Chitranjjan National Cancer Institute Kolkata - 2021
Mental Health Nursing
Easy
A disorder of thought in which patient has a false and fixed belief that members of his family are trying to kill him is?
Appeared in: Chitranjjan National Cancer Institute Kolkata - 2021
Explanation
- A delusion is a fixed, false belief that is not in keeping with a person's culture and is maintained despite evidence to the contrary.
- The specific content of this patient's belief is that his family is trying to kill him.
- This theme of being harmed, attacked, or conspired against is the defining characteristic of a delusion of persecution.
- The search results confirm that delusions of persecution are the most common type in schizophrenia and often involve fears of being plotted against or killed by others, including family members.
Why Other Options Were Wrong
- Option B: Delusion of grandeur involves an inflated sense of self-worth, power, or importance. The patient's belief is about being harmed, not about being powerful or special.
- Option C: Nihilistic delusion is the belief that oneself or the world does not exist. The patient's belief is about an external threat, not about non-existence.
- Option D: Delusion of guilt is a false belief of having committed a terrible sin or crime. The patient's belief is about being a victim, not a perpetrator.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Types of Delusions in Psychiatric Disorders to guide bedside assessment, documentation, and the next nursing action.
- Recognizing the type of delusion is crucial for a nurse to assess the risk of harm. A patient with persecutory delusions may act violently towards their perceived persecutors out of fear or a desire for self-defense.
- The primary nursing approach is to build a therapeutic alliance by acknowledging the patient's fear and distress without validating the delusion itself. Never argue or try to reason the patient out of their delusion.
- What if the patient's belief was that his family was trying to save him from an alien invasion? This would shift the delusion's theme from persecutory to potentially grandiose or a mix of themes, changing the immediate risk assessment from potential violence against family to other unpredictable behaviors.
How to Approach the Question
- First, identify the core concept in the question stem: a 'false and fixed belief'. This immediately points to a delusion.
- Next, analyze the specific content of the belief: 'members of his family are trying to kill him'.
- Break down the content into its theme. The theme is one of being threatened, plotted against, and harmed.
- Evaluate the options based on this theme. 'Persecution' directly matches the theme of being harmed or attacked.
- Compare this with the definitions of the other options (grandeur = inflated self-worth, nihilistic = non-existence, guilt = remorse for a perceived sin) to confirm they do not match the scenario.
Concept Tested & Keywords
- Concept Tested: Types of Delusions in Psychiatric Disorders
- Stem keywords: disorder of thought, false and fixed belief, family trying to kill him
- Lead-in keywords: is
- Clinical cues: The content of the belief (being killed by family) is the key to identifying the type of delusion.
Question ID
QLIANlbhJfRIctyq7WuKcu
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 4723-4725, 3249-3251, 3807-3809
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