Rosh Psychiatry Board Practice Exam

What condition is indicated by the patient's claim of feeling like no one is looking out for him?

1. Atypical depression

2. Paranoid delusions

3. Social anxiety

4. Obsessive-compulsive disorder

The correct answer is: Paranoid delusions

The patient's feeling of believing that no one is looking out for him suggests a sense of isolation or mistrust, which aligns closely with paranoid delusions. Paranoid delusions are characterized by intense and irrational fears that others are engaging in harmful behavior or that one is being persecuted. This sense of vulnerability can lead an individual to feel as if they are not being cared for or protected by those around them. In contrast, atypical depression may involve feelings of helplessness or sadness, but it does not usually manifest as a persistent belief that others are actively undermining one’s well-being. Social anxiety involves excessive worry about judgment from others in social situations but does not typically present as a belief in betrayal or abandonment. Obsessive-compulsive disorder involves intrusive thoughts and compulsive behaviors, which do not directly address a feeling of being unprotected or uncared for by others. Therefore, the correct interpretation of the patient's claim about feeling neglected or unlooked after is a form of paranoia that fits within the realm of paranoid delusions, highlighting the nature of distrust towards others in their environment.