😀 EASY

In this MCQ, we have ten questions for you to practice distinguishing between some of the basic classifications of hallucination and delusion.

Reviewed by: awaiting review

Delusions and hallucinations

Congratulations - you have completed Delusions and hallucinations.

You scored %%SCORE%% out of %%TOTAL%%.

Your performance has been rated as %%RATING%%


Your answers are highlighted below.
Question 1
For the following questions, identify the type of delusion or hallucination being described.

A patient went to the supermarket. When he was handed his receipt he instantly knew that all the birds would die and fall from the sky tomorrow.
A
Delusion of control
B
Delusion of reference
C
Delusional perception
D
Grandiose delusion
E
Nihilistic delusion
Question 1 Explanation: 
A delusional perception is one where a normal perception (being handed a receipt) is connected with a delusional conclusion that has no discernible connection with the original perception (not only are all birds unlikely to die tomorrow, but there is no way being passed a receipt would have any relationship with such an event). Delusional perceptions are one of Schneider's First Rank symptoms of schizophrenia. Watch this video for another example of a delusional perception: https://youtu.be/CfXjTPInwpI
Question 2
A patient was frightened when they mistook their cat's shadow for an intruder.
A
Delusional perception
B
Delusion of reference
C
Illusion
D
Persecutory delusion
E
Visual hallucination
Question 2 Explanation: 
An illusion is when a patient misinterprets a real stimulus, whereas an hallucination is when a patient has a sensory experience that wasn't real. In this case, the cat cast a real shadow on the floor, so the sensory stimulus was real.
Question 3
A patient is speaking to his psychiatrist. He describes hearing two male voices with local accents who are telling him what to do and threatening him. The patient can hear them now. They are telling the patient that he (the patient) will be in trouble when he leaves this meeting.
A
Elemental auditory hallucination
B
2nd person auditory hallucination
C
3rd person auditory hallucination
D
Running commentary
E
Persecutory delusion
Question 3 Explanation: 
This is a hallucination because the patient is imagining these voices. It is a second person hallucination because the voices are speaking to the patient whereas the voices would be talking about the patient in a third person hallucination. In first person hallucinations, the patient would hear themselves speaking allowed, also known as thought echo. A running commentary is a type of third person hallucination. Although the voices may be threatening the patient, there is nothing in the description to say he thinks he is in danger.
Question 4
An alcoholic is on AMU experiencing delirium tremens as he goes through acute alcohol withdrawal. He is scared and scratching himself because he can feel insects crawling under his skin.
A
Elemental hallucination
B
Delusion of perception
C
Illusion
D
Pseudohallucination
E
Somatic hallucination
Question 4 Explanation: 
This is a type of somatic hallucination known as 'formication', where a patient may feel insects on or under their skin. It is common in alcohol withdrawal and with cocaine use. In this case, the patient would probably be given lorazepam to manage the delirium tremens and these hallucinations.
Question 5
A patient confides in you that they are on a secret mission for British Intelligence. They have been entrusted to break up a Russian spy ring and capture a code book being used by their agents.
A
Command hallucination
B
Delusion of grandeur
C
Delusion of perception
D
Persecutory delusion
E
Thought insertion
Question 5 Explanation: 
This is a delusion because the patient believes they have been given this mission.
Question 6
A patient says they don’t want to eat. There’s no point in eating as they are dying and their insides are rotting.
A
Delusion of control
B
Delusion of reference
C
Gustatory hallucination
D
Nihilistic delusion
E
Somatic hallucination
Question 6 Explanation: 
This is a sign of a nihilistic delusion. Patients with major depression may experience nihilistic delusions or negative hallucinations such as hearing screaming voices or seeing demons.
Question 7
A patient doesn’t trust his family and tries to avoid them because they can hear what he is thinking.
A
1st person auditory hallucination
B
Control delusion
C
Running commentary
D
Thought broadcast
E
Thought withdrawal
Question 7 Explanation: 
When a patient believes that other people can hear their thoughts, that is thought broadcasting. Note, he is not hearing these thoughts himself which would thought echo/1st person auditory hallucination.
Question 8
A patient visits her GP complaining of hearing a low-pitched buzzing.
A
Delusional perception
B
Delusion of reference
C
Elemental hallucination
D
Illusion
E
Pseudohallucination
Question 8 Explanation: 
This is an elemental hallucination - the patient can hear a sound rather than voices. Other examples of elemental hallucinations might include seeing flashing lights or zigzig lines. Elemental hallucinations are normally a symptom of an organic pathology rather than psychosis. In this woman's case, she could just be experiencing tinnitus, but you would want to explore if they had any problems with hearing loss, balance, vertigo, facial weakness, sight and aural fullness to help determine your differentials and investigations.
Question 9
A young man suffering from schizophrenia tells his mental health worker that he has been hearing his neighbours talking about him. When the mental health worker explores further, he explains that he hears them not only at home, but when he is on the bus or in the shops.
A
1st person auditory hallucination
B
2nd person auditory hallucination
C
3rd person auditory hallucination
D
Persecutory delusion
E
Delusion of perception
Question 9 Explanation: 
As the patient hears voices talking about him rather than to him, this is a third person auditory hallucination. Note that the mental health worker seeks further clarification to help confirm whether this is a hallucination; maybe he could have overheard his neighbours talking about him on the street. In some cases the voices the patient hears are describing what the patient is doing. This is a form of third person auditory hallucination called running commentary.
Question 10
Every week the patient goes food shopping and gets his receipt. He is then able decode the information on the receipt to tell him how long he will live.
A
Delusion of control
B
Delusion of reference
C
Delusional perception
D
Elemental hallucination
E
Persecutory delusion
Question 10 Explanation: 
A delusion of reference is simply any delusional idea in which ordinary, everyday occurrences in the outside world are believed by the patient to relate to them in some special, personal way. Other examples include a newscaster on the TV speaking to the patient directly, or car licence plates containing coded text only the patient understands.

You might have thought this was a delusional perception (correct perception with delusional conclusion) but because the information on the receipt is communicating something personal to the patient, delusion of reference is the correct definition.

Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results
There are 10 questions to complete.

Spotted an error?

4 + 11 =