Obsessive-Compulsive and Related Disorders Practice Questions

Q: Excessive buying is termed as: DNB 08

Oniomania. ***Oniomania*** - **Oniomania** is characterized by an uncontrollable urge to **buy goods**, often leading to financial difficulties and personal distress. - It is also known as **compulsive buying disorder** or **buying addiction**. *Trichotillomania* - This impulse control disorder involves the **recurrent, irresistible urge to pull out one's hair**, leading to noticeable hair loss. - It is not associated with excessive buying but rather with **self-inflicted hair removal**. *Pyromania* - **Pyromania** is an impulse control disorder characterized by a fascination with fire and an uncontrollable urge to **deliberately set fires**. - It is distinct from buying impulses and is associated with **arsonistic behavior**. *Kleptomania* - **Kleptomania** is an impulse control disorder involving the recurrent failure to resist urges to **steal items** that are not needed for personal use or monetary value. - This condition is about stealing, not compulsive purchasing.

Q: A person having irresistible urge to steal objects not needed for personal use or monetary value is suffering from:

Kleptomania. ***Kleptomania*** - This disorder is characterized by **recurrent failure to resist impulses to steal objects** that are not needed for personal use or for their monetary value. - The individual experiences **increasing tension before the theft** and feels pleasure, gratification, or relief when committing the theft. - The stealing is **not committed to express anger or vengeance** and is not in response to a delusion or hallucination. - This is a classic **impulse control disorder** as described in DSM-5. *Intermittent Explosive Disorder* - This condition involves **recurrent behavioral outbursts** representing a failure to control aggressive impulses. - Manifests as verbal aggression or physical aggression toward property, animals, or individuals. - **Does not involve stealing behavior** - it is focused on explosive anger and aggression. *Pyromania* - Characterized by **deliberate and purposeful fire setting** on more than one occasion. - The individual experiences tension or arousal before the act and fascination with fire. - Does not involve stealing; focused solely on fire-setting behavior. *Trichotillomania* - This is a **hair-pulling disorder** characterized by recurrent pulling out of one's hair, resulting in hair loss. - Represents an impulse control problem but manifests as self-directed repetitive behavior, not stealing.

Q: Basanti, a 27-year-old female, thinks that her nose is ugly. Her idea is fixed and is not shared by anyone else. Whenever she goes out of the home, she hides her face. She visits a surgeon for plastic surgery. The appropriate next step would be:

Refer to psychiatrist. ***Refer to psychiatrist*** - Basanti's fixed belief that her nose is ugly, despite it not being shared by others, and her subsequent **social avoidance** (hiding her face) are characteristic signs of **Body Dysmorphic Disorder (BDD)**. - Patients with BDD often present to plastic surgeons seeking multiple procedures, and surgery is typically ineffective and can worsen their distress; therefore, a psychiatric referral for diagnosis and treatment (e.g., **CBT and SSRIs**) is the appropriate first step. *Reassure the patient* - Reassurance alone is insufficient for a patient with BDD, as their distress is rooted in a **distorted self-perception** rather than a lack of understanding about their appearance. - While reassurance might provide temporary comfort, it does not address the underlying **psychological condition** and the severe impact it has on their life. *Investigate and then operate* - Performing investigations or surgery without addressing the underlying psychological disorder would be inappropriate and potentially harmful. - Surgery is unlikely to alleviate the patient's distress in BDD and may lead to dissatisfaction, further surgeries, and increased psychological morbidity, as the perceived defect is often **imagined or greatly exaggerated**. *Immediate operation* - An immediate operation would be highly unethical and detrimental given the clear indicators of a **psychiatric disorder**. - Surgery in such cases risks worsening the patient's **body image dissatisfaction** and mental health, as their perception of the defect is not based on reality.

Q: Repetitive hand washing is a symptom of

Obsessive compulsive disorder. ***Obsessive compulsive disorder*** - **Repetitive hand washing** is a classic example of a **compulsion** in OCD, driven by an obsession (e.g., fear of contamination). - Patients with OCD feel compelled to perform these actions to reduce anxiety or prevent a dreaded outcome, despite recognizing their irrationality. *Anorexia nervosa* - Characterized by an intense **fear of gaining weight** and a distorted body image, leading to severe calorie restriction and low body weight. - Its symptoms revolve around eating habits, body image, and weight control, not repetitive hand washing. *Post traumatic stress disorder* - Develops after exposure to a **traumatic event** and is characterized by intrusive thoughts, flashbacks, avoidance behaviors, and hyperarousal. - While anxiety is a feature, repetitive hand washing is not a core symptom or compulsion associated with PTSD. *Depression* - Primary symptoms include **persistent sadness**, loss of interest or pleasure, changes in appetite or sleep, and feelings of worthlessness. - Though an individual with depression may have poor hygiene or, less commonly, obsessive thoughts, repetitive hand washing is not characteristic of major depressive disorder itself.

