Rosh Psychiatry Board Practice Exam

What is a distinguishing feature of psychotic disorders compared to other mental illnesses?

1. Chronic sadness

2. Memory loss

3. Severe impairments in reality perception

4. Persistent fear

The correct answer is: Severe impairments in reality perception

A distinguishing feature of psychotic disorders is the severe impairments in reality perception. Individuals with psychotic disorders, such as schizophrenia, manifest a fundamental disruption in their ability to differentiate between what is real and what is not. This can include experiencing hallucinations (false perceptions, such as hearing voices) or delusions (strongly held false beliefs that are not grounded in reality). These symptoms signify a significant departure from normal cognitive functioning and can profoundly impact an individual's capacity to engage with the world around them. In contrast, chronic sadness, memory loss, and persistent fear, while they can occur in various mental health conditions, do not define psychotic disorders. For instance, chronic sadness might be more characteristic of depressive disorders, memory loss is often associated with cognitive disorders or dementia, and persistent fear can be prominent in anxiety disorders, but none of these conditions inherently involve the same level of reality distortion that is characteristic of psychosis. Thus, the hallmark of psychotic disorders is primarily centered around the severe impairment in reality perception.