NR547 Differential Diagnosis in Psychiatric-Mental Health
Midterm 2024/2025 – Chamberlain Review
1. What is the first step in creating a differential diagnosis (DDx) for psy-
chiatric symptoms?
A. Determine the specific primary disorder
B. Rule out malingering or factitious disorder
C. Rule out substance etiology
D. Rule out an etiological medical condition
Correct Answer: B
Rationale: The first step in formulating a differential diagnosis is to rule out
malingering or factitious disorder to ensure the patient’s symptoms are gen-
uine and not motivated by external incentives or intentional deception. This
step is critical for accurate psychiatric diagnosis.
2. What is the duration of continuous signs of disturbance required for a
schizophrenia diagnosis?
A. 1 month
B. 3 months
C. 6 months
D. 12 months
Correct Answer: C
Rationale: According to DSM-5-TR, a diagnosis of schizophrenia requires
continuous signs of disturbance for at least 6 months, including at least 1
month of active-phase symptoms.
3. Which of the following is a diagnostic criterion for schizophrenia?
A. Elevated mood for at least one week
B. Two or more: delusions, hallucinations, disorganized speech, disorganized
or catatonic behavior, negative symptoms
C. Recurrent panic attacks
D. Excessive worry for at least 3 months
Correct Answer: B
Rationale: DSM-5-TR specifies that schizophrenia diagnosis requires two or
more of the listed symptoms (delusions, hallucinations, disorganized speech,
disorganized or catatonic behavior, negative symptoms) for a significant por-
tion of time during a 1-month period.
4. What is the second step in creating a differential diagnosis?
A. Rule out malingering
B. Rule out substance etiology
C. Determine specific primary disorder
D. Differentiate adjustment disorders
Correct Answer: B
Rationale: After ruling out malingering or factitious disorder, the second
step is to rule out substance etiology, as substances can cause psychiatric
symptoms that resolve upon cessation.
5. How long must psychiatric symptoms persist after stopping a substance
1
, to consider a primary psychiatric disorder?
A. 1 week
B. 2 weeks
C. 1 month
D. 2 months
Correct Answer: C
Rationale: DSM-5-TR criteria indicate that if psychiatric symptoms persist
beyond 1 month after substance cessation, a primary psychiatric disorder
should be considered.
6. What is a key indicator that psychiatric symptoms are due to a medical
condition?
A. Symptoms begin before the medical condition
B. Symptoms vary with the severity of the medical condition
C. Symptoms persist after substance cessation
D. Symptoms are consistent with malingering
Correct Answer: B
Rationale: Psychiatric symptoms caused by a medical condition typically
begin after the onset of the condition, vary with its severity, and resolve when
the condition is treated.
7. What is the third step in creating a differential diagnosis?
A. Rule out malingering
B. Rule out substance etiology
C. Rule out a medical condition
D. Determine the primary disorder
Correct Answer: C
Rationale: The third step involves ruling out an etiological medical condi-
tion to ensure psychiatric symptoms are not secondary to a physical health
issue.
8. When should a general medical condition be considered in the differen-
tial diagnosis?
A. When symptoms are typical for a psychiatric disorder
B. When symptoms are atypical in pattern, age, or course
C. When the patient has a history of substance use
D. When symptoms resolve within 1 month
Correct Answer: B
Rationale: Atypical symptom patterns, age at onset, or course suggest a pos-
sible medical etiology, such as severe memory loss with depression, which
may indicate a medical condition.
9. What is the fourth step in creating a differential diagnosis?
A. Rule out malingering
B. Determine the specific primary disorder
C. Rule out substance etiology
D. Differentiate adjustment disorders
Correct Answer: B
Rationale: After ruling out malingering, substances, and medical conditions,
2
, the fourth step is to identify the specific primary psychiatric disorder using
DSM-5-TR criteria.
10. What is the fifth step in creating a differential diagnosis?
A. Rule out medical conditions
B. Differentiate adjustment disorders from other specified or unspecified dis-
orders
C. Establish boundaries with no mental disorder
D. Rule out substance etiology
Correct Answer: B
Rationale: The fifth step involves distinguishing adjustment disorders from
other specified or unspecified disorders to ensure accurate diagnosis.
11. Which of the following is characteristic of malingering?
A. Symptoms are intentionally produced for internal psychological gain
B. Symptoms are motivated by external incentives like avoiding legal respon-
sibility
C. Symptoms resolve with medical treatment
D. Symptoms are consistent with a recognized clinical entity
Correct Answer: B
Rationale: Malingering involves intentional symptom production for exter-
nal incentives, such as avoiding legal or military responsibilities, unlike fac-
titious disorder, which seeks psychological gain.
12. What is a hallmark feature of factitious disorder?
A. External incentives drive symptom production
B. Symptoms are feigned for psychological gain
C. Symptoms are consistent with a medical condition
D. Symptoms resolve after substance cessation
Correct Answer: B
Rationale: Factitious disorder is characterized by feigned symptoms for psy-
chological gain, such as assuming the sick role, without clear external incen-
tives.
13. Which symptom is NOT typically associated with major depressive dis-
order?
A. Anhedonia
B. Hallucinations
C. Fatigue
D. Feelings of worthlessness
Correct Answer: B
Rationale: Hallucinations are not a core feature of major depressive disor-
der but may occur in psychotic depression, a severe subtype. Anhedonia,
fatigue, and worthlessness are hallmark symptoms.
