DSSSB 6 September 2024
Mental Health Nursing
Easy
Which of the following types of schizophrenia is commonly characterised by excitement and stupor?
Appeared in: DSSSB 6 September 2024
Explanation
- Catatonic schizophrenia is defined by its hallmark psychomotor disturbances.
- These disturbances manifest as dramatic shifts between opposite states: catatonic excitement (excessive, purposeless motor activity) and catatonic stupor (immobility, mutism, and unresponsiveness).
- Associated features like waxy flexibility, negativism, and echopraxia are also characteristic of this subtype.
- The question's keywords, 'excitement' and 'stupor', directly point to the defining features of the catatonic type.
Why Other Options Were Wrong
- Option A: Residual schizophrenia is characterized by the absence of prominent positive symptoms like excitement or stupor. Instead, negative symptoms like emotional flatness and lack of motivation are present.
- Option B: Hebephrenic (or disorganized) schizophrenia is marked by disorganized speech, disorganized behavior, and inappropriate affect, not the specific motor disturbances of excitement and stupor.
- Option C: Paranoid schizophrenia's primary features are prominent delusions and auditory hallucinations. Motor function is generally preserved and not characterized by stupor or excitement.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of Schizophrenia and their characteristic symptoms as background academic context rather than a clinical decision trigger.
- Recognizing the signs of catatonia is critical for patient safety. During catatonic excitement, the nurse's priority is to prevent harm to the patient and others. During catatonic stupor, the priority shifts to physiological support, including nutrition, hydration, and prevention of complications of immobility like pressure sores and contractures.
- What if? If a patient presented with extreme psychomotor agitation but also had a high fever, unstable blood pressure, and delirium, the condition might be Malignant Catatonia, a life-threatening emergency requiring immediate medical intervention, often including ECT (Electroconvulsive Therapy).
How to Approach the Question
- First, identify the key descriptive words in the question stem: 'excitement' and 'stupor'.
- Recognize that these terms describe extreme states of psychomotor activity—one of hyperactivity and the other of immobility.
- Review the options provided, which are different subtypes of schizophrenia.
- Recall the defining characteristics of each subtype.
- Match the key symptoms (excitement and stupor) to the subtype that is specifically defined by these motor disturbances.
- Catatonic schizophrenia is the only subtype where such dramatic psychomotor abnormalities are the core feature, making it the correct answer.
Concept Tested & Keywords
- Concept Tested: Types of Schizophrenia and their characteristic symptoms
- Stem keywords: schizophrenia, excitement, stupor
- Lead-in keywords: Which of the following, characterised by
Question ID
Q3Tbto64FOIRbzlJvvBNLM
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1104-1106, 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. 2338-2340
Practise the full DSSSB 6 September 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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