Psychotic disorders: depressive stupor versus catatonia: 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 · Psychotic disorders: depressive stupor versus catatonia

Sample item

A 52-year-old woman is mute and barely moves, after weeks of low mood, early waking and weight loss. On examination she has a sad facial expression and tearful eyes, but there is no posturing, waxy flexibility or active resistance to movement. Which feature favours depressive stupor over catatonic stupor?

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

The answer and the reasoning

B. Absence of posturing, waxy flexibility and negativism, with a sad expression

In depressive stupor the face shows emotion and catatonic signs such as waxy flexibility, posturing and gegenhalten are absent. Mutism, immobility and food refusal occur in both conditions. A lorazepam challenge can help but does not exclude depression.

Option by option

  • A. Marked reduction in spontaneous movement

    Reduced spontaneous movement is shared by both stupors.

  • B. Absence of posturing, waxy flexibility and negativism, with a sad expression (correct)

    Correct. Preserved affective expression without catatonic motor signs points to depression.

  • C. Mutism

    Mutism is common to both conditions and does not separate them.

  • D. Refusal of food

    Food refusal occurs in both and does not discriminate.

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 B, Absence of posturing, waxy flexibility and negativism, with a sad expression. In depressive stupor the face shows emotion and catatonic signs such as waxy flexibility, posturing and gegenhalten are absent.

Why is "Marked reduction in spontaneous movement" not the answer?

Reduced spontaneous movement is shared by both stupors.

Why is "Mutism" not the answer?

Mutism is common to both conditions and does not separate them.

Why is "Refusal of food" not the answer?

Food refusal occurs in both and does not discriminate.

What concept does this question test?

It tests Psychotic disorders: depressive stupor versus catatonia in Psychiatry. Mutism, immobility and food refusal occur in both conditions. A lorazepam challenge can help but does not exclude depression.

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: depressive stupor versus catatonia?

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.