MENTAL STATUS EXAMINATION

MENTAL STATUS EXAMINATION

Q. 1

Loosening of association is an example of which of the following thought pathology?

 A

Perseveration

 B

Concrete thinking

 C

Formal thought disorder

 D

Schneiderian first rank symptoms

Q. 1

Loosening of association is an example of which of the following thought pathology?

 A

Perseveration

 B

Concrete thinking

 C

Formal thought disorder

 D

Schneiderian first rank symptoms

Ans. C

Explanation:

Loosening of associations is an example of formal thought disorder, which is a disturbance in the form of thought rather than content of thought. It is a characteristic feature of schizophrenia.

Loosening of association refers to lack of connection between the ideas expressed by the patient. The links between ideas may be illogical or they wander from the original theme. In its extreme form, loosening of association leads to totally incoherent thought and speech (word salad).

Ref: Psychiatry By John Geddes, 4th edition page 248; Kaplan & Sadock’s Comprehensive Textbook of Psychiatry, 9th edition page 924; Psychopathology: History, Diagnosis, and Empirical Foundations By W. Edward Craighead, 2nd edition page 406.


Q. 2

All of the following are thought disorders, EXCEPT:

 A

Paranoia

 B

OCD

 C

Delusion

 D

Visual Hallucination

Q. 2

All of the following are thought disorders, EXCEPT:

 A

Paranoia

 B

OCD

 C

Delusion

 D

Visual Hallucination

Ans. D

Explanation:

Thought disorders can be of 2 types:

a) Disorders of thought form or stream e.g. Thought block, formal thought disorder in Schizophrenia, disorganised thinking, derailment in thinking etc
b) Disorders of thought content e.g. Delusions, obsessions and compulsions etc

Hallucinations are not thought disorders. They are perceptual abnormalities. Hallucinations can however lead to secondary delusions. 


Q. 3

Which one of the following can be seen in Othello syndrome?

 A

Delusion of persecution

 B

Delusion of Grandeur

 C

Delusion of Infidelity

 D

Delusion of Doubles

Q. 3

Which one of the following can be seen in Othello syndrome?

 A

Delusion of persecution

 B

Delusion of Grandeur

 C

Delusion of Infidelity

 D

Delusion of Doubles

Ans. C

Explanation:

Othello Syndrome or Delusional jealousy is a psychiatric disorder in which a person holds a strong delusional belief that their spouse or sexual partner is being unfaithful without having any, very little, or insignificant proof to back up their claim.

People who suffer from this disorder have a strong association with stalking, cyberstalking, sabotage, or even violence.

It can be found in the context of schizophrenia and delusional disorder, such as bipolar disorder, but is also associated with alcoholism and sexual dysfunction and after neurological illness.

Quiz In Between


Q. 4

Alexithymia is :

 A

A feeling of intense rapture

 B

Pathological sadness

 C

Affective flattening

 D

Inability to recognise and describe feelings

Q. 4

Alexithymia is :

 A

A feeling of intense rapture

 B

Pathological sadness

 C

Affective flattening

 D

Inability to recognise and describe feelings

Ans. D

Explanation:

D. i.e. Inability to recognize & describe feelings 

Alexithymia is inability or disability in describing or being aware of one’s emotions or moodQ. It is seen in elaboration of fantasies associated with depression, substance abuse, and post traumatic stress disorder.


Q. 5

Hallucinations which occur at the ‘start’ of sleep is :

 A

Hypnagogic hallucinations

 B

Hypnopompic hallucinations

 C

Jactatio nocturna capitis

 D

Non – specific hallucination

Q. 5

Hallucinations which occur at the ‘start’ of sleep is :

 A

Hypnagogic hallucinations

 B

Hypnopompic hallucinations

 C

Jactatio nocturna capitis

 D

Non – specific hallucination

Ans. A

Explanation:

A. i.e. Hypnagogic hallucinations


Q. 6

All are examples of form of thought disorder except

 A

Obsessive compulsive Neurosis

 B

Delusion

 C

Schizophrenia

 D

Loosening of association

Q. 6

All are examples of form of thought disorder except

 A

Obsessive compulsive Neurosis

 B

Delusion

 C

Schizophrenia

 D

Loosening of association

Ans. B

Explanation:

B. i.e. Delusion

Quiz In Between


Q. 7

True about thought is A/E

 A

Perseveration is out of context repetition

 B

Circumstantiality is over inclusion of irrelevant details eventually getting back to original point.

