Forensic psychiatry: delirium tremens: practice question

A Forensic Medicine 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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Forensic Medicine · Forensic psychiatry: delirium tremens

Sample item

A chronic alcohol-dependent man, three days after stopping drinking, is in a state of delirium with vivid hallucinations of insects. Believing his brother to be an intruder, he kills him. What is the likely legal position?

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

The answer and the reasoning

D. He may claim the defence of unsoundness of mind, as delirium tremens is a disease of the mind and not mere intoxication

Voluntary intoxication is generally no defence, but delirium tremens is a withdrawal psychosis, a disease of the mind that may impair knowledge of the nature of the act. It can therefore support a plea of legal insanity if the McNaghten criteria are met. The distinction is between being drunk and being mentally ill from alcohol withdrawal.

Option by option

  • A. The offence is excused only if he was drunk at the time

    He was not drunk; the state is withdrawal, so being intoxicated is not the basis.

  • B. He is absolutely liable for murder because he chose to drink

    Past choices to drink do not remove the insanity defence in delirium tremens.

  • C. He has no defence because all alcohol-related states are voluntary intoxication

    Withdrawal delirium differs from voluntary intoxication, so the plea is not barred.

  • D. He may claim the defence of unsoundness of mind, as delirium tremens is a disease of the mind and not mere intoxication (correct)

    Correct. Withdrawal delirium is a mental disorder that can ground an insanity defence.

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 Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, He may claim the defence of unsoundness of mind, as delirium tremens is a disease of the mind and not mere intoxication. Voluntary intoxication is generally no defence, but delirium tremens is a withdrawal psychosis, a disease of the mind that may impair knowledge of the nature of the act.

Why is "The offence is excused only if he was drunk at the time" not the answer?

He was not drunk; the state is withdrawal, so being intoxicated is not the basis.

Why is "He is absolutely liable for murder because he chose to drink" not the answer?

Past choices to drink do not remove the insanity defence in delirium tremens.

Why is "He has no defence because all alcohol-related states are voluntary in…" not the answer?

Withdrawal delirium differs from voluntary intoxication, so the plea is not barred.

What concept does this question test?

It tests Forensic psychiatry: delirium tremens in Forensic Medicine. It can therefore support a plea of legal insanity if the McNaghten criteria are met. The distinction is between being drunk and being mentally ill from alcohol withdrawal.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Forensic psychiatry: delirium tremens?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine 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.