Geriatric psychiatry: late-onset psychosis: 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 · Geriatric psychiatry: late-onset psychosis

Sample item

A 72-year-old woman living alone with long-standing deafness develops a well-organised persecutory delusion and auditory hallucinations, with preserved personality and no dementia. This is termed:

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

The answer and the reasoning

D. Late paraphrenia (very-late-onset schizophrenia-like psychosis)

Late paraphrenia is late-onset paranoid psychosis, more common in women with sensory impairment such as deafness and social isolation, with preserved affect and personality. Low-dose antipsychotics are used, with correction of sensory deficits.

Option by option

  • A. Delirium

    Delirium shows clouded consciousness.

  • B. Alzheimer disease

    Alzheimer disease would show cognitive decline.

  • C. Lewy body dementia

    Lewy body dementia shows fluctuating cognition and parkinsonism.

  • D. Late paraphrenia (very-late-onset schizophrenia-like psychosis) (correct)

    Correct. Late-onset persecutory psychosis with hearing loss suggests late paraphrenia.

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, Late paraphrenia (very-late-onset schizophrenia-like psychosis). Late paraphrenia is late-onset paranoid psychosis, more common in women with sensory impairment such as deafness and social isolation, with preserved affect and personality.

Why is "Delirium" not the answer?

Delirium shows clouded consciousness.

Why is "Alzheimer disease" not the answer?

Alzheimer disease would show cognitive decline.

Why is "Lewy body dementia" not the answer?

Lewy body dementia shows fluctuating cognition and parkinsonism.

What concept does this question test?

It tests Geriatric psychiatry: late-onset psychosis in Psychiatry. Low-dose antipsychotics are used, with correction of sensory deficits.

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 Geriatric psychiatry: late-onset psychosis?

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.