 C

Verbigeration is senseless repetition

 D

Vorbiereden is skirting around end point but never reaching it.

Q. 7

True about thought is A/E

 A

Perseveration is out of context repetition

 B

Circumstantiality is over inclusion of irrelevant details eventually getting back to original point.

 C

Verbigeration is senseless repetition

 D

Vorbiereden is skirting around end point but never reaching it.

Ans. D

Explanation:

D . i.e. Loosening of association is logically connected loss of goal directedness


Q. 8

Not a disorder of form of thought is: 

 A

Tangentiality

 B

Derailment

 C

Thought Block

 D

Loosening of association

Q. 8

Not a disorder of form of thought is: 

 A

Tangentiality

 B

Derailment

 C

Thought Block

 D

Loosening of association

Ans. C

Explanation:

C i.e. Thought Block

Formal thought disorder typically refer to marked abnormalities in the form & flow of or connectiity of thought; some clinicians use the term broadly to include any psychotic cognitive sign or symptoms. So broadly speaking all can be included in formal thought disorder but in tangentiality, loosening of association and derailment the form of thought is more disordered than thought blockQ. (Kaplan’s & CDTP)

In formal thought disorder, the structure or form of thought is disordered. It includes perseveration, flight of ideas (clang association, puns, rhymes), loosening of associations, derailmentQ, vorbeireden, verbigeration (word salad) (Oxford); tangentialityQ, transitory thinking, substitution, omission, drivelling, desultory thinking, neologism, poverty of speech and poverty of content (Fish). Whereas thought block is mainly a disorder of flow/stream of thoughtQ.


Q. 9

The content of thought in delusional paranomia is:

 A

Erotic

 B

Infedelity

 C

Love

 D

Foul odour

Q. 9

The content of thought in delusional paranomia is:

 A

Erotic

 B

Infedelity

 C

Love

 D

Foul odour

Ans. D

Explanation:

D i.e. Foul odour

Quiz In Between


Q. 10

Infedelity & jealousy involving spouse is the thought content of which disorder:

 A

Capgras syndrome

 B

Othello syndrome

 C

Hypochondrial paranomia

 D

Declerambault’s syndrome

Q. 10

Infedelity & jealousy involving spouse is the thought content of which disorder:

 A

Capgras syndrome

 B

Othello syndrome

 C

Hypochondrial paranomia

 D

Declerambault’s syndrome

Ans. B

Explanation:

B i.e. Othello syndrome

It is characterized by nonbizzare delusion of atleast one month durationQ with overall well preserved personality (except in the area of delusion) and absence of significant hallucinations. 


Q. 11

Illusion with altered sensorium is seen in

 A

Schizophrenia

 B

Hysteria

 C

MDP

 D

Delirium

Q. 11

Illusion with altered sensorium is seen in

 A

Schizophrenia

 B

Hysteria

 C

MDP

 D

Delirium

Ans. D

Explanation:

D i.e. Delirium


Q. 12

All of the following are formal thought disorder EXCEPT:           

March 2013 (b, c, h)

 A

Schizophrenia

 B

Delusion

 C

Loosening of association

 D

Mania

Q. 12

All of the following are formal thought disorder EXCEPT:           

March 2013 (b, c, h)

 A

Schizophrenia

 B

Delusion

 C

Loosening of association

 D

Mania

Ans. B

Explanation:

Ans. B i.e. Delusion

Delusion is a disorder of thought content (NOT a formal thought disorder/disorder of thought process)

