Formal thought disorder: derailment: 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 · Formal thought disorder: derailment

Sample item

A patient with schizophrenia says, 'I went to the market. Politics is a game of birds. The colour blue is expensive.' The ideas slip between unrelated topics without a goal. This is:

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

The answer and the reasoning

A. Derailment (loosening of association)

In derailment the connection between successive ideas is lost, so the speech moves from one topic to unrelated ones without a goal. It is a core formal thought disorder of schizophrenia.

Option by option

  • A. Derailment (loosening of association) (correct)

    Correct. Unconnected, goalless slipping between topics is derailment.

  • B. Tangentiality

    Tangentiality is an oblique reply that never reaches the point of the question but remains loosely related.

  • C. Pressure of speech

    Pressure of speech is rapid, hard-to-interrupt speech, usually in mania.

  • D. Circumstantiality

    Circumstantiality involves excessive detail but the goal is eventually reached.

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 A, Derailment (loosening of association). In derailment the connection between successive ideas is lost, so the speech moves from one topic to unrelated ones without a goal.

Why is "Tangentiality" not the answer?

Tangentiality is an oblique reply that never reaches the point of the question but remains loosely related.

Why is "Pressure of speech" not the answer?

Pressure of speech is rapid, hard-to-interrupt speech, usually in mania.

Why is "Circumstantiality" not the answer?

Circumstantiality involves excessive detail but the goal is eventually reached.

What concept does this question test?

It tests Formal thought disorder: derailment in Psychiatry. It is a core formal thought disorder of schizophrenia.

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 Formal thought disorder: derailment?

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.