Psychotic Disorders Practice Questions

Q: Which of the following negative symptoms of schizophrenia is characterized by poverty of speech and thought?

Alogia. ***Alogia*** - **Alogia** refers to the reduction in the quantity of speech and thought, often manifesting as **poverty of speech** or **poverty of content of speech**. - This negative symptom is characteristic of schizophrenia, where individuals may have difficulty producing spontaneous speech or providing detailed answers. *Anhedonia* - **Anhedonia** is the inability to experience pleasure from activities that are usually enjoyable. - While it is a negative symptom of schizophrenia, it does not directly relate to poverty of speech or thought. *Hallucination* - **Hallucinations** are perceptual experiences that occur in the absence of an external stimulus, such as hearing voices or seeing things that aren't there. - Hallucinations are considered **positive symptoms** of schizophrenia, not negative symptoms, and do not involve poverty of speech or thought. *Avolition* - **Avolition** is a decrease in the motivation to initiate and perform self-directed purposeful activities. - This negative symptom manifests as a lack of drive or interest in goal-directed behavior but is distinct from difficulties in speech or thought production.

Q: A 25-year-old patient presents with persistent delusions of persecution, auditory hallucinations, and social withdrawal for the past 8 months. There is no history of substance abuse or medical illness. What is the most likely diagnosis?

Schizophrenia. ***Schizophrenia*** - This patient presents with **psychotic symptoms** (delusions of persecution, auditory hallucinations) and **negative symptoms** (social withdrawal) lasting for **8 months**. - The duration of symptoms **exceeds 6 months**, which meets the diagnostic criteria for **schizophrenia** according to DSM-5. - The presence of **two or more characteristic symptoms** (delusions and hallucinations) along with **social/occupational dysfunction** (social withdrawal) and **no substance abuse or medical illness** confirms this diagnosis. *Major depressive disorder with psychotic features* - While psychotic features can occur in major depression, the primary symptoms would be **depressed mood** and/or **anhedonia**, which are not reported here. - The prominent **delusions of persecution** and **auditory hallucinations** without significant mood symptoms make this diagnosis unlikely. *Brief psychotic disorder* - This disorder is characterized by the sudden onset of **psychotic symptoms** lasting **less than 1 month**. - The patient's symptoms have persisted for **8 months**, far exceeding the criteria for brief psychotic disorder. *Bipolar disorder, manic episode* - A manic episode would involve a distinct period of **abnormally and persistently elevated, expansive, or irritable mood**, increased goal-directed activity or energy, and other manic symptoms. - The primary symptoms described are **psychotic** and **negative symptoms** rather than mood elevation, making this diagnosis incorrect.

Q: In which of the following delusions is infidelity seen?

Othello syndrome. ***Othello syndrome*** - **Othello syndrome**, also known as delusional jealousy, is characterized by the **unshakable belief that one's partner is being unfaithful**, despite a lack of evidence. - The individual with this syndrome may engage in obsessive behaviors to find "proof" of the infidelity, leading to significant distress and relationship problems. *De Clerambault's syndrome* - **De Clerambault's syndrome**, or **erotomania**, is a delusional belief that another person, usually of higher social standing, is in love with the individual. - It does not involve delusions of infidelity but rather an idealized, unrequited love fantasy. *Couvade syndrome* - **Couvade syndrome** refers to a phenomenon where a man experiences **pregnancy-like symptoms** (e.g., weight gain, nausea, mood swings) when his partner is pregnant. - This is a psychosomatic condition and is not associated with delusions of infidelity. *Ekbom's syndrome* - **Ekbom's syndrome**, or **delusional parasitosis**, is a delusional disorder where an individual firmly believes their body is infested with parasites, insects, or other organisms despite medical assurances to the contrary. - This delusion is focused on infestation and has no connection to infidelity.

Q: Which of the following signs is least characteristic of catatonia?

