A schizophrenia patient believes that the neighbor has installed a circuit inside his body. This is an example of which type of delusion?

1. A

   Delusion of persecution

2. B

   Delusion of reference

3. C

   Delusion of control

4. D

   Somatic delusion

Appeared in: NORCET 9 Mains - 2025

Explanation

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• A delusion of control is a false belief that one's will, thoughts, or feelings are being controlled by external forces.
• The patient's belief that a neighbor has 'installed a circuit' inside his body is a specific, classic example of this delusion.
• The core theme is the loss of personal autonomy to an outside agent or device, which is the defining feature of a delusion of control.
• While it may have persecutory or somatic elements, the primary and most specific classification is control.

Why Other Options Were Wrong

• Option A: A delusion of persecution involves the belief of being conspired against, spied on, or harassed. While installing a circuit is a persecutory act, the delusion's main theme is the function of the circuit (control), making 'delusion of control' a more precise diagnosis.
• Option B: A delusion of reference is the belief that random, unrelated events or objects have a special personal meaning. The patient's belief is not about interpreting a neutral event but about a specific action directed at them.
• Option D: A somatic delusion is a false belief about one's body, such as having a terrible disease or a physical abnormality. The patient's belief is not about a health condition but about an external device implanted for control.

Related Visual

• Visual 1: Infographic: A chart comparing the different types of delusions (Persecutory, Control, Reference, Somatic, Grandiose) with clear definitions and examples for each.

Clinical Relevance

• Nursing practice connection: Use the key finding related to Types of Delusions in Schizophrenia to guide bedside assessment, documentation, and the next nursing action.
• When interacting with a patient experiencing delusions, it is crucial for the nurse to build trust and not directly challenge or argue about the delusion. This can increase agitation and paranoia.
• The nursing priority is to focus on the feelings generated by the delusion (e.g., fear, anxiety) and to ensure the safety of the patient and others.
• What if? If the patient's belief was that the neighbor was simply spying on them through the walls, the delusion would be classified as persecutory, as the element of direct bodily control would be absent.

How to Approach the Question

• First, read the clinical scenario carefully to identify the patient's core belief. The patient believes a 'circuit' is 'inside his body' and was 'installed by the neighbor'.
• Analyze the key components: an external agent (neighbor), a mechanism (circuit), and an outcome (implied control or monitoring).
• Review the definitions of the delusion types provided in the options.
• Match the core belief from the scenario to the most fitting definition. The belief that an external force is controlling one's body via an implanted device directly matches the definition of a 'delusion of control'.
• Differentiate from other options. It's not just persecution (harm), somatic (illness), or reference (neutral events), but specifically about being controlled.

Concept Tested & Keywords

• Concept Tested: Types of Delusions in Schizophrenia
• Stem keywords: schizophrenia, patient believes, neighbor, installed a circuit, delusion
• Lead-in keywords: example of which type
• Clinical cues: The belief in an 'installed circuit' is a key clinical cue pointing towards a delusion of control, as it implies a mechanism for external influence.

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