Psychotic Disorders Practice Questions

Q: Waxy flexibility is a feature of ?

Catatonia. ***Catatonia*** - **Waxy flexibility** (or catalepsy) is a classic symptom of **catatonia**, where an individual's limbs can be **placed in any position by the examiner and remain in that position for an extended period**, as if molded from wax. - It reflects a severe psychomotor disturbance, often seen in conditions like **schizophrenia** or **mood disorders** with catatonic features. *Echolalia* - **Echolalia** refers to the **involuntary repetition of another person's spoken words**, typically without understanding. - It is a symptom of thought disorder or communication difficulties, not a state of motor rigidity. *Stereotypy* - **Stereotypy** involves **repetitive, seemingly purposeless movements or utterances** (e.g., body rocking, hand flapping). - While repetitive, it does not involve maintaining a fixed posture imposed by another, as seen in waxy flexibility. *Mannerisms* - **Mannerisms** are **habitual, idiosyncratic gestures or behaviors** that may appear odd but are often voluntary and goal-directed (e.g., an exaggerated bow before speaking). - They are distinct from the involuntary, often rigid, posturing characteristic of waxy flexibility.

Q: Visual hallucinations are typically seen in all of the following conditions except?

Depression. **Depression** - While other forms of hallucinations can occur in severe depression with psychotic features (e.g., auditory), **visual hallucinations are rare**. - **Mood-congruent delusions** are more common in psychotic depression than visual hallucinations. *Delirium* - **Visual hallucinations** are a hallmark symptom of delirium, often described as polymorphic and vivid. - They are typically accompanied by **fluctuating consciousness** and cognitive impairment. *Schizophrenia* - Although **auditory hallucinations** are more common, visual hallucinations can occur in schizophrenia, particularly in advanced or severe cases. - These hallucinations are often well-formed, frequent, and can be **persecutory** or **bizarre** in nature. *Alcohol withdrawal* - **Alcohol withdrawal delirium** (delirium tremens) is characterized by prominent **visual hallucinations**, tactile hallucinations, and autonomic instability. - These hallucinations can be terrifying and are due to **CNS hyperexcitability**.

Q: Which of the following is the most common type of delusional misidentification syndrome?

Capgras. **Capgras** - **Capgras delusion** is a misidentification syndrome where an individual believes that a familiar person (e.g., a spouse, child, or parent) has been replaced by an identical imposter. - This delusion is often seen in psychiatric disorders like **schizophrenia** and neurological conditions such as **dementia**. *Fregoli* - **Fregoli delusion** involves the belief that different people are in fact a single person in disguise, who changes their appearance. - Unlike Capgras, where a familiar person is replaced, Fregoli focuses on the idea of a single persecutor or familiar individual appearing in various forms. *Cotard* - **Cotard delusion** is a rare mental illness in which the affected person holds the delusional belief that they are dead, do not exist, are rotting, or have lost their internal organs. - It does not involve the misidentification of other people but rather a nihilistic belief about one's own existence or body. *Subjective double* - The term "subjective double" is not a recognized classic delusion of misidentification in psychiatric diagnostic systems. - While concepts of "doubles" exist in various delusional states, this specific phrasing does not refer to a distinct, widely defined misidentification syndrome in the same way as Capgras or Fregoli.

Q: Which of the following statements is NOT true about type 1 schizophrenia?

It has a poor prognosis.. ***It has a poor prognosis.*** - This statement is **NOT true** about type 1 schizophrenia, making it the correct answer to this question. - Type 1 schizophrenia is generally associated with a **better prognosis** and good response to antipsychotic medication. - It is characterized by the prominence of **positive symptoms**, which tend to be more responsive to treatment. *It is an acute illness.* - This statement is **TRUE** about type 1 schizophrenia, so it is not the answer. - Type 1 schizophrenia is often characterized by an **acute onset** of symptoms, particularly positive symptoms. - This acute presentation differentiates it from type 2, which typically has a more insidious onset. *Intellect is usually maintained.* - This statement is **TRUE** about type 1 schizophrenia, so it is not the answer. - In type 1 schizophrenia, **cognitive function**, including intellect, is usually better preserved compared to type 2 schizophrenia. - While some cognitive deficits may occur, they are generally less severe and less pervasive than in type 2. *It is characterized by negative symptoms.* - This statement is **FALSE** about type 1 schizophrenia, but it is not the best answer because the prognosis statement is more definitively incorrect. - Type 1 schizophrenia is primarily characterized by the predominance of **positive symptoms**, such as hallucinations, delusions, and disorganized thought. - **Negative symptoms** (e.g., apathy, anhedonia, alogia, blunted affect) are the hallmark of type 2 schizophrenia.

