In a patient, repeated senseless thoughts are coming and the person has a feeling that someone else is putting these thoughts in his mind, is?

Appeared in: Central Institute of Psychiatry - 9 July 2022

Explanation

The patient's belief that thoughts are being placed in their mind by an external entity is the textbook definition of thought insertion.
The core feature is the loss of ownership of one's own thoughts; the patient does not recognize the thoughts as self-generated.
Thought insertion is a specific type of delusion and is considered a 'first-rank' symptom, which is strongly suggestive of schizophrenia.

Why Other Options Were Wrong

Option A: In obsessions, the individual recognizes the intrusive and unwanted thoughts as their own, even though they are distressing (ego-dystonic). The patient in the scenario believes the thoughts are from an external source.
Option C: A hallucination is a false sensory perception (e.g., hearing voices, seeing things) without an external stimulus. The question describes a disorder of thought content, not perception.
Option D: While thought insertion is a type of delusion (a fixed false belief), 'Thought insertion' is a more specific and precise term for the described symptom. In nursing and medical exams, the most specific correct answer is preferred over a general category.

Related Visual

Clinical Relevance

Nursing practice connection: Use the key finding related to Disorders of Thought Content to guide bedside assessment, documentation, and the next nursing action.
Nurses must assess for patient safety, including command hallucinations or delusional beliefs that could lead to self-harm or harm to others.
Building a therapeutic alliance is crucial. Do not argue with or challenge the patient's delusion, as this can increase agitation and damage rapport. Instead, focus on the underlying feelings of fear and distress by saying, 'That must be very frightening for you.'.
Administering and monitoring the effects of antipsychotic medications is a key nursing role, as these medications are the primary treatment for reducing psychotic symptoms like thought insertion.

How to Approach the Question

First, analyze the patient's experience described in the stem: 'repeated senseless thoughts' and the feeling 'someone else is putting these thoughts in his mind'.
Identify the key feature: the patient attributes the origin of their thoughts to an external source. This indicates a loss of ownership over one's thoughts.
Evaluate the options based on this key feature. 'Obsession' involves thoughts that are recognized as one's own. 'Hallucination' is a disorder of perception, not thought content.
Compare 'Thought insertion' and 'Delusion'. 'Delusion' is a broad category of false beliefs. 'Thought insertion' specifically describes the belief that thoughts are being implanted by an outside force.
Select the most specific and accurate term that precisely matches the clinical picture, which is 'Thought insertion'.

Concept Tested & Keywords

Concept Tested: Disorders of Thought Content
Stem keywords: repeated senseless thoughts, someone else is putting thoughts in his mind
Lead-in keywords: is
Negative lead-in flag: false

Question ID

QsexuES7N_fWTgJ2LfsAbs

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. 3796-3798, 3797-3799

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 50-52

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