This involves **sexual attraction to inanimate objects or non-genital body parts**. - While it could theoretically involve objects used for enemas, "klismaphilia" specifically describes the act with enemas. *Frotteurism* - This paraphilia is characterized by **sexual gratification from rubbing against or touching a nonconsenting person** in crowded public places. - It does not involve enemas and is instead focused on physical contact without consent.

Practice by Chapter

Clinical Interview Techniques

Practice Questions

Mental Status Examination

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Diagnostic Formulation

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Rating Scales and Questionnaires

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Psychological Testing

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Neuropsychological Assessment

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Risk Assessment

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Laboratory Investigations in Psychiatry

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Neuroimaging in Clinical Assessment

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Cultural Considerations in Assessment

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Developmental Assessment

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Diagnostic Classification Systems

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