Psychotic disorders: forced normalisation: 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.

Try it

Psychiatry · Psychotic disorders: forced normalisation

Sample item

A man with long-standing temporal lobe epilepsy has his seizures controlled with a new anticonvulsant, and his EEG becomes normal. Within weeks he becomes suspicious, hears voices and shows disorganised behaviour while fully alert. Which concept best explains this?

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

The answer and the reasoning

B. Forced normalisation (alternative psychosis)

Forced normalisation, described by Landolt, is the emergence of psychosis when seizures are suppressed and the EEG normalises, with the psychosis improving if seizures return. Postictal psychosis follows a cluster of seizures after a lucid interval, which is not the sequence here.

Option by option

  • A. Postictal psychosis

    Postictal psychosis follows a seizure cluster after a short lucid interval, not seizure suppression.

  • B. Forced normalisation (alternative psychosis) (correct)

    Correct. Psychosis appearing as seizures stop and the EEG normalises is forced normalisation.

  • C. Primary schizophrenia unrelated to epilepsy

    Attributing it to coincidental schizophrenia ignores the clear temporal link to seizure control.

  • D. Anticonvulsant-induced delirium

    Delirium would show clouded consciousness, but he is fully alert.

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.

More Psychiatry questions

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Forced normalisation (alternative psychosis). Forced normalisation, described by Landolt, is the emergence of psychosis when seizures are suppressed and the EEG normalises, with the psychosis improving if seizures return.

Why is "Postictal psychosis" not the answer?

Postictal psychosis follows a seizure cluster after a short lucid interval, not seizure suppression.

Why is "Primary schizophrenia unrelated to epilepsy" not the answer?

Attributing it to coincidental schizophrenia ignores the clear temporal link to seizure control.

Why is "Anticonvulsant-induced delirium" not the answer?

Delirium would show clouded consciousness, but he is fully alert.

What concept does this question test?

It tests Psychotic disorders: forced normalisation in Psychiatry. Postictal psychosis follows a cluster of seizures after a lucid interval, which is not the sequence here.

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 Psychotic disorders: forced normalisation?

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.