NIMHANS Nursing Officer - 2021
Mental Health Nursing
Hard
All statements are true about obsession, except?
Appeared in: NIMHANS Nursing Officer - 2021
Explanation
- This statement is the correct exception because obsessions are the hallmark feature of Obsessive-Compulsive Disorder (OCD), not schizophrenia.
- While a subset of patients with schizophrenia can have co-occurring obsessive-compulsive symptoms, it is not a characteristic or defining feature of obsession itself.
- The core symptoms of schizophrenia are delusions, hallucinations, and disorganized thought processes, which are distinct from obsessions.
- In a clinical context, the presence of true obsessions (with insight and resistance) points away from a primary psychotic disorder and towards OCD.
Why Other Options Were Wrong
- Option A: This statement is a core, defining feature of an obsession. The person recognizes the thought as intrusive and tries to resist or ignore it, but it persists.
- Option C: This statement is a correct classification. Obsessions are considered a disorder of thought content because they relate to the theme or subject of the thought (e.g., contamination, doubt, order).
- Option D: This statement is a fundamental characteristic of an obsession. 'Ego-dystonic' means the thought is repugnant, unwanted, and inconsistent with the person's sense of self, causing anxiety.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The core definitional features of obsession and its differentiation from psychotic symptoms as background academic context rather than a clinical decision trigger.
- Nurses must be able to differentiate between an obsession and a delusion to accurately assess a patient's mental state and report to the healthcare team.
- Assessment involves asking about the patient's reaction to the thought. Questions like, 'Do these thoughts feel like your own, even though you don't want them?' or 'Do you try to fight them?' can help clarify the presence of insight and resistance, key features of obsession.
- What if? If a patient expresses a bizarre thought but shows no resistance and firmly believes it is true (e.g., 'The FBI planted a chip in my brain'), the nurse should suspect a delusion (symptom of psychosis) rather than an obsession, warranting an urgent psychiatric evaluation for psychosis.
How to Approach the Question
- First, identify the negative framing of the question by spotting the keyword 'except'. This means you are looking for the statement that is false or the one that doesn't fit with the others.
- Next, recall the core definition of 'obsession' as taught in psychiatric nursing. The key elements are: it's an intrusive, unwanted thought (ego-dystonic); the person tries to resist it; and they have insight that it's their own irrational thought.
- Evaluate each option against this core definition.
- Option A ('persists despite resistance') is a core feature.
- Option C ('Disorder of thought content') is the correct classification.
- Option D ('Ego dystonic') is a core feature.
Concept Tested & Keywords
- Concept Tested: The core definitional features of obsession and its differentiation from psychotic symptoms.
- Stem keywords: obsession, true, statements
- Lead-in keywords: except
- Negative lead-in flag: The question uses the word 'except', requiring the identification of the statement that is not a core truth about obsession. This means three statements are defining features, and one is not.
Question ID
QDsuyFhy-st48sMlpX-4FH
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. 3797-3799, 12490-12492
Practise the full NIMHANS Nursing Officer - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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