A patient suffering from schizophrenia makes up a totally new word that is not in a dictionary – ‘tynmis’ for sausage.
Which of the following phenomena is he exhibiting?
B. Neologism refers to making up a totally new word that is not in a dictionary or using a known word with a completely different meaning. Perseveration refers to repetition of the same response to different stimuli. Perseveration also includes persistent repetition of specific words or concepts in the process of speaking. Such repeated responses may be meaningful but inappropriate, for example providing the same answer to different questions. Perseveration is seen as a frontal dysfunction. Verbigeration refers to meaningless and stereotyped repetition of words or phrases, as seen in schizophrenia. Verbigeration is also called cataphasia.
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Which of the following describes the most common type of hypnogogic hallucinations?
A. Both illusions and hallucinations are not necessarily pathological though they both are false perceptions, along with pseudohallucinations. Hypnagogic hallucinations are hallucinations occurring when going to sleep (‘go’ for ‘go’) these are usually auditory hallucinations. One’s name being called by a familiar voice is the most common hypnagogic hallucination. This is also seen in narcolepsy–cataplexy where it can be visual or tactile too. Hypnopompic hallucinations (hallucinations when waking up) can occur in normal individuals. They also occur in glue sniffing, postinfective depression, children with febrile illness, and in phobic anxiety.
Which of the following is a neurological illness that mimics schizophrenic speech disturbance?
C. Wernicke’s aphasia is also called jargon aphasia. Here the comprehension of a patient is limited but motor production is more or less preserved. This leads to error-prone language similar to the incoherence noted in schizophrenic speech disturbances. In Broca’s aphasia the patient cannot produce fluent language although his comprehension is preserved. Alexia is inability to read words while agraphia is inability to write. Although schizophrenic speech disturbances can be deciphered from one’s writing, this does not equate to having agraphia. Astereognosis refers to the inability to differentiate the character of an object by using a single perceptual modality, for example closing one’s eyes and palpating a coin should be sufficient to discover the shape of the coin normally. This ability is absent in patients with astereognosis.
Which of the following is not a type of paranoid delusion?
E. Paranoia is a loosely used term. Paranoia literally means ‘beside the mind’. Paranoid delusions include any self-referential delusions such as referential delusions, persecutory delusions, grandiose delusions, hypochondriacal delusions, and nihilistic delusions. Some bizarre delusions are not self referential and are not classified as paranoid delusions, as in this question.
A patient with dementia is asked to perform a cognitive task beyond his current ability. He becomes very agitated. This is called:
A. Catastrophic reaction is seen in demented patients who are asked to perform a task that is clearly beyond their cognitive capacity. They may become anxious, agitated, and angry. This is not a universal phenomenon. This occurs in some patients even if they do not have explicit awareness of their cognitive impairment.
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