ABPN Psychiatric Assessment and Diagnosis 3 — Questions and Answers
Question 1: A 25-year-old presents with 8 months of hallucinations, disorganized speech, and social withdrawal without a mood episode. Which diagnosis best fits?
- Brief psychotic disorder
- Schizophreniform disorder
- Schizophrenia (Correct answer)
- Schizoaffective disorder
Correct answer: Schizophrenia
Symptoms persisting 6 months or longer with functional decline and no dominant mood episode meet criteria for schizophrenia.
Question 2: Which feature distinguishes delirium from dementia on assessment?
- Gradual onset over months
- Preserved level of consciousness
- Acute onset with fluctuating attention (Correct answer)
- Stable course throughout the day
Correct answer: Acute onset with fluctuating attention
Delirium is characterized by acute onset, waxing-and-waning course, and impaired attention/consciousness.
Question 3: A patient reports at least two distinct identity states that recurrently take control of behavior, with gaps in memory. This suggests:
- Borderline personality disorder
- Dissociative identity disorder (Correct answer)
- Schizophrenia
- Bipolar I disorder
Correct answer: Dissociative identity disorder
Dissociative identity disorder involves two or more distinct personality states plus recurrent amnesia.
Question 4: Per DSM-5, a manic episode must last at least how long (if not requiring hospitalization)?
- 4 days
- 1 week (Correct answer)
- 2 weeks
- 1 month
Correct answer: 1 week
A manic episode requires elevated or irritable mood and increased energy lasting at least 1 week (or any duration if hospitalization is needed).
Question 5: Which of the following is a negative symptom of schizophrenia?
- Delusions
- Hallucinations
- Avolition (Correct answer)
- Disorganized speech
Correct answer: Avolition
Avolition (lack of motivation) is a negative symptom reflecting a reduction in normal function.
Question 6: A patient displays a lack of emotional reactivity with a face that shows minimal expression. This is documented as:
- Labile affect
- Blunted or flat affect (Correct answer)
- Euthymic mood
- Expansive affect
Correct answer: Blunted or flat affect
Markedly reduced intensity of emotional expression is described as blunted or flat affect.
Question 7: Which laboratory or clinical step is most important before attributing new psychiatric symptoms to a primary mental disorder?
- Ordering a personality inventory
- Ruling out medical and substance-induced causes (Correct answer)
- Starting an antidepressant immediately
- Scheduling weekly psychotherapy
Correct answer: Ruling out medical and substance-induced causes
Medical conditions and substances must be excluded before diagnosing a primary psychiatric disorder.
ABPN Psychiatric Assessment and Diagnosis 3
A 25-year-old presents with 8 months of hallucinations, disorganized speech, and social withdrawal without a mood episode.
Which diagnosis best fits?