Somatic and Dissociative Disorders MCQs

Psychiatry · 24 free questions with answers & explanations.

1. A 35-year-old woman presents with persistent, distressing abdominal pain, fatigue, and headaches lasting 18 months. Extensive investigations are normal. She is highly preoccupied with the possibility of a serious underlying illness, frequently checks her body, and seeks repeated medical consultations. Her preoccupation persists even after thorough reassurance. Which DSM-5-TR diagnosis best fits?
2. A 22-year-old woman is brought to the emergency department after an episode in which she suddenly travelled to a different city, assumed a different name, and had no memory of her past life or identity for three days. She then abruptly regained her original identity and could not recall the period of travel. What is the most likely diagnosis?
3. A 35-year-old woman presents with multiple physical complaints (pain, GI symptoms, sexual dysfunction) over 5 years, causing significant distress, despite extensive negative workup. She is excessively worried and rates her health as poor. In DSM-5, what key feature distinguishes Somatic Symptom Disorder (SSD) from Illness Anxiety Disorder (IAD)?
4. A 22-year-old woman develops sudden inability to move her left leg following a stressful event. MRI brain and spine are normal. Neurological examination shows Hoover's sign. What is the most appropriate initial management approach?
5. In Dissociative Identity Disorder (DID), which of the following is a key diagnostic criterion in DSM-5?
6. A 35-year-old woman presents with multiple medically unexplained symptoms — fatigue, pain in multiple areas, bloating — for 4 years. She spends excessive time reading about these symptoms online, frequently visits different physicians, and rates health anxiety as severely impairing. In DSM-5, the MOST likely diagnosis is:
7. A 28-year-old soldier returns from deployment and develops episodes of bilateral limb shaking without loss of consciousness or postictal confusion. EEG during an episode is normal. The MOST appropriate term for his condition in DSM-5 is:
8. La belle indifférence (apparent lack of concern about a serious neurological symptom) is classically associated with which disorder, though is no longer considered pathognomonic in DSM-5?
9. A 40-year-old woman has been to 8 physicians over 2 years with complaints of fatigue, headaches, abdominal pain, and palpitations. All investigations are normal. She is excessively preoccupied and distressed about these symptoms and finds them disabling. She does NOT believe she has a serious disease (no health anxiety). According to DSM-5, the MOST appropriate diagnosis is:
10. A 25-year-old woman develops sudden inability to move her left arm after witnessing a traumatic accident. Neurological examination shows no weakness, normal reflexes, and normal MRI. She appears indifferent to the loss of function ('la belle indifférence'). Which DSM-5 diagnosis is MOST appropriate?
11. A 28-year-old woman describes periods where she feels like she is watching herself from outside her body—observing her own actions as if she is a detached observer. This happens during stress and resolves spontaneously. She is distressed by it. Reality testing remains intact. What is the CORRECT DSM-5 term for this experience?
12. A 38-year-old woman develops sudden inability to walk following news of her husband's death in an accident. Neurological examination reveals normal reflexes, no Babinski sign, and a positive Hoover's sign. Brain and spinal MRI are normal. What is the DSM-5 diagnosis and what has replaced the DSM-IV requirement for a psychological precipitant?
13. A 30-year-old woman experiences episodes of feeling detached from her body and surroundings, as if watching herself from outside. She is fully oriented and has no psychotic features. She describes the experience as unpleasant and alien to her. What defence mechanism underlies the psychodynamic understanding of this presentation?
14. DSM-5 replaced DSM-IV Somatisation Disorder, Undifferentiated Somatoform Disorder, and Pain Disorder with a new diagnosis. What is this diagnosis and what is its core defining criterion in DSM-5?
15. A 22-year-old woman presents with sudden inability to move her right arm after witnessing domestic violence. Neurological examination, MRI brain, and nerve conduction studies are all normal. She appears remarkably unconcerned about her disability ('la belle indifférence'). The most likely DSM-5 diagnosis is:
16. Dissociative Identity Disorder (DID) in DSM-5 is distinguished from DSM-IV by which modification?
17. A patient with Factitious Disorder Imposed on Another (FDIA, formerly Munchausen syndrome by proxy) is identified in a paediatric ward. The most critical immediate action is:
18. A 38-year-old woman presents with multiple physical symptoms (pain, fatigue, GI symptoms, neurological complaints) across multiple body systems over 7 years, for which no adequate medical explanation is found. She has significant functional impairment and spends considerable time seeking medical opinions. Per DSM-5, the most appropriate diagnosis is:
19. A 35-year-old woman presents with recurrent, medically unexplained weakness of her right arm that appears during times of emotional stress, with normal neurological examination and normal MRI brain/spine. The MOST important distinguishing clinical sign that supports a functional neurological symptom disorder (conversion disorder) diagnosis is:
20. A patient has recurrent episodes in which she feels detached from her own thoughts, body, and actions — as if she is an outside observer of herself — with intact reality testing. This symptom is BEST described as:
21. A 35-year-old woman presents with a sudden onset of inability to walk, with normal sensation. Neurological exam reveals give-way weakness, inconsistency on different examination maneuvers (Hoover sign positive), and normal MRI brain/spine. She recently had a severe interpersonal conflict. DSM-5 diagnosis is:
22. Depersonalization/Derealization Disorder involves persistent experiences of feeling detached from one's thoughts and body (depersonalization) or surroundings seeming unreal (derealization). The most important feature that DISTINGUISHES it from a psychotic disorder is:
23. A 22-year-old woman presents with left arm paralysis and inability to feel her left hand after witnessing her boyfriend's accident. Neurological examination shows inconsistent 'give-way' weakness and splitting of midline vibration sense. All neuroimaging and electrophysiology are normal. The DSM-5 diagnosis is:
24. Which dissociative disorder is characterised by sudden, unexpected travel away from home, inability to recall one's past, confusion about personal identity, or assumption of a new identity, lasting hours to days?