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DSSSB - 28 August 2019 (Shift-1)
Mental Health Nursing
Easy

Which type of delusional disorder is commonly found in paranoid schizophrenia?

Appeared in: DSSSB - 28 August 2019 (Shift-1)

Explanation

  • Delusion of persecution is a fixed, false belief that one is being harmed, threatened, cheated, or conspired against.
  • This is the most characteristic and common type of delusion experienced by individuals with paranoid schizophrenia, endorsed by up to 80% of inpatients with the condition.
  • The content of the delusion often involves fears of being watched, followed, or plotted against, which directly relates to the 'paranoid' aspect of the diagnosis.

Why Other Options Were Wrong

  • Option A: This is a false belief of being responsible for a terrible sin or crime. While it can occur in schizophrenia, it is more characteristic of severe depression with psychotic features.
  • Option C: This is a false belief of having exceptional power, wealth, or importance. It is the hallmark symptom of the manic phase of bipolar disorder, not typically paranoid schizophrenia.
  • Option D: This is the false belief that oneself, others, or the world is non-existent or ending. It is also known as Cotard's syndrome and is most often associated with severe depression.

Related Visual

Visual explanation — Related Visual
Clinical Relevance
  • Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of delusions in paranoid schizophrenia as background academic context rather than a clinical decision trigger.
  • Recognizing the specific type of delusion is crucial for accurate diagnosis and tailoring treatment. A patient with persecutory delusions requires a nursing approach focused on building trust and ensuring the patient feels safe.
  • Nurses must respond to the emotional content of the delusion (e.g., the fear in persecution) rather than arguing about the reality of the belief. Directly confronting a delusion is counterproductive and can damage the therapeutic relationship.
  • What if? If a patient presented with delusions of grandeur and hyperactivity instead of persecutory beliefs, the primary diagnosis would likely shift from schizophrenia to bipolar I disorder (manic episode), requiring mood stabilizers as a primary treatment instead of only antipsychotics.
How to Approach the Question
  • First, identify the key terms in the question: 'delusional disorder' and 'paranoid schizophrenia'.
  • Focus on the word 'paranoid'. This term itself implies suspicion, mistrust, and the belief that one is being targeted.
  • Evaluate the options based on this core concept. 'Delusion of persecution' directly aligns with the theme of being paranoid and fearing harm from others.
  • Recall or deduce the conditions associated with the other delusions. Grandeur is linked to mania, while guilt and nihilism are more strongly linked to severe depression.
  • This process of association and elimination confirms that persecution is the delusion most commonly found in paranoid schizophrenia.
Concept Tested & Keywords
  • Concept Tested: Types of delusions in paranoid schizophrenia
  • Stem keywords: delusional disorder, paranoid schizophrenia
  • Lead-in keywords: commonly found
  • Negative lead-in flag: false

Question ID

QgZlvC57-FDNEd34paBTuF

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. 4722-4724, 4723-4725, 3803-3805

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