Psychotic 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 · Psychotic disorders

Sample item

A 40-year-old unmarried woman firmly believes that a famous film director is secretly in love with her and sends her coded messages. She works well and has no hallucinations or mood symptoms. This has persisted for 14 months. What is the most likely diagnosis?

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

The answer and the reasoning

D. Delusional disorder, erotomanic type

Erotomania (de Clerambault syndrome) is a subtype of delusional disorder in which the patient believes another person, usually of higher status, is in love with her. Delusional disorder requires non-bizarre delusions for at least one month with relatively preserved functioning and no prominent hallucinations or disorganisation.

Option by option

  • A. Schizoaffective disorder

    Schizoaffective disorder needs prominent mood episodes alongside psychotic symptoms.

  • B. Schizophrenia, paranoid type

    Schizophrenia would need hallucinations, disorganisation or negative symptoms with marked functional decline.

  • C. Bipolar disorder with psychotic features

    Bipolar disorder with psychotic features requires a mood episode, which is absent here.

  • D. Delusional disorder, erotomanic type (correct)

    Correct. A single, systematised non-bizarre delusion with preserved functioning fits delusional disorder.

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 D, Delusional disorder, erotomanic type. Erotomania (de Clerambault syndrome) is a subtype of delusional disorder in which the patient believes another person, usually of higher status, is in love with her.

Why is "Schizoaffective disorder" not the answer?

Schizoaffective disorder needs prominent mood episodes alongside psychotic symptoms.

Why is "Schizophrenia, paranoid type" not the answer?

Schizophrenia would need hallucinations, disorganisation or negative symptoms with marked functional decline.

Why is "Bipolar disorder with psychotic features" not the answer?

Bipolar disorder with psychotic features requires a mood episode, which is absent here.

What concept does this question test?

It tests Psychotic disorders in Psychiatry. Delusional disorder requires non-bizarre delusions for at least one month with relatively preserved functioning and no prominent hallucinations or disorganisation.

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 Psychotic 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.