Which of the following statements with respect to the natural history of eating disorders is true?
A. Bulimia nervosa and anorexia nervosa are not mutually exclusive disorders. Significant overlap occurs between the two and also with EDNOS (eating disorder not otherwise specified). In bulimia, more impulsivity and less perfectionist traits are noted. Bulimia nervosa is characterized by higher rates of partial and full recovery compared with anorexia nervosa. Both anorexia and bulimia cannot be diagnosed at the same time as a range of bulimic behaviours are described under the diagnosis of anorexia itself.
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Dementia can be differentiated from pseudodementia by all of the following EXCEPT:
A. In some elderly patients with depression, marked difficulties with concentration and memory can present similar to dementia. Presence of previous history of depression; clearly observable depressed mood; biological symptoms of depression; voluntary complaints about memory failure (patients with dementia tend not to realize their own memory problems); indifference and ‘I don’t know’ answers when formally testing memory (while confabulation may be seen in dementia); and response to antidepressant medication (unusual in true dementia) are some clues to pseudodementia. In cognitive tests, visuospatial and executive functions can be impaired in dementia but such impairment is highly unlikely to be due to isolated depression. Neurological signs, including frontal release, points towards dementia.
Which one of the following statement about paraphrenia is NOT correct? Paraphrenia is:
D. Paraphrenia is a late-onset psychotic disorder characterized by persecutory and referential delusions with or without auditory hallucinations. It is believed to be a very-late-onset (>60) variant of schizophrenia as many patients with a family history of schizophrenia show an increased rate of paraphrenia. Negative symptoms are conspicuously absent in paraphrenia. Schneiderian first-rank symptoms are uncommon too.
Multiple personality disorder is a controversial diagnosis described under which of the following group of disorders?
D. According to DSM-IV-TR, dissociative identity disorder (multiple personality disorder) is characterized by the presence of two or more distinct identities or personality states that recurrently take control of the individual’s behaviour. The patient cannot recall important personal information that occurs when the alternate personality is in control (one-way amnesia). The personality states are also called alters. Often alters are widely different in their perception, relation, and adaptation to the environment and self. This controversial and dramatic condition is placed under dissociative disorders in both ICD and DSM.
Which of the following symptoms is/are a characteristic feature in dissociative fugue?
D. Dissociative fugue is characterized by sudden, unexpected but purposeful travel away from one’s routine dwelling, associated with amnesia for strikingly significant periods of the past. This may be associated with assumption of a new identity. Though this can occur in depression, it is more often seen as stress-induced dissociation state. Depersonalization is not a characteristic accompaniment. Family history of epilepsy in a patient with fugue state must prompt investigations for TLE. Usually, patients with fugue have no anterograde amnesia or attention difficulties and have apparently good self care and social interaction.
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