A 66-year-old man tends to repeat the same answer for all subsequent questions. This is pathognomonic of:
B. In perseveration the thought process tends to persist beyond a point at which they are relevant. Perseveration generally occurs with clouded consciousness and is considered pathognomonic of organic brain disease. Perseveration can be demonstrated verbally or through repetitive motor activity. It can be seen in schizophrenia too. Stuttering is due to motor speech in-coordination and does not involve the mechanism of perseveration.
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Obsessions are intrusive and repetitive mental phenomenon. In which of the following forms can an obsession occur?
E. Obsessions usually evoke distress and anxiety and are not pleasurable by definition. They are unwanted, intrusive, repetitive, senseless thoughts experienced by patients as troublesome and resisted. Obsessions can be thoughts, words, impulses, or images. They usually occur in themes of sex, religion, violence, safety, and grooming (e.g. orderliness, washing out germs, etc.).
Obsessions are appreciated to be against values and ideals of self.
Which of the following terms corresponds to this description?
A. In obsessions, though the appearance of the thoughts themselves is appreciated to be beyond a patient’s control, they are not claimed to be due to an external agency. Obsessions are regarded to be one’s own mind’s product but ego-dystonic – against one’s values and needs. Often during the course of OCD, primary obsessions fade while compulsions dominate the clinical picture; some compulsions can be mental behaviours such as praying, counting, etc.
Passivity phenomena can occur as any of the following EXCEPT:
D. A subjective disturbance in thinking seen in schizophrenia is described as passivity, which can occur in the form of thought insertion, thought withdrawal, and thought broadcasting. These are first-rank symptoms of schizophrenia. Thought blocking is not a passivity or alienation phenomenon.
Which of the following is NOT a first-rank symptom of schizophrenia?
B. The first-rank symptoms are:
Three hallucinations:
Three ‘made’ phenomena:
Three thought phenomena: (experiences themselves are more important than later explanations of how a patient interprets them):
Two isolated symptoms:
Somatic hallucinations are NOT first rank symptoms unless there is a delusional elaboration and attribution of the origin of sensations to an external agency (passivity).
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