Ambivalence. ***Ambivalence (Correct Answer - Least Characteristic)*** - **Ambivalence** refers to the coexistence of opposing emotions, attitudes, or desires towards a person, object, or idea - It is one of **Bleuler's 4 A's of schizophrenia** (Autism, Ambivalence, Affect, Association) - a thought disorder, not a motor symptom - While it can occur in various mental disorders, it is **not a defining feature of catatonia**, which primarily involves **motor and behavioral disturbances** - This makes it the **least characteristic** sign among the options *Akathisia (Incorrect)* - **Akathisia** is characterized by inner restlessness and an uncontrollable urge to move - While primarily an **extrapyramidal side effect** of antipsychotic medications, it can overlap with psychomotor agitation - Some agitation can occur in **excited catatonia**, but akathisia's specific pattern of restless movements differs from typical catatonic motor phenomena - More characteristic of catatonia than ambivalence, but less so than ambitendency or akinesia *Ambitendency (Incorrect)* - **Ambitendency** is a **classic catatonic symptom** where the patient shows alternating movements or inability to complete an action due to opposing motor impulses - Example: patient's hand approaches an object but repeatedly stops and withdraws - This reflects the **motor and volitional disturbance** central to catatonia - **Highly characteristic** of catatonic syndrome *Akinesia (Incorrect)* - **Akinesia** refers to loss or severe impairment of voluntary movement - This is a **hallmark symptom of catatonic stupor** - one of the most common presentations of catatonia - Patients may remain immobile for prolonged periods with mutism and diminished responsiveness - **Highly characteristic** of catatonia

Q: Which of the following is considered a good prognostic factor for schizophrenia?

Acute onset of symptoms. ***Acute onset of symptoms*** - An **acute onset of symptoms** is one of the most well-established **good prognostic factors** in schizophrenia. - It suggests a more sudden disturbance rather than a gradual deterioration process, indicating better potential for treatment response and remission. - This typically means the individual experienced a more defined break from baseline functioning, which is more amenable to intervention. *Childhood onset of symptoms* - **Childhood onset** (or very early onset) schizophrenia is associated with a **poor prognosis**, often due to more pervasive neurodevelopmental abnormalities and prolonged impact on development. - Individuals with childhood onset often have more severe symptoms, greater cognitive deficits, and poorer functional outcomes. *Poor premorbid functioning* - **Poor premorbid functioning** (e.g., social isolation, academic difficulties before symptom onset) is a well-established indicator of **poor prognosis** in schizophrenia. - This suggests pre-existing vulnerabilities and less developed coping mechanisms, making recovery more challenging. *Predominant negative symptoms* - **Predominant negative symptoms** (e.g., avolition, alogia, affective flattening, anhedonia) are associated with **poor prognosis** in schizophrenia. - Negative symptoms are less responsive to antipsychotic medications compared to positive symptoms and are strongly associated with worse functional outcomes and greater disability.

Question 1

Which of the following negative symptoms of schizophrenia is characterized by poverty of speech and thought?

Accepted Answer

Alogia

Answer

Anhedonia

Answer

Hallucination

Answer

Avolition

Question 2

A 25-year-old patient presents with persistent delusions of persecution, auditory hallucinations, and social withdrawal for the past 8 months. There is no history of substance abuse or medical illness. What is the most likely diagnosis?

Accepted Answer

Schizophrenia

Answer

Major depressive disorder with psychotic features

Answer

Brief psychotic disorder

Answer

Bipolar disorder, manic episode

Question 3

In which of the following delusions is infidelity seen?

Accepted Answer

Othello syndrome

Answer

Couvade syndrome

Answer

Ekbom's syndrome

Answer

De Clerambault's syndrome

Question 4

Which of the following signs is least characteristic of catatonia?

Accepted Answer

Ambivalence

Answer

Akathisia

Answer

Ambitendency

Answer

Akinesia

Question 5

Which of the following is considered a good prognostic factor for schizophrenia?

Accepted Answer

Acute onset of symptoms

Answer

Childhood onset of symptoms

Answer

Poor premorbid functioning

Answer

Predominant negative symptoms

Psychotic Disorders — MCQs

Psychotic Disorders — MCQs

On this page

Practice by Chapter

Want unlimited practice?