This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Psychiatry
[{'content': 'A 60 year old man is brought to a psychiatrist with a 10 year history, that he suspects his neighbours and he feels that whenever he passes by they sneeze and plan against behind his back. He feels that his wife has been replaced by a double and calls the police for help. He is quite well groomed alert, occasionally consumes alcohol, likely diagnosis is- \nSelect and explain. \nA. Paranoid personality, B. Paranoid schizophrenia, C. Alcohol withdrawal, D. Conversion disorder', 'role': 'user'}, {'content': 'Answer: B \nExplanation: This patient has:-\n\n\nDelusion of persecution (suspects his neighbours sneeze and plan against him).\nDelusion of double (wife has been replaced by double).\nNo impairment in consciousness (patient is well alert)\nSymptoms for 10 years.\n\n\nDelusion of double is a bizarre delusion (i.e., belief which is impossible in reality). If delusion is bizarre, only one criteria is required for diagnosis.\n\nAbout other options\n\nDelusions are a feature of psychosis, and amongst the given disorder only schizophrenia is a typical example of schizophrenia.\nAlcohol withdrawal can also cause psychotic symptoms, but it can be excluded because:-\n\n\nIn alcohol, withdrawal patient is not well alert (impaired consciousness)\nAlcohol withdrawal is rare with occasional consumption\nSymptoms will not persist for 10 years\n\n\n\nParanoid personality and conversion disorder are not psychosis → No delusion.', 'role': 'assistant'}]