IGNOU PB Bsc Entrance-2023
Mental Health Nursing
Medium
Dementia is seen in all EXCEPT:
Appeared in: IGNOU PB Bsc Entrance-2023
Explanation
- Schizophrenia is classified as a functional psychotic disorder, not an organic neurocognitive disorder like dementia.
- While schizophrenia involves significant cognitive deficits, these are considered a core symptom of the illness itself, not the result of the progressive, global brain degeneration that defines dementia.
- The term 'dementia praecox' (premature dementia) was historically used for schizophrenia but was abandoned because the condition does not follow the progressive deteriorating course of true dementias.
- The underlying pathology differs; dementia involves structural brain changes (e.g., plaques, tangles, cell death), whereas schizophrenia is primarily linked to neurochemical and connectivity abnormalities.
Why Other Options Were Wrong
- Option B: Head injury, especially severe or repeated traumatic brain injury (TBI), is a well-established cause of dementia due to direct, organic damage to brain tissue.
- Option C: Huntington's chorea is a classic example of a neurodegenerative disease that directly and invariably causes a progressive subcortical dementia as one of its primary features.
- Option D: While not classified as a primary cause of major neurocognitive disorder in the same way as alcohol, chronic heavy cannabis use is associated with significant cognitive impairment and is considered a risk factor or contributor to cognitive decline.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differential diagnosis between dementia and other psychiatric disorders with cognitive symptoms as background academic context rather than a clinical decision trigger.
- Accurate diagnosis is critical for patient management. Mistaking the cognitive symptoms of schizophrenia for dementia (or vice-versa) leads to inappropriate treatment, incorrect prognostic counseling, and poor outcomes.
- A nurse must be able to differentiate between long-standing cognitive deficits in a patient with schizophrenia and a new, superimposed process like delirium or a developing dementia, which requires urgent medical evaluation.
- What if? An elderly patient with a long history of stable schizophrenia presents with rapid memory loss and disorientation. The nurse should not assume this is a worsening of their schizophrenia. Instead, they must suspect a new, co-occurring condition like Alzheimer's disease or delirium and advocate for a full neurological and medical workup.
How to Approach the Question
- First, identify the negative framing of the question by spotting the word 'EXCEPT'. This means you are looking for the option that does not belong with the others.
- The core concept is 'Dementia'. Recall its definition: an organic brain syndrome with progressive cognitive decline.
- Evaluate each option to see if it is a known cause of, or is strongly associated with, organic brain changes leading to dementia.
- Option A, Schizophrenia, is a functional psychiatric disorder. While it has cognitive symptoms, it's not classified as a dementia.
- Options B (Head injury) and C (Huntington's) are direct causes of organic dementia.
- Option D (Cannabis use) is associated with cognitive impairment. Therefore, Schizophrenia is the distinct outlier and the correct answer.
Concept Tested & Keywords
- Concept Tested: Differential diagnosis between dementia and other psychiatric disorders with cognitive symptoms.
- Stem keywords: Dementia, Schizophrenia, Head injury, Huntington's chorea, Cannabis use disorder
- Lead-in keywords: EXCEPT
- Negative lead-in flag: Question is negatively framed with 'EXCEPT'
Question ID
QyCJZDwhCb4dQC-fyWCBsD
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 778-780
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4077-4079
Practise the full IGNOU PB Bsc Entrance-2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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