Q: Which of the following is NOT considered one of Bleuler's fundamental symptoms of schizophrenia?

Delusions. ***Delusions*** - **Delusions** are considered a **first-rank symptom** of schizophrenia according to Schneider, but not one of Bleuler's fundamental "4 A's". - Bleuler classified delusions as **accessory symptoms**, which are variable and not always present, unlike fundamental symptoms. *Loosening of associations* - This is one of Bleuler's **"4 A's"**, representing a disturbance in the logical flow of thought, leading to incoherent speech and fractured thinking. - Bleuler saw this as a core cognitive dysfunction in schizophrenia. *Affect disturbances* - This refers to **inappropriate affect** (e.g., laughing at a funeral) or **blunted/flattened affect**, which is another of Bleuler's "4 A's." - It signifies a disruption in the normal experience and expression of emotions. *Autism* - Bleuler's term **"autism"** (or autismus) refers to a pathological self-preoccupation, withdrawal from social interaction, and an immersion in one's own internal world. - This is also one of Bleuler's **"4 A's"**, highlighting a foundational disturbance in social engagement.

Q: What is the medical term for the phenomenon where an individual perceives a double or duplicate of themselves?

Autoscopy. ***Autoscopy*** - **Autoscopy** is a dissociative phenomenon where an individual perceives a vision of their own body projected outside themselves. - It often involves the sensation of seeing a **double** or **duplicate** of oneself from a different spatial perspective. *Capgras syndrome* - **Capgras syndrome** is a delusional misidentification syndrome where a person believes that a close relative or friend has been replaced by an identical impostor. - It does not involve seeing oneself, but rather perceiving others as duplicates or impostors. *Fregoli delusion* - The **Fregoli delusion** is a rare delusional misidentification syndrome in which the affected person believes that different people are in fact a single person in disguise, shifting appearance or identity. - This involves seeing other people as disguised versions of a known individual, not seeing a double of oneself. *Cotard delusion* - **Cotard delusion** (also known as walking corpse syndrome) is a rare mental illness in which the affected person holds the delusional belief that they are dead, do not exist, are putrefying, or have lost their blood or internal organs. - This delusion specifically involves beliefs about one's own non-existence or loss of bodily parts, rather than seeing a double of oneself.

Q: Which of the following is not a feature of psychosis?

Preserved contact with reality. ***Preserved contact with reality*** - Psychosis is fundamentally characterized by a **loss of contact with reality**, making this option a defining non-feature of the condition. - Individuals experiencing psychosis often have profound difficulties distinguishing between what is real and what is not. *Loss of insight* - **Lack of insight** into one's own mental illness is a hallmark feature of psychosis, meaning the affected individual may not recognize their thoughts or perceptions as abnormal. - This symptom contributes to the difficulty in engaging individuals with psychosis in treatment. *Presence of delusions* - **Delusions** are fixed, false beliefs that are resistant to reason or evidence, and they are a core positive symptom of psychosis. - These beliefs are often bizarre and can significantly impair an individual's functioning and perception of reality. *Personality disturbances* - While not a primary diagnostic criterion, **personality disturbances** can be associated with psychotic disorders. - Changes in personality, mood, and behavior may occur as a result of the psychotic experience or the underlying illness.

Q: The delusion that involves the belief that a familiar person has been replaced by someone else is known as?

Capgras syndrome. ***Capgras syndrome*** - This **delusional misidentification syndrome** is characterized by the belief that a familiar person (e.g., a spouse, child, or parent) has been replaced by an identical imposter. - It often occurs in individuals with **schizophrenia**, **dementia**, or following **brain injury**. *Cotard syndrome* - This syndrome involves a nihilistic delusion where the individual believes they are **dead**, do not exist, or have lost their organs or blood. - It is often associated with severe **depression**, psychosis, or neurological disorders. *Othello syndrome* - Also known as **delusional jealousy**, this involves the unfounded belief that one's partner is being unfaithful. - It is a **primary delusional disorder** but can also be seen in conditions like alcohol dependence or neurodegenerative diseases. *Fregoli syndrome* - This is another **delusional misidentification syndrome** where the person believes that different people are actually the same person in disguise. - It is the opposite of Capgras syndrome and may occur in **schizophrenia** or **organic brain disorders**.

