Grandiose delusions occur in which of the following disorder?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2021

Mental Health Nursing

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2021

Explanation

Grandiose delusions are fixed, false beliefs of inflated self-worth, power, knowledge, identity, or having a special relationship with a deity or famous person.
These delusions are a characteristic symptom of mania, a state of elevated or irritable mood that is a core feature of Bipolar I Disorder.
During a manic episode, a person's thought content often includes themes of self-aggrandizement and unrealistic beliefs about their own abilities or importance.
Studies show that approximately 75% of patients in a manic state experience delusions, which are often mood-congruent and grandiose in nature.

Option B: Obsessive-compulsive disorder (OCD) is defined by obsessions (intrusive thoughts) and compulsions (repetitive behaviors), not by delusions. Patients with OCD usually have insight and recognize their thoughts are irrational.
Option C: Phobic disorder is an anxiety disorder characterized by an intense, irrational fear of a specific object or situation (e.g., heights, spiders). It does not involve false beliefs about one's own identity or power.
Option D: Anxiety disorder is a broad term for conditions involving excessive worry, fear, and nervousness. While it can be debilitating, it is not characterized by psychotic symptoms like grandiose delusions.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Symptomatology of Mood Disorders as background academic context rather than a clinical decision trigger.
Recognizing grandiose delusions is crucial for nurses as it signals a potential manic episode, which requires immediate intervention to ensure patient safety due to impaired judgment and risk-taking behaviors.
A key nursing responsibility is to create a safe, structured environment for a patient with mania, gently reorienting them to reality without directly challenging their delusions, which could cause agitation and escalate the situation.
What if? If a patient's false beliefs were bizarre and not related to mood (e.g., believing aliens control their thoughts), this might suggest a different psychotic disorder like schizophrenia rather than a manic episode.

How to Approach the Question

First, identify and define the core concept in the question: 'grandiose delusions.' This refers to a fixed, false belief of having inflated worth, power, or identity.
Next, systematically review the defining characteristics of each disorder listed in the options.
Recall that Manic disorder (a feature of Bipolar Disorder) is defined by a period of elevated mood, increased energy, and often includes grandiosity.
Recognize that Obsessive-compulsive disorder, Phobic disorder, and Anxiety disorder are all primarily characterized by fear, worry, and distress, not by psychotic features like delusions.
Conclude by matching the definition of grandiose delusions to the disorder it characterizes. The clear and classic match is with Manic disorder.

Concept Tested & Keywords

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E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1173-1175

E6 Pharmacology Nursing Lilley 11e Part 1 p. 269-271