Q: Defence mechanism in OCD?

Reaction formation. ***Reaction formation*** - In **Obsessive-Compulsive Disorder (OCD)**, individuals often use **reaction formation** by expressing the opposite of their true, unacceptable impulses or feelings. - This mechanism helps to keep unwanted **obsessive thoughts** or impulses out of conscious awareness by actively demonstrating behaviors or attitudes contrary to them. - **Note**: OCD also prominently involves other defense mechanisms like **undoing** (rituals to neutralize obsessions) and **isolation of affect** (separating emotion from thought). *Sublimation* - **Sublimation** involves channeling unacceptable impulses or emotions into socially acceptable or even productive behaviors. - While considered a mature defense mechanism, it is not the primary defense mechanism associated with the rigid and often ritualistic behaviors seen in OCD. *Regression* - **Regression** is a return to an earlier, more childlike, or less mature state of functioning in response to stress or anxiety. - While some individuals with OCD might show regressive behaviors, it is not the central or defining defense mechanism of the disorder. *Progression* - **Progression** is not a recognized psychological defense mechanism in psychodynamic theory. - It describes a movement forward or development, which is distinct from the unconscious strategies used to protect the ego from anxiety.

Q: A patient with obsessive-compulsive disorder (OCD) is most likely to develop

Depression. ***Depression*** - **Comorbidity** between OCD and depression is very high, with a significant percentage of individuals with OCD experiencing a major depressive episode at some point. - **Chronic stress**, functional impairment, and feelings of hopelessness associated with managing OCD symptoms often lead to the development of depression. *Schizophrenia* - Schizophrenia is a **psychotic disorder** characterized by significant disturbances in thought, perception, emotion, and behavior, which is distinct from the anxiety-based and ritualistic nature of OCD. - While there can be some overlapping obsessive features in schizophrenia, it is not a direct or highly probable development from OCD. *Hallucination* - **Hallucinations** are perceptual experiences that occur in the absence of an external stimulus, most commonly associated with psychotic disorders like schizophrenia, substance use, or severe mood disorders with psychotic features. - They are not a typical feature or direct development from OCD, which is primarily characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). *Delusion* - **Delusions** are fixed, false beliefs that are not amenable to change in light of conflicting evidence, a hallmark symptom of psychotic disorders. - While some individuals with OCD may experience **poor insight** into the irrationality of their obsessions and compulsions, these are distinct from true delusions.

Q: A person going to temple experiences unwanted, intrusive thoughts urging them to abuse God, which cause significant distress. The likely diagnosis is

Obsessive-Compulsive Disorder. ***Obsessive-Compulsive Disorder*** - The patient experiences **unwanted, intrusive thoughts** (obsessions) that cause significant anxiety and distress, such as the urge to abuse God. - The **irresistible urge** despite personal values suggests a compulsion to alleviate distress associated with the obsessive thought, even if the action is not performed. *Mania* - Characterized by an **elevated or irritable mood**, increased energy, and goal-directed activity, which does not fit the described symptom of internal, distressing urges. - Symptoms often include **racing thoughts**, grandiosity, and decreased need for sleep. *Schizophrenia* - Involves disruptions in thought processes, perceptions, emotional responsiveness, and social interactions, often including **hallucinations** or **delusions**. - The described symptom is an urge, not a break from reality or a hallucination. *Delusion* - A **fixed, false belief** that is not amenable to change in light of conflicting evidence. - The scenario describes an urge or an intrusive thought, which the person recognizes as distressing and unwanted, not a held belief.

Q: Which of the following is NOT true about Obsessive-Compulsive Disorder (OCD)?

