Psychiatry
10 questionsWhat is considered the most effective treatment for Borderline Personality Disorder?
Which personality disorder is commonly associated with bipolar disorder?
Which of the following is a characteristic of borderline personality disorder?
Which personality disorder is characterized by suspiciousness?
Which of the following is not a characteristic feature of personality disorders?
Which of the following symptoms is NOT included in the diagnostic criteria for DSM-IV-TR somatization disorder?
Astasia-abasia is associated with which of the following conditions?
A student unable to deliver speech before an audience is suffering from?
What is the drug of choice for treating generalized anxiety disorder?
Which of the following disorders is classified under somatic symptom and related disorders in the DSM-5?
NEET-PG 2013 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1201: What is considered the most effective treatment for Borderline Personality Disorder?
- A. Combination of DBT and pharmacotherapy
- B. Cognitive Behavioural Therapy (CBT)
- C. Pharmacotherapy alone
- D. Dialectical Behaviour Therapy (DBT) (Correct Answer)
Explanation: ***Dialectical Behaviour Therapy (DBT)*** - **DBT** is the **gold standard** and most evidence-based psychotherapy specifically developed for Borderline Personality Disorder - Developed by **Marsha Linehan** specifically to target the core symptoms of BPD including emotional dysregulation, impulsivity, and interpersonal difficulties - Combines **cognitive-behavioral techniques** with mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills - Has the **strongest research evidence** for reducing suicidal behavior, self-harm, and improving overall functioning in BPD patients - Multiple RCTs demonstrate DBT's superiority in treating BPD compared to standard care *Cognitive Behavioural Therapy (CBT)* - While **CBT** is effective for many mental health conditions and can help with certain BPD symptoms, it was not specifically designed for BPD - DBT is actually a specialized adaptation of CBT tailored for BPD, making it more targeted and effective for this specific condition - Generic CBT may help with co-occurring conditions like depression or anxiety but lacks the comprehensive approach needed for core BPD features *Combination of DBT and pharmacotherapy* - This combination is clinically useful, especially when treating **co-morbid conditions** like depression, anxiety, or severe mood instability - However, psychotherapy (particularly DBT) remains the **cornerstone** of BPD treatment, with medications serving an adjunctive role - The question asks for the single most effective treatment, which is DBT alone *Pharmacotherapy alone* - **No medication** is FDA-approved specifically for BPD - Pharmacotherapy may help manage specific symptoms (mood swings, impulsivity, brief psychotic episodes) but does not address the core **personality pathology** - Generally not recommended as monotherapy for BPD; should always be combined with psychotherapy
Question 1202: Which personality disorder is commonly associated with bipolar disorder?
- A. Narcissistic Personality Disorder
- B. Borderline Personality Disorder (Correct Answer)
- C. Obsessive-Compulsive Personality Disorder
- D. Antisocial Personality Disorder
Explanation: ***Borderline Personality Disorder*** - **Borderline Personality Disorder (BPD)** and **bipolar disorder** share overlapping symptoms such as mood instability, impulsivity, and relational difficulties. - Due to these shared features, there is a high comorbidity rate, and distinguishing between the two can be challenging, often requiring careful assessment of symptom origins and patterns. *Obsessive-Compulsive Personality Disorder* - **Obsessive-Compulsive Personality Disorder (OCPD)** is characterized by a preoccupation with orderliness, perfectionism, and control. - While an individual can have both, OCPD does not typically share the prominent **mood instability** or **impulsivity** that are core to bipolar disorder. *Narcissistic Personality Disorder* - **Narcissistic Personality Disorder (NPD)** involves a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy, often presenting with inflated self-esteem or sense of superiority. - While **grandiosity** can be seen in manic phases of bipolar disorder, the chronic and pervasive nature of NPD, particularly the lack of empathy, differs from the episodic mood extremes of bipolar disorder. *Antisocial Personality Disorder* - **Antisocial Personality Disorder (ASPD)** is characterized by a disregard for and violation of the rights of others, often involving deception, impulsivity, and criminal behavior. - While **impulsivity** and **reckless behavior** can occur during manic episodes in bipolar disorder, ASPD's core features are a pervasive pattern of deceitfulness and lack of remorse, which are not primary symptoms of bipolar disorder.
