MNS 2024
Mental Health Nursing
Easy
Which is not a first-rank symptom of schizophrenia?
Appeared in: MNS 2024
Explanation
- Thought block is a formal thought disorder characterized by a sudden interruption in a person's speech and the underlying thought process.
- While it is a significant symptom often seen in schizophrenia, it is not included in Kurt Schneider's specific list of first-rank symptoms (FRS).
- The first-rank symptoms are a distinct set of experiences, such as audible thoughts and thought broadcasting, considered highly indicative of schizophrenia.
Why Other Options Were Wrong
- Option A: Audible thoughts (hearing one's thoughts spoken aloud) is a classic first-rank symptom, categorized under auditory hallucinations.
- Option B: Thought broadcasting is a core first-rank symptom, falling under the category of thought alienation phenomena.
- Option C: Made volition (the feeling that an external force is controlling one's actions) is a first-rank symptom, classified as a passivity phenomenon.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Schneider's First-Rank Symptoms of Schizophrenia helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Accurate identification of specific psychotic symptoms is crucial for nurses in mental health settings. Differentiating between first-rank symptoms and other thought disorders helps in precise documentation and communication with the multidisciplinary team.
- The presence of one or more FRS can raise the index of suspicion for schizophrenia, prompting a more thorough psychiatric evaluation and facilitating earlier diagnosis and treatment.
- What if? If a patient exhibits thought block but no first-rank symptoms, the clinical focus might shift. While schizophrenia is still a possibility, the differential diagnosis would more strongly include conditions like severe anxiety, delirium, complex partial seizures, or dissociative disorders, requiring a different diagnostic and management approach.
How to Approach the Question
- First, recognize the negative framing of the question: 'Which is NOT...'. This means you are looking for the one option that does not belong to the specified group.
- Next, recall the definition of Schneider's First-Rank Symptoms (FRS) of schizophrenia. These are a specific, defined list of symptoms.
- Systematically evaluate each option against your knowledge of FRS.
- Option A, 'Audible thoughts,' is a well-known FRS (an auditory hallucination). Therefore, it is not the answer.
- Option B, 'Thought broadcasting,' is also a classic FRS (a thought alienation phenomenon). It is not the answer.
- Option C, 'Made volition,' is an FRS (a passivity phenomenon). It is not the answer.
Concept Tested & Keywords
- Concept Tested: Schneider's First-Rank Symptoms of Schizophrenia
- Stem keywords: first-rank symptom, schizophrenia
- Lead-in keywords: not
- Negative lead-in flag: The question asks to identify the option that is NOT a first-rank symptom.
Question ID
qpkUBXKcgp33uHDum4uPX
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, 3794-3796
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1092-1094
Practise the full MNS 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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