NIMHANS Nursing Officer - 2021
Mental Health Nursing
Easy
Posture Deformity is seen in which type of schizophrenia?
Appeared in: NIMHANS Nursing Officer - 2021
Explanation
- Posture deformity, clinically referred to as 'posturing', is a defining psychomotor symptom of catatonic schizophrenia.
- Posturing is the spontaneous and active maintenance of a rigid, inappropriate, or bizarre posture against gravity for long periods.
- Catatonia itself is a syndrome of psychomotor disturbance that can involve decreased motor activity (stupor, catalepsy, posturing), extreme negativism, or excessive and peculiar motor activity.
- According to diagnostic criteria, posturing is one of the key symptoms used to identify catatonia as a specifier for schizophrenia and other mental disorders.
Why Other Options Were Wrong
- Option A: Residual schizophrenia is primarily defined by the presence of negative symptoms (e.g., blunted affect, apathy, social withdrawal) following at least one acute psychotic episode. Prominent positive symptoms like hallucinations or catatonic behaviors are absent.
- Option B: Hebephrenic, or disorganized, schizophrenia is characterized by disorganized speech (e.g., incoherence, word salad), disorganized behavior, and flat or inappropriate affect. While behavior is odd, it does not involve the fixed, rigid postures seen in catatonia.
- Option D: This is a residual category used when the symptoms of schizophrenia are present but do not meet the criteria for the paranoid, disorganized, or catatonic types. It indicates a non-specific presentation, whereas posture deformity is a very specific sign.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical features and subtypes of Schizophrenia as background academic context rather than a clinical decision trigger.
- Nurses must prioritize patient safety and physical well-being in catatonia. Due to immobility and refusal to eat or drink, patients are at high risk for dehydration, malnutrition, skin breakdown, and deep vein thrombosis (DVT).
- Nursing interventions include regular repositioning, passive range-of-motion exercises, meticulous skin care, monitoring intake and output, and ensuring adequate nutrition and hydration, sometimes via nasogastric tube.
- What if? If a patient on antipsychotics develops posturing along with high fever, muscle rigidity, and autonomic instability, the nurse must immediately consider Neuroleptic Malignant Syndrome (NMS), a life-threatening emergency, and escalate care.
How to Approach the Question
- First, identify the key clinical sign mentioned in the question: 'Posture Deformity'.
- Translate this term into its clinical equivalent, which is 'posturing' or 'catalepsy'—a type of psychomotor symptom.
- Next, review the options provided, which are different subtypes of schizophrenia.
- Recall the defining characteristics of each subtype: Residual (negative symptoms), Hebephrenic/Disorganized (disorganized speech/behavior), and Catatonic (psychomotor disturbances).
- Directly associate the key sign (posturing) with the subtype known for prominent psychomotor symptoms, which is Catatonic schizophrenia.
- This direct link makes Catatonic the correct answer and allows for the elimination of the other options which are defined by different symptom clusters.
Concept Tested & Keywords
- Concept Tested: Clinical features and subtypes of Schizophrenia.
- Stem keywords: Posture Deformity, schizophrenia
- Lead-in keywords: seen in which type
- Negative lead-in flag: false
Question ID
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Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1102-1104
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4738-4740
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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