Delusion

  • Disorder of thought;
  • False unshaken belief not amenable to reasoning

Hallucination

  • Disorder of perception;
  • Perception in the absence of external stimuli;
  • Not dependent of will of observer

Illusion

  • Misinterpretation of external stimuli

Quiz In Between


Q. 13

Illusion is:             

September 2007

 A

A false unshaken belief not keeping one’s sociao­cultural background

 B

Perception without stimuli

 C

Abnormal perception by a sensory misinterpretation of actual stimulus

 D

Fear of closed spaces

Q. 13

Illusion is:             

September 2007

 A

A false unshaken belief not keeping one’s sociao­cultural background

 B

Perception without stimuli

 C

Abnormal perception by a sensory misinterpretation of actual stimulus

 D

Fear of closed spaces

Ans. C

Explanation:

Ans. C: Abnormal perception by a sensory misinterpretation of actual stimulus

Illusion is an abnormal perception caused by a sensory misinterpretation of actual stimulus, sometimes precipitated by strong emotion, e.g. fear provoking a person to imagine they have seen an intruder in the shadows.


Q. 14

Illusion is:        

AIIMS 07

 A

Misinterpretation of real objects

 B

False firm belief

 C

Absence of sensory stimulus

 D

Hearing of voices

Q. 14

Illusion is:        

AIIMS 07

 A

Misinterpretation of real objects

 B

False firm belief

 C

Absence of sensory stimulus

 D

Hearing of voices

Ans. A

Explanation:

Ans. Misinterpretation of real objects


Q. 15

Cotard’s syndrome has ‑

 A

Persecutory delusions

 B

Religious delusions

 C

Nihilistic delusions

 D

Hypochondrical delusions

Q. 15

Cotard’s syndrome has ‑

 A

Persecutory delusions

 B

Religious delusions

 C

Nihilistic delusions

 D

Hypochondrical delusions

Ans. C

Explanation:

Ans. is ‘c’ i.e., Nihilistic delusions

Types of delsions

  • Based on the contents of delusions, they are divided into :-
  1. Persecutory delusions (paranoid) : – The patient feels that he is being persecuted against. There is false belief that one is being harmed, threatened, cheated, poisoned, harassed or spied on or is a victim of conspiracy to damage his reputation. The supposed persecutor of the patient may be people in the environment (e.g., members of family, neighbours, former friend) or may be political or religious groups. These delusions occur in schizophrenia (especially paranoid), severe affective disorders (sever mania or severe depression), and organic brain syndrome. This is the most common type of delusion. Delusion of persecution may occur in the context of primary delusional experiences, auditory hallucinations, bodily hallucinations or experiences of passivity.
  2. Grandiose delusion (expansive delusions) : – False belief that one is exceptionally powerful, talented or important. These delusions seen most commonly in mania, However, can also occur in schizophrenia and organic states.
  3. Delusions of reference : – False belief that certain objects, people or events have intense personal significance and refer specifically to one self, e.g., believing that a television news reader is talking directly about oneself, or people walking on the road are talking about him. These delusions are seen in schizophrenia, mania and organic states.
  4. Religious delusions : – False belief pertaining to a religious theme, often grandiose in nature, e.g., believing that one is a special messenger from God. These delusions are seen in schizophrenia.
  5. Delusions of love (erotomania) : – False belief that another person is in love with one (commoner in woman). In one form, termed de clerambault sydrome, a woman (usually) believes that a man, frequently older and of higher status, is in love with her.
  6. Delusion of infidility (morbid jealousy, othello syndrome :- False belief that one’s lover has been unfaithful. These are seen in schizophrenia, alcohol related psychosis, organic states.
  7.  Delusion of misidentification : – a) Capgras syndrome (Delusion of double) : – Belief that a familiar person has been replaced by an exact double i.e. an impostor. b) Fregoli syndrome : – Belief that a complete stranger is actually a familiar person already known to one.
  8. Delusion of self accusation or guilt : – False feeling of remorse of guilt. It occur in Depression.
  9. Nihilistic delusions : – False belief that oneself, others or the world is non-existent or about to end. There are pessimistic ideas that the patient’s career is finished, he is about to die, world is doomed. These occurs in severe depression. If nihilistic delusions are accompanied by ideas concerning bodily function failure, e.g., putrefaction of intestines, etc., the syndrome is called COTARD’s SYNDROME.
  10. Hypochondriacal delusions : – False belief about one’s health, patient wrongly believes that he has severe medical illness, contrary to the all medical evidences. It is seen in depression.
  11. Delusion of infestations : – False belief that one is infested with small but visible organisms. As a monosymptomatic delusional disorder this is called EKBOM SYNDROME. It is seen in acute confusional state (due to drugs or alcohol withdrawal), in schizophrenia, in dementing illness, and as delusional eloboration of tactile hallucinatory experiences (secondary to formication).
  12. Delusion of control : – Belief that his actions, impulses or thoughts are controlled by an outside agency and accordingly called as made action, made impulse or made affect. Also called somatic passivity experiences (passivity phenomenon). Commonly seen in schizophrenia.
  13. Delusions concerning possession of thoughts – Patients with delusions about possession of thoughts may lose the conviction that their thoughts are their own. Most commonly seen in schizophrenia.
  • Delusions of thought insertion – thoughts have been implanted by an outside agency.
  • Delusions of thought withdrawal – thoughts are being taken out of their mind. This is usually accompanied by “thought block”.
  • Delusions of thought broadcast – unspoken thoughts are known to other people through radio, telepathy or in some other way.