Question 1203: Which of the following is a characteristic of borderline personality disorder?
- A. Unstable interpersonal relationship (Correct Answer)
- B. Grandiosity
- C. Low self esteem
- D. Excessive need for admiration
Explanation: ***Unstable interpersonal relationship*** - A core feature of **borderline personality disorder (BPD)** is a pattern of intense and unstable relationships, often characterized by idealization and devaluation. - Individuals with BPD struggle with a **fear of abandonment**, leading to desperate efforts to avoid real or imagined separation. *Excessive need for admiration* - This is a hallmark feature of **narcissistic personality disorder**, where individuals consistently seek praise and attention. - In BPD, the need is more focused on affirmation and avoiding abandonment rather than pure admiration. *Grandiosity* - **Grandiosity** is a defining characteristic of **narcissistic personality disorder**, involving an exaggerated sense of self-importance and superiority. - While individuals with BPD may have an unstable sense of self-worth, grandiosity is not a primary or consistent feature. *Low self esteem* - While individuals with BPD often experience **low self-esteem** and feelings of worthlessness, this is a symptom present in many mental health conditions and is not specific enough to characterize BPD alone. - The more defining features relate to **identity disturbance**, **affective instability**, and **impulsivity**.
Question 1204: Which personality disorder is characterized by suspiciousness?
- A. Paranoid personality disorder (Correct Answer)
- B. Schizoid personality disorder
- C. Anankastic personality disorder
- D. Schizotypal personality disorder
Explanation: ***Paranoid personality disorder*** - This disorder is fundamentally characterized by a pervasive **distrust and suspiciousness** of others' motives, interpreting them as malevolent. - Individuals with this disorder often believe others are exploiting, harming, or deceiving them, even without sufficient evidence. *Schizoid personality disorder* - Characterized by a pervasive pattern of **detachment from social relationships** and a restricted range of emotional expression in interpersonal settings. - Individuals with schizoid personality disorder typically show no interest in social interactions and exhibit **emotional coldness**, not suspiciousness. *Anankastic personality disorder* - This is another name for **Obsessive-Compulsive Personality Disorder (OCPD)**, which is characterized by a preoccupation with orderliness, perfectionism, and mental and interpersonal control. - Individuals with OCPD are concerned with rules, details, and schedules, often at the expense of flexibility and efficiency, and do not typically exhibit suspiciousness. *Schizotypal personality disorder* - Characterized by a pattern of acute discomfort with, and reduced capacity for, close relationships, as well as **cognitive or perceptual distortions** and eccentricities of behavior. - While they may exhibit odd beliefs or magical thinking, their primary feature is not suspiciousness but rather unique patterns of thought, perception, and behavior.
Question 1205: Which of the following is not a characteristic feature of personality disorders?
- A. Starts in childhood.
- B. Behavior is maladaptive.
- C. Disorder results in personal distress.
- D. Ego dystonic symptoms (Correct Answer)
Explanation: ***Ego dystonic symptoms*** - Personality disorders are characterized by **ego-syntonic** traits, meaning the individual perceives their thoughts, feelings, and behaviors as consistent with their self-image and acceptable. - **Ego-dystonic symptoms**, conversely, are experienced as alien, inconsistent with one's self-concept, and distressing (e.g., in OCD or major depressive disorder), which is **definitively NOT** a feature of personality disorders. - This is the key distinguishing feature: personality disorder traits are not perceived as problematic by the individual themselves (ego-syntonic), unlike neurotic disorders. *Starts in childhood.* - While personality traits and vulnerabilities may emerge in childhood, **formal diagnosis** of personality disorders is made in **late adolescence or early adulthood** (typically after age 18). - Per DSM-5 and ICD-11, the enduring pattern must be evident by early adulthood. - However, this option is less definitive as some underlying patterns do appear earlier, making "ego dystonic" the better answer. *Behavior is maladaptive.* - A **core diagnostic feature** of personality disorders is a pervasive pattern of **maladaptive behaviors** and inner experiences that deviate from cultural expectations. - These behaviors lead to distress, impairment in social, occupational, or other important areas of functioning. - This IS characteristic of personality disorders. *Disorder results in personal distress.* - Despite ego-syntonic symptoms, individuals with personality disorders frequently experience **significant personal distress**, often arising from consequences of their behaviors, interpersonal conflicts, or functional impairment. - This distress IS characteristic, though it may be indirect rather than from the symptoms themselves. - This IS a feature of personality disorders.
