Dissociative and somatic disorders: 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 · Dissociative and somatic disorders

Sample item

A 20-year-old woman develops sudden paralysis of both legs the day after a bitter quarrel with her family. Neurological examination and MRI are normal, and she seems unconcerned about the disability. Which is the most likely diagnosis?

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

The answer and the reasoning

C. Conversion (functional neurological symptom) disorder

Conversion disorder involves neurological symptoms incompatible with recognised disease, with psychological stress as a trigger, and the symptoms are not intentionally produced. Relative unconcern (la belle indifference) may be seen but is not diagnostic. Treatment is explanation, reassurance and psychotherapy with physiotherapy.

Option by option

  • A. Somatic symptom disorder with predominant pain

    Somatic symptom disorder with pain does not present with abrupt motor paralysis.

  • B. Malingering

    Malingering is intentional feigning for an obvious external gain, which is not present here.

  • C. Conversion (functional neurological symptom) disorder (correct)

    Correct. A neurological deficit without organic cause after a stressor, not feigned, is conversion disorder.

  • D. Factitious disorder

    Factitious disorder is intentional production of symptoms for the sick role, which is also absent.

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, Conversion (functional neurological symptom) disorder. Conversion disorder involves neurological symptoms incompatible with recognised disease, with psychological stress as a trigger, and the symptoms are not intentionally produced.

Why is "Somatic symptom disorder with predominant pain" not the answer?

Somatic symptom disorder with pain does not present with abrupt motor paralysis.

Why is "Malingering" not the answer?

Malingering is intentional feigning for an obvious external gain, which is not present here.

Why is "Factitious disorder" not the answer?

Factitious disorder is intentional production of symptoms for the sick role, which is also absent.

What concept does this question test?

It tests Dissociative and somatic disorders in Psychiatry. Relative unconcern (la belle indifference) may be seen but is not diagnostic. Treatment is explanation, reassurance and psychotherapy with physiotherapy.

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 Dissociative and somatic disorders?

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.