Q: Which type of delusion is primarily associated with Cotard's syndrome?

Nihilistic delusions. ***Nihilistic delusions*** - **Cotard's syndrome** is characterized by beliefs of **non-existence**, such as the patient being dead, not existing, or having lost their organs, which are typical of **nihilistic delusions**. - These delusions can also extend to the belief that the world or parts of it no longer exist. *Persecutory delusions* - These involve the belief that one is being **harassed, tricked, spied upon, or conspired against**, which is not the primary feature of Cotard's syndrome. - While they can co-occur with other psychiatric conditions, **persecutory themes** are distinct from the non-existence themes of Cotard's. *Religious delusions* - These delusions focus on **religious or spiritual themes**, such as believing one is a prophet or has a special relationship with a deity. - They are not a core component of Cotard's syndrome, which centers on themes of **death and non-existence**. *Hypochondriacal delusions* - These involve a preoccupation with the belief that one has a **serious, undiagnosed medical condition**, despite medical reassurance. - While Cotard's syndrome can involve bodily concerns, the belief in **non-existence of organs** or death goes beyond typical hypochondriacal fears of illness.

Q: In stupor catatonia, all are seen except -

Agitation. ***Agitation*** - **Stuporous catatonia** is characterized by a significant reduction or absence of motor activity and responsiveness, making **agitation**—increased motor activity—an unlikely feature. - In such a state, the patient is typically rigid, immobile, and unresponsive to external stimuli, which is the antithesis of agitation. *Catalepsy* - **Catalepsy** refers to a trance-like state with a loss of voluntary motion and active posturing, where the limbs maintain any position in which they are placed (waxy flexibility). - This is a hallmark feature of **catatonic stupor**, indicating a profound disturbance in motor control. *Mutism* - **Mutism** is the absence or profound reduction of speech, which is a common and defining feature of **catatonic stupor**. - Patients in a stuporous state typically do not speak or respond verbally to questions or commands. *Akinesia* - **Akinesia** is the absence of movement, or pronounced difficulty in initiating voluntary movements, which is a key component of **catatonic stupor**. - Patients exhibit severe motor retardation, often appearing frozen or rigid.

Question 1

Waxy flexibility is a feature of ?

Accepted Answer

Catatonia

Answer

Echolalia

Answer

Stereotypy

Answer

Mannerisms

Question 2

Visual hallucinations are typically seen in all of the following conditions except?

Accepted Answer

Depression

Answer

Schizophrenia

Answer

Alcohol withdrawal

Answer

Delirium

Question 3

Which of the following is the most common type of delusional misidentification syndrome?

Accepted Answer

Capgras

Answer

Fregoli

Answer

Cotard

Answer

Subjective double

Question 4

Which of the following statements is NOT true about type 1 schizophrenia?

Accepted Answer

It has a poor prognosis.

Answer

Intellect is usually maintained.

Answer

It is an acute illness.

Answer

It is characterized by negative symptoms.

Question 5

Which of the following is NOT considered one of Bleuler's fundamental symptoms of schizophrenia?

Accepted Answer

Delusions

Answer

Loosening of associations

Answer

Affect disturbances

Answer

Autism

Question 6

What is the medical term for the phenomenon where an individual perceives a double or duplicate of themselves?

Accepted Answer

Autoscopy

Answer

Capgras syndrome

Answer

Fregoli delusion

Answer

Cotard delusion

Question 7

Which of the following is not a feature of psychosis?

Accepted Answer

Preserved contact with reality

Answer

Loss of insight

Answer

Personality disturbances

Answer

Presence of delusions

Question 8

The delusion that involves the belief that a familiar person has been replaced by someone else is known as?

Accepted Answer

Capgras syndrome

Answer

Cotard syndrome

Answer

Othello syndrome

Answer

Fregoli syndrome

Question 9

Which type of delusion is primarily associated with Cotard's syndrome?

Accepted Answer

Nihilistic delusions

Answer

Persecutory delusions

Answer

Religious delusions

Answer

Hypochondriacal delusions

Question 10

In stupor catatonia, all are seen except -

Accepted Answer

Agitation

Answer

Mutism

Answer

Akinesia

Answer

Catalepsy

Psychotic Disorders — MCQs

Psychotic Disorders — MCQs

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