AIIMS Raipur - 2017 (shift-2)
Psychiatric Nursing
Easy
Mr. Raju says that he is the first lead of the world and he is born with a special mission in life?
Appeared in: AIIMS Raipur - 2017 (shift-2)
Explanation
- The patient's belief that he is the 'first lead of the world' and has a 'special mission' is a classic example of a delusion of grandeur.
- This type of delusion involves a false, fixed belief about one's own greatness, power, identity, or special abilities.
- The content of the delusion is centered on an exaggerated sense of self-importance, which directly aligns with the definition of a grandiose delusion.
Why Other Options Were Wrong
- Option A: An autochthonous delusion describes the sudden, 'out of the blue' origin of a delusion, not its content. The content of Mr. Raju's delusion is grandiose, regardless of how it originated.
- Option C: A delusion of persecution involves the belief that one is being harmed, harassed, or plotted against. Mr. Raju's statement does not express fear or a sense of being threatened.
- Option D: A delusion of reference is the belief that neutral events or objects have a special, personal meaning. Mr. Raju is stating a belief about himself, not interpreting an external event.
Related Visual
- Visual 1: Infographic: A chart comparing the different types of delusions (Grandeur, Persecution, Reference, Control, etc.) with clear definitions and examples for each.
- Visual 2: Flowchart: A decision tree for nurses to help differentiate between types of thought content disorders based on patient statements.
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of Delusions in Psychiatry as background academic context rather than a clinical decision trigger.
- Correctly identifying the type of delusion is crucial for assessing risk. Grandiose delusions can lead to impulsive or reckless behavior as the person may feel invincible or above the law.
- The nursing approach must be non-confrontational. Acknowledging the patient's underlying feelings while gently orienting them to reality helps build trust and de-escalate potential agitation.
- What if the patient said, 'I am the first lead of the world, and the news anchor last night confirmed it by winking at me'? This would indicate the presence of both a delusion of grandeur and a delusion of reference, making the clinical picture more complex.
How to Approach the Question
- First, carefully read the patient's statement: 'he is the first lead of the world and he is born with a special mission in life'.
- Identify the core theme of the statement. The theme is about being exceptionally powerful, important, and having a unique purpose.
- Next, review the definitions of the delusion types provided in the options.
- Match the theme of the patient's statement to the correct definition. The belief in one's own exaggerated importance is the hallmark of a delusion of grandeur.
- Eliminate the other options by confirming they do not fit. The statement isn't about being harmed (persecution), interpreting neutral events (reference), or its sudden onset (autochthonous).
Concept Tested & Keywords
- Concept Tested: Types of Delusions in Psychiatry
- Stem keywords: first lead of the world, special mission, delusion
- Lead-in keywords: FIRST
- Clinical cues: Patient's statement reflects an inflated sense of self-importance and purpose.
- Negative lead-in flag: false
Question ID
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Practise the full AIIMS Raipur - 2017 (shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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