Organic mental 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 · Organic mental disorders: forced normalisation

Sample item

A man with refractory temporal lobe epilepsy becomes seizure-free after an anticonvulsant is added. Within weeks he becomes paranoid and hears voices, and an EEG now shows loss of his previous epileptiform discharges. Which diagnosis is most likely?

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

The answer and the reasoning

C. Alternative psychosis (forced normalisation)

Landolt's forced normalisation describes psychosis emerging when seizures are suppressed and the EEG normalises. It appears to be an inverse relationship between seizure control and psychiatric symptoms, and may resolve if seizures recur or the drug is changed.

Option by option

  • A. Postictal psychosis

    Postictal psychosis follows a cluster of seizures after a lucid interval, not seizure freedom.

  • B. Chronic interictal psychosis of Slater

    Interictal psychosis develops over years of epilepsy, without a link to seizure suppression.

  • C. Alternative psychosis (forced normalisation) (correct)

    Correct. Psychosis emerges as seizures and EEG abnormalities are suppressed.

  • D. Acute alcohol withdrawal psychosis

    There is no history of alcohol use or withdrawal to explain this.

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 C, Alternative psychosis (forced normalisation). Landolt's forced normalisation describes psychosis emerging when seizures are suppressed and the EEG normalises.

Why is "Postictal psychosis" not the answer?

Postictal psychosis follows a cluster of seizures after a lucid interval, not seizure freedom.

Why is "Chronic interictal psychosis of Slater" not the answer?

Interictal psychosis develops over years of epilepsy, without a link to seizure suppression.

Why is "Acute alcohol withdrawal psychosis" not the answer?

There is no history of alcohol use or withdrawal to explain this.

What concept does this question test?

It tests Organic mental disorders: forced normalisation in Psychiatry. It appears to be an inverse relationship between seizure control and psychiatric symptoms, and may resolve if seizures recur or the drug is changed.

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 Organic mental 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.