Psychopathology: delusional infestation: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Psychopathology: delusional infestation

Sample item

A 62-year-old woman is convinced that tiny insects are crawling under her skin. She brings matchboxes containing skin fragments as proof, although dermatology finds nothing. What is the most appropriate term?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Delusional parasitosis (Ekbom syndrome)

Delusional parasitosis is a monosymptomatic delusional disorder, somatic type, with a fixed belief of infestation and the matchbox sign of bringing specimens. Treatment is with low-dose antipsychotics such as risperidone or pimozide. A medical and substance cause such as stimulants, B12 deficiency or thyroid disease should be excluded.

Option by option

  • A. Body dysmorphic disorder

    Body dysmorphic disorder is preoccupation with an imagined defect in appearance.

  • B. Capgras syndrome

    Capgras syndrome is the belief that a familiar person has been replaced by an impostor.

  • C. Delusional parasitosis (Ekbom syndrome) (correct)

    Correct. A fixed belief of infestation with specimen collecting is delusional parasitosis.

  • D. Formication from cocaine only

    Cocaine bugs are tactile hallucinations in intoxication and here no drug history is given, and the patient has a fixed belief with collected specimens.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, Delusional parasitosis (Ekbom syndrome). Delusional parasitosis is a monosymptomatic delusional disorder, somatic type, with a fixed belief of infestation and the matchbox sign of bringing specimens.

Why is "Body dysmorphic disorder" not the answer?

Body dysmorphic disorder is preoccupation with an imagined defect in appearance.

Why is "Capgras syndrome" not the answer?

Capgras syndrome is the belief that a familiar person has been replaced by an impostor.

Why is "Formication from cocaine only" not the answer?

Cocaine bugs are tactile hallucinations in intoxication and here no drug history is given, and the patient has a fixed belief with collected specimens.

What concept does this question test?

It tests Psychopathology: delusional infestation in Psychiatry. Treatment is with low-dose antipsychotics such as risperidone or pimozide. A medical and substance cause such as stimulants, B12 deficiency or thyroid disease should be excluded.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Psychopathology: delusional infestation?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.