Quiz In Between


Q. 16

Repetitive irresesistable thought to do something

 A

Phobia

 B

Obsession

 C

Compulsion

 D

Anxiety

Q. 16

Repetitive irresesistable thought to do something

 A

Phobia

 B

Obsession

 C

Compulsion

 D

Anxiety

Ans. B

Explanation:

Ans. is ‘b’ i.e., Obsession

Obsessive compulsive disorder (OCD)

  • OCD is an anxiety disorder which is characterized by recurrent, unwanted thoughts (Obsessions) and repettive behaviors (compulsions).
  • An obsession has following characteristic : –
  1. An idea, impulse or image which intrudes into the conscious awareness repeatedly.
  2. It is recognized as one’s own ideas, impulse or image but is perceived as egoalien (foreign to one’s personality).
  3. It is recognized as irrational and absurd (insight is present –4 Patient knows about disorder).
  4. Patient tries to resist against it but is unable to do so which leads to marked distress or anxiety.
  • A compulsion has following characteristics :-
  1. It is repetitive, purposeful form of behavior is carried out because of strong feeling of compulsion to do so.
  2. It usually follows an obsession.
  3. ts goal is to prevent or reduce the anxiety or stress caused by obsession however it do not always succeed in doing so.
  4. It is irrational or excessive and not realistic.
  5. Insight is present.
  • A patient with OCD may have an obsession, a compulsion or both (mostly patients have both).
  • A patient with OCD realizes the irrationality of the obsession and experiences both the obsession and the compulsion as ego-dystonic (unwanted behavior).
  • The person is preoccupied with details rules, list order, organisation or schedules to the extent that the major point of activity is lost.
  • The person shows perfectionism that interfers with task completion (e.g., unable to complete project because his own overtly strict standard are not met).

Q. 17

Neologism is characteristic of :

 A

OCD

 B

Mania

 C

Bipolar disorder

 D

Schizophrenia

Q. 17

Neologism is characteristic of :

 A

OCD

 B

Mania

 C

Bipolar disorder

 D

Schizophrenia

Ans. D

Explanation:

Ans. D. Schizophrenia

Neologisms:

  • Refers to a new word or condensed combination of several words that is not a true word & is not readily understandable, although sometimes the intended meaning or partial meaning may be apparent.
  • Feature of schizophrenia(thought & speech disorder)

Quiz In Between



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