Question 1206: Which of the following symptoms is NOT included in the diagnostic criteria for DSM-IV-TR somatization disorder?
- A. Sexual symptom
- B. Pain symptom
- C. GI symptom
- D. Visual symptoms (Correct Answer)
Explanation: ***Visual symptoms*** - **Visual symptoms** is NOT a separate diagnostic category in DSM-IV-TR somatization disorder criteria. - While visual symptoms (such as **double vision** or **blindness**) ARE part of the diagnostic criteria, they fall under the **pseudoneurological symptom** category, not as a distinct standalone category. - The DSM-IV-TR required **one pseudoneurological symptom** (which could include visual, motor, sensory symptoms, or seizures), but did not list "visual symptoms" as one of the four main symptom categories. *Sexual symptom* - The DSM-IV-TR diagnostic criteria for somatization disorder explicitly included **sexual symptoms** as one of the four main categories. - At least **one sexual symptom** was required (such as sexual indifference, erectile dysfunction, irregular menses, or painful intercourse). *Pain symptom* - The DSM-IV-TR criteria included **pain symptoms** as one of the four main categories. - The criteria required **four pain symptoms** occurring in at least four different sites or functions (e.g., head, abdomen, back, joints, chest). *GI symptom* - The DSM-IV-TR criteria included **gastrointestinal symptoms** as one of the four main categories. - At least **two gastrointestinal symptoms** were required (such as nausea, bloating, vomiting other than during pregnancy, or diarrhea). **Key Point:** The four DSM-IV-TR symptom categories for somatization disorder were: (1) Pain, (2) Gastrointestinal, (3) Sexual, and (4) Pseudoneurological—NOT "visual symptoms" as a separate category.
Question 1207: Astasia-abasia is associated with which of the following conditions?
- A. Post-Traumatic Stress Disorder
- B. Depressive Disorder
- C. Bipolar Mood Disorder
- D. Functional Neurological Symptom Disorder (Correct Answer)
Explanation: ***Functional Neurological Symptom Disorder*** - **Astasia-abasia**, which refers to an inability to stand (astasia) and walk (abasia) despite normal motor function when examined in bed, is a classical presentation of **Functional Neurological Symptom Disorder** (formerly conversion disorder). - This disorder involves neurological symptoms that are incompatible with recognized medical conditions and often linked to **psychological stressors**. - The gait disturbance is bizarre and inconsistent with any known neurological pattern. *Post-Traumatic Stress Disorder* - Characterized by re-experiencing a **traumatic event**, avoidance behaviors, negative alterations in cognitions and mood, and hyperarousal. - While it can manifest with physical symptoms, **astasia-abasia** is not a primary or characteristic feature. *Depressive Disorder* - Primarily involves persistent **sadness**, loss of interest or pleasure, changes in appetite or sleep, and feelings of worthlessness or guilt. - Although physical symptoms like fatigue and psychomotor retardation can occur, **astasia-abasia** is not a typical presentation. *Bipolar Mood Disorder* - Distinguished by episodes of both **mania** (or hypomania) and **depression**. - Symptoms are predominantly mood-related, including extreme shifts in energy, activity levels, and concentration, not specific neurological deficits like astasia-abasia.
Question 1208: A student unable to deliver speech before an audience is suffering from?
