A schizophrenic patient is stating that I am coming from other Planet and I have power to change the world. Patient may suffer from?

Appeared in: NORCET 5 Prelims - Sept 2023 (Shift-2)

Explanation

The patient's statement, "I am coming from other Planet and I have power to change the world," demonstrates a belief in having a special identity and unique, extraordinary abilities.
This directly aligns with the definition of a grandiose delusion, which is characterized by an exaggerated or inflated sense of one's own importance, power, knowledge, or identity.
According to psychiatric definitions, a grandiose delusion involves the belief that one has special powers, influence, or a unique relationship with a deity or famous person.

Option B: This is incorrect because the patient is not expressing fear of being harmed, harassed, or conspired against. The statement is about power, not persecution.
Option C: This is incorrect because the patient is not interpreting a neutral, external event as having a special, personal meaning. The belief is about their own internal state and identity.
Option D: This is incorrect as it involves the belief in non-existence. The patient's statement is the opposite, asserting a powerful existence and ability to influence the world.

Visual 1: Infographic: A chart comparing the core beliefs of different types of delusions (grandiose, persecutory, reference, nihilistic, somatic) with simple icons for each to aid memory.

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.
Identifying the specific type of delusion is crucial for risk assessment. A patient with grandiose delusions may neglect self-care or engage in risky behaviors, believing they are invulnerable.
The nurse's primary role is to build a therapeutic alliance. Instead of directly confronting the delusion (which can increase agitation), the nurse should focus on the underlying feelings and redirect the conversation to reality-based topics.
What if the patient stated, 'The people on the bus were talking about me and laughing at me'? This would suggest a delusion of reference, possibly with a persecutory theme, rather than a delusion of grandeur.

How to Approach the Question

First, carefully read the patient's statement: "I am coming from other Planet and I have power to change the world."
Identify the central theme of this belief. The key elements are a special origin ('other Planet') and exaggerated ability ('power to change the world').
This theme points towards an inflated sense of self-importance and power.
Next, review the definitions of the delusion types provided in the options.
Match the identified theme to the correct definition. The patient's belief directly corresponds to the definition of a delusion of grandeur.
Eliminate the other options by confirming their definitions do not match the patient's statement (e.g., no mention of harm, special messages from events, or non-existence).

Concept Tested & Keywords

Concept Tested: Types of Delusions in Schizophrenia
Stem keywords: schizophrenic patient, coming from other Planet, power to change the world
Lead-in keywords: suffer from

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Practise the full NORCET 5 Prelims - Sept 2023 (Shift-2)

Attempt every question from this paper in a timed mock, then review the full solution for each one.