Insight is always present. ***Insight is always present*** - While many individuals with OCD have good insight into the irrationality of their obsessions and compulsions, insight exists on a spectrum in OCD. - Some individuals may have **poor insight** or even **absent insight/delusional beliefs**, especially in severe cases, making this statement incorrect. *Ego-alien* - **Ego-alien** specifically refers to thoughts or impulses that are perceived as foreign, intrusive, and not originating from one's own self. - This term is often used interchangeably with **ego-dystonic**, describing the nature of obsessions in OCD. *Patient tries to resist against* - Individuals with OCD typically experience their obsessions and compulsions as distressing and make active efforts to **resist them** or neutralize them. - This resistance is a core feature, although it often fails, leading to the performance of compulsive acts. *Ego dystonic* - **Ego-dystonic** means that the thoughts, impulses, or behaviors are inconsistent with one's fundamental beliefs, values, and sense of self. - Obsessions in OCD are typically **ego-dystonic**, perceived as unpleasant, unwanted, and not in line with the person's character, which causes significant distress.

Q: A 40-year-old teacher reports excessive handwashing, counting rituals, and difficulty in completing daily tasks. She believes these actions prevent harm to her students. What is the diagnosis?

Obsessive-compulsive disorder. ***Obsessive-compulsive disorder*** - The patient's presentation of **recurrent, intrusive thoughts** (worries about students' harm) and **repetitive behaviors** (excessive handwashing, counting rituals) performed to reduce anxiety or prevent a dreaded event is characteristic of OCD. - The individual recognizes that these obsessions or compulsions are **excessive or unreasonable**, causing significant distress and impairment in daily functioning. *Generalized anxiety disorder* - This disorder is characterized by **persistent and excessive worry** about various aspects of life, not typically focused on specific, intrusive obsessions leading to compulsive rituals. - While anxiety is present, it does not manifest as specific **compulsive behaviors** performed in response to obsessions. *Paranoid schizophrenia* - Schizophrenia involves **psychotic symptoms** such as delusions (fixed false beliefs, often persecutory), hallucinations, disorganized speech, and negative symptoms. - The patient's symptoms are not indicative of a thought disorder, delusions, or hallucinations but rather anxiety-driven, repetitive behaviors. *Phobic disorder* - **Phobic disorders** involve intense, irrational fear of specific objects or situations (e.g., social phobia, specific phobia). - The patient's symptoms are not primarily triggered by a specific phobic stimulus but rather by intrusive thoughts leading to ritualistic behaviors.

Question 1

Excessive buying is termed as: DNB 08

Accepted Answer

Oniomania

Answer

Trichotillomania

Answer

Pyromania

Answer

Kleptomania

Question 2

Compulsive sexual behavior is most closely associated with which of the following disorders?

Accepted Answer

Hair pulling

Answer

Gambling

Answer

Stealing

Answer

Sexual desire

Question 3

A person having irresistible urge to steal objects not needed for personal use or monetary value is suffering from:

Accepted Answer

Kleptomania

Answer

Pyromania

Answer

Intermittent Explosive Disorder

Answer

Trichotillomania

Question 4

Basanti, a 27-year-old female, thinks that her nose is ugly. Her idea is fixed and is not shared by anyone else. Whenever she goes out of the home, she hides her face. She visits a surgeon for plastic surgery. The appropriate next step would be:

Accepted Answer

Refer to psychiatrist

Answer

Reassure the patient

Answer

Investigate and then operate

Answer

Immediate operation

Question 5

Repetitive hand washing is a symptom of

Accepted Answer

Obsessive compulsive disorder

Answer

Anorexia nervosa

Answer

Post traumatic stress disorder

Answer

Depression

Question 6

Defence mechanism in OCD?

Accepted Answer

Reaction formation

Answer

Sublimation

Answer

Regression

Answer

Progression

Question 7

A patient with obsessive-compulsive disorder (OCD) is most likely to develop

Accepted Answer

Depression

Answer

Schizophrenia

Answer

Hallucination

Answer

Delusion

Question 8

A person going to temple experiences unwanted, intrusive thoughts urging them to abuse God, which cause significant distress. The likely diagnosis is

Accepted Answer

Obsessive-Compulsive Disorder

Answer

Mania

Answer

Schizophrenia

Answer

Delusion

Question 9

Which of the following is NOT true about Obsessive-Compulsive Disorder (OCD)?

Accepted Answer

Insight is always present

Answer

Ego-alien

Answer

Patient tries to resist against

Answer

Ego dystonic

Question 10

A 40-year-old teacher reports excessive handwashing, counting rituals, and difficulty in completing daily tasks. She believes these actions prevent harm to her students. What is the diagnosis?

Accepted Answer

Obsessive-compulsive disorder

Answer

Generalized anxiety disorder

Answer

Paranoid schizophrenia

Answer

Phobic disorder

Obsessive-Compulsive and Related Disorders — MCQs

Obsessive-Compulsive and Related Disorders — MCQs

On this page

Practice by Chapter

Want unlimited practice?