- A. Social anxiety disorder (Correct Answer)
- B. Fear of open spaces
- C. Fear of enclosed spaces
- D. Obsessive Compulsive Disorder
Explanation: ***Social anxiety disorder*** - This condition involves an intense, persistent fear of social situations, particularly those where one might be scrutinized or judged by others. - Public speaking is a classic scenario that can trigger significant distress and avoidance in individuals with **social anxiety disorder**. *Fear of open spaces* - This symptom describes **agoraphobia**, which is an anxiety disorder characterized by fear and avoidance of situations or places that might cause panic, helplessness, or embarrassment, often due to a perceived inability to escape. - While it can sometimes involve fear of public gatherings, its core is about escape/safety from open, unfamiliar, or overwhelming spaces, not specifically about performance. *Fear of enclosed spaces* - This refers to **claustrophobia**, which is an anxiety disorder characterized by an irrational fear of confined spaces. - It does not involve the fear of speaking or performance before an audience. *Obsessive Compulsive Disorder* - **OCD** is characterized by recurrent and persistent thoughts (obsessions) and/or repetitive behaviors or mental acts (compulsions) performed to reduce anxiety. - It does not typically manifest as an inability to deliver a speech before an audience unless the obsessions or compulsions directly interfere with such an activity, which is not the primary mechanism of this symptom.
Question 1209: What is the drug of choice for treating generalized anxiety disorder?
- A. Alprazolam
- B. Buspirone (Correct Answer)
- C. Phenytoin
- D. β-blocker
Explanation: ***Buspirone*** - **Buspirone** is a non-benzodiazepine anxiolytic that is effective for generalized anxiety disorder (GAD) and has a lower risk of dependence and sedation compared to benzodiazepines. - It acts as a partial agonist at **5-HT1A serotonin receptors**, which contributes to its anxiolytic effects without affecting GABAergic systems. *β-blocker* - **β-blockers** are primarily used to manage the **physical symptoms of anxiety**, such as palpitations and tremors, often in performance anxiety, rather than the core cognitive and emotional symptoms of GAD. - They do not address the underlying psychological aspects of generalized anxiety. *Alprazolam* - **Alprazolam** is a **benzodiazepine** that provides rapid relief of anxiety symptoms but carries a significant risk of **dependence, withdrawal, and sedation**, making it less suitable for long-term treatment of GAD. - Due to these risks, benzodiazepines are typically reserved for short-term use or acute anxiety management rather than as a first-line treatment for chronic GAD. *Phenytoin* - **Phenytoin** is an **antiepileptic drug** primarily used to treat seizures and does not have a recognized role in the management of generalized anxiety disorder. - Its mechanism of action involves stabilizing neuronal membranes and is unrelated to the neurochemical pathways targeted in anxiety disorders.
Question 1210: Which of the following disorders is classified under somatic symptom and related disorders in the DSM-5?
- A. Post-Traumatic Stress Disorder (PTSD)
- B. Phobic disorders (e.g., social anxiety disorder)
- C. Conversion disorder (functional neurological symptom disorder) (Correct Answer)
- D. Obsessive-Compulsive Disorder (OCD)
Explanation: ***Conversion disorder (functional neurological symptom disorder)*** - **Conversion disorder** is characterized by neurological symptoms (e.g., paralysis, blindness) that are **incompatible with recognized neurological or medical conditions**, yet are not intentionally produced. - It falls under **somatic symptom and related disorders** because the primary features are physical symptoms causing distress or functional impairment, rather than being malingered or feigned. *Phobic disorders (e.g., social anxiety disorder)* - **Phobic disorders** are classified under **anxiety disorders** in the DSM-5, not somatic symptom and related disorders. - They are primarily characterized by **intense, irrational fears** of specific objects or situations, leading to avoidance rather than prominent physical symptoms without a medical cause. *Post-Traumatic Stress Disorder (PTSD)* - **PTSD** is classified under **trauma- and stressor-related disorders** in the DSM-5, distinguished by symptoms developing after exposure to a traumatic event. - Its core features include **intrusive memories, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity**, rather than unexplained physical symptoms. *Obsessive-Compulsive Disorder (OCD)* - **OCD** is classified under **obsessive-compulsive and related disorders** in the DSM-5. - It is primarily characterized by the presence of **obsessions (recurrent, intrusive thoughts)** and/or **compulsions (repetitive behaviors or mental acts)**, which are distinct from somatic symptoms.