A patient admitted in the psychiatric ward refused to eat her lunch stating that the food is poisoned. This kind of response is an example of?

Appeared in: AIIMS Patna NO - 2020

Explanation

Delusion because it is defined as a fixed, false belief that is not amenable to logic and is inconsistent with the person's cultural and educational background.
The patient's conviction that her food is poisoned, despite a lack of evidence, perfectly fits the definition of a delusion.
This specific type of belief is classified as a persecutory delusion, where the individual feels they are being targeted or harmed.
Unlike illusions or hallucinations, delusions are disorders of thought content, not perception.

Why Other Options Were Wrong

Option A: A hallucination is a false sensory perception in the absence of any real external stimulus. In this case, the food is a real stimulus, so the patient's experience is not a hallucination.
Option B: Sympathy is an emotion involving feeling pity or sorrow for someone else's situation. It is not a psychiatric symptom or a thought disorder.
Option C: An illusion is a misinterpretation or misperception of a real external stimulus. The patient is not misinterpreting a sensory aspect of the food (e.g., thinking a piece of carrot is a bug); they are assigning a false quality (poison) based on an internal belief.

Related Visual

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Disorders of thought content, specifically the differentiation between delusions, hallucinations, and illusions in acute care settings.
Nurses must recognize delusions to ensure patient safety. A patient with persecutory delusions about food is at high risk for malnutrition and dehydration.
It is crucial for the nurse not to argue with or challenge the delusion, as this can increase agitation and damage the therapeutic relationship. Instead, use therapeutic communication and focus on the feelings generated by the belief.
Nursing interventions include offering pre-packaged, sealed food or allowing the patient to choose their food to help build trust and ensure adequate nutrition.

How to Approach the Question

First, analyze the patient's statement: 'the food is poisoned.' This represents a thought or belief.
Next, evaluate the nature of this belief. It is false (assuming the hospital food is safe) and fixed (the patient is acting on it by refusing to eat).
Differentiate between disorders of thought and disorders of perception. Hallucinations and illusions are perceptual disturbances, while delusions are thought disturbances.
Since the patient's issue is a belief, not a sensory experience, you can narrow the options to 'Delusions'.
Eliminate 'Sympathy' as it is an emotion and not a clinical symptom of a thought disorder.
Confirm your choice by matching the scenario to the definition of a delusion: a fixed, false belief held despite contrary evidence.

Concept Tested & Keywords

Concept Tested: Disorders of thought content, specifically the differentiation between delusions, hallucinations, and illusions.
Stem keywords: psychiatric ward, refused to eat, food is poisoned
Lead-in keywords: example of
Clinical cues: The patient's statement 'the food is poisoned' is a direct indicator of a specific type of thought disturbance.

Question ID

QsXoyMR_pd9BP_W80Kc14k

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. 3802-3804, 3250-3252, 3249-3251

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