14. What is the minimum duration for a major depressive episode?
A. 1 week
B. 2 weeks
C. 1 month
D. 2 months
3
Midterm 2024/2025 – Chamberlain Review
1. What is the first step in creating a differential diagnosis (DDx) for psy-
chiatric symptoms?
A. Determine the specific primary disorder
B. Rule out malingering or factitious disorder
C. Rule out substance etiology
D. Rule out an etiological medical condition
Correct Answer: B
Rationale: The first step in formulating a differential diagnosis is to rule out
malingering or factitious disorder to ensure the patient’s symptoms are gen-
uine and not motivated by external incentives or intentional deception. This
step is critical for accurate psychiatric diagnosis.
2. What is the duration of continuous signs of disturbance required for a
schizophrenia diagnosis?
A. 1 month
B. 3 months
C. 6 months
D. 12 months
Correct Answer: C
Rationale: According to DSM-5-TR, a diagnosis of schizophrenia requires
continuous signs of disturbance for at least 6 months, including at least 1
month of active-phase symptoms.
3. Which of the following is a diagnostic criterion for schizophrenia?
A. Elevated mood for at least one week
B. Two or more: delusions, hallucinations, disorganized speech, disorganized
or catatonic behavior, negative symptoms
C. Recurrent panic attacks
D. Excessive worry for at least 3 months
Correct Answer: B
Rationale: DSM-5-TR specifies that schizophrenia diagnosis requires two or
more of the listed symptoms (delusions, hallucinations, disorganized speech,
disorganized or catatonic behavior, negative symptoms) for a significant por-
tion of time during a 1-month period.
4. What is the second step in creating a differential diagnosis?
A. Rule out malingering
B. Rule out substance etiology
C. Determine specific primary disorder
D. Differentiate adjustment disorders
Correct Answer: B
Rationale: After ruling out malingering or factitious disorder, the second
step is to rule out substance etiology, as substances can cause psychiatric
symptoms that resolve upon cessation.
5. How long must psychiatric symptoms persist after stopping a substance
1
, to consider a primary psychiatric disorder?
A. 1 week
B. 2 weeks
C. 1 month
D. 2 months
Correct Answer: C
Rationale: DSM-5-TR criteria indicate that if psychiatric symptoms persist
beyond 1 month after substance cessation, a primary psychiatric disorder
should be considered.
6. What is a key indicator that psychiatric symptoms are due to a medical
condition?
A. Symptoms begin before the medical condition
B. Symptoms vary with the severity of the medical condition
C. Symptoms persist after substance cessation
D. Symptoms are consistent with malingering
Correct Answer: B
Rationale: Psychiatric symptoms caused by a medical condition typically
begin after the onset of the condition, vary with its severity, and resolve when
the condition is treated.
7. What is the third step in creating a differential diagnosis?
A. Rule out malingering
B. Rule out substance etiology
C. Rule out a medical condition
D. Determine the primary disorder
Correct Answer: C
Rationale: The third step involves ruling out an etiological medical condi-
tion to ensure psychiatric symptoms are not secondary to a physical health
issue.
8. When should a general medical condition be considered in the differen-
tial diagnosis?
A. When symptoms are typical for a psychiatric disorder
B. When symptoms are atypical in pattern, age, or course
C. When the patient has a history of substance use
D. When symptoms resolve within 1 month
Correct Answer: B
Rationale: Atypical symptom patterns, age at onset, or course suggest a pos-
sible medical etiology, such as severe memory loss with depression, which
may indicate a medical condition.
9. What is the fourth step in creating a differential diagnosis?
A. Rule out malingering
B. Determine the specific primary disorder
C. Rule out substance etiology
D. Differentiate adjustment disorders
Correct Answer: B
Rationale: After ruling out malingering, substances, and medical conditions,
2
, the fourth step is to identify the specific primary psychiatric disorder using
DSM-5-TR criteria.
10. What is the fifth step in creating a differential diagnosis?
A. Rule out medical conditions
B. Differentiate adjustment disorders from other specified or unspecified dis-
orders
C. Establish boundaries with no mental disorder
D. Rule out substance etiology
Correct Answer: B
Rationale: The fifth step involves distinguishing adjustment disorders from
other specified or unspecified disorders to ensure accurate diagnosis.
11. Which of the following is characteristic of malingering?
A. Symptoms are intentionally produced for internal psychological gain
B. Symptoms are motivated by external incentives like avoiding legal respon-
sibility
C. Symptoms resolve with medical treatment
D. Symptoms are consistent with a recognized clinical entity
Correct Answer: B
Rationale: Malingering involves intentional symptom production for exter-
nal incentives, such as avoiding legal or military responsibilities, unlike fac-
titious disorder, which seeks psychological gain.
12. What is a hallmark feature of factitious disorder?
A. External incentives drive symptom production
B. Symptoms are feigned for psychological gain
C. Symptoms are consistent with a medical condition
D. Symptoms resolve after substance cessation
Correct Answer: B
Rationale: Factitious disorder is characterized by feigned symptoms for psy-
chological gain, such as assuming the sick role, without clear external incen-
tives.
13. Which symptom is NOT typically associated with major depressive dis-
order?
A. Anhedonia
B. Hallucinations
C. Fatigue
D. Feelings of worthlessness
Correct Answer: B
Rationale: Hallucinations are not a core feature of major depressive disor-
der but may occur in psychotic depression, a severe subtype. Anhedonia,
fatigue, and worthlessness are hallmark symptoms.
14. What is the minimum duration for a major depressive episode?
A. 1 week
B. 2 weeks
C. 1 month
D. 2 months
3
