A patient in the emergency department is observed maintaining an awkward, rigid posture with one hand raised and one leg stretched out for an extended period. When asked why he is maintaining this posture, he replies, I do not know. I am not aware of my position. This psychomotor abnormality is known as:

1. A

   Delusion

2. B

   Hallucination

3. C

   Catalepsy

4. D

   Echolalia

Appeared in: NORCET-11 Prelims

Explanation

• Catalepsy is the maintenance of a rigid, awkward posture for a prolonged period, often seen in catatonia.
• Patients with catalepsy are typically unaware of their abnormal posture and cannot explain why they are holding it.
• Catalepsy is a key sign of catatonic states, which require urgent psychiatric evaluation.
• The scenario describes a motor/postural abnormality, not a belief, perception, or speech issue.

Why Other Options Were Wrong

• Option A: Delusion refers to a fixed, false belief not in keeping with reality. It does not involve abnormal posturing or motor symptoms.
• Option B: Hallucination is a false sensory perception (seeing, hearing, or feeling things that are not present). It does not involve abnormal posture or movement.
• Option D: Echolalia is the involuntary repetition of another person's spoken words. It is a speech abnormality, not a motor or postural one.

Related Visual

Clinical Relevance

• Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Recognition of catalepsy as a psychomotor abnormality in catatonia in acute care settings.
• Nurses must recognize catalepsy as a sign of catatonia, which can be a psychiatric emergency requiring urgent intervention.
• Catalepsy may indicate underlying schizophrenia, mood disorder, or medical causes such as encephalitis or drug toxicity.
• What if? If the patient was actively resisting movement or imitating the examiner's actions, the diagnosis would shift to negativism or echopraxia, respectively, changing the management approach.

How to Approach the Question

• Identify the main abnormality described (rigid, awkward posture held for a long time).
• Note the patient's lack of awareness or explanation for the posture.
• Recall definitions of key psychiatric terms: catalepsy (motor), delusion (belief), hallucination (perception), echolalia (speech).
• Match the scenario to the term that best fits the observed behavior.
• Eliminate options that do not involve motor or postural symptoms.

Concept Tested & Keywords

• Concept Tested: Recognition of catalepsy as a psychomotor abnormality in catatonia
• Stem keywords: emergency department, awkward rigid posture, one hand raised, one leg stretched, unaware of position
• Lead-in keywords: psychomotor abnormality, known as
• Clinical cues: Patient unaware of posture
• Clinical cues: Prolonged maintenance of abnormal position

Question ID

QC-zKuVWURmbd4A2DG_6dP

Copy ID

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. 3898-3900, 4738-4740