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🧠 MBBS PSYCHIATRY QUIZ PREPARATION

TOPIC 1: HISTORY OF PSYCHIATRY

College → Zone → State → National Level

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QUICK ORIENTATION

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PART 1: FULL CONCEPTUAL COVERAGE

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1. DEFINITION

• The term "psychiatry" was coined by Johann Christian Reil in 1808
• Before psychiatry, mental illness was managed by priests, philosophers, and later, "mad-doctors" (alienists)

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2. ERAS OF PSYCHIATRIC HISTORY

ERA 1 - Ancient/Pre-Scientific Era (Before 1800)

• Black bile = Melancholia (depression)
• Yellow bile = Choleric (irritability)
• Blood = Sanguine (cheerful)
• Phlegm = Phlegmatic (calm/sluggish)

• Black bile → Melancholia
• Blood → Sanguine
• Choleric → Yellow bile
• Phlegm → Phlegmatic

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ERA 2 - Reform Era / Moral Treatment (1790-1850)

Philippe Pinel (France, 1745-1826)

• "Father of Modern Psychiatry"
• In 1793, removed chains from patients at Bicetre Hospital (Paris)
• Later reformed Salpetriere Hospital (for women)
• Introduced "Traitement Moral" (Moral Treatment) - humane, non-restraint approach
• Wrote "Traité médico-philosophique sur l'aliénation mentale" (1801) - first psychiatric textbook
• Classified mental illness into: melancholia, mania, dementia, idiotism
• His student: Jean-Etienne Esquirol - coined the term "hallucination" (1817)

William Tuke (England, 1732-1822)

• Quaker reformer
• Founded York Retreat in 1796 - model humane asylum
• Non-medical approach emphasizing kindness and dignity

Dorothea Dix (USA, 1802-1887)

• American reformer
• Advocated for state mental hospitals across the USA
• Responsible for founding 32 state hospitals

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ERA 3 - Scientific Psychiatry / Nosological Era (1850-1950)

Wilhelm Griesinger (Germany, 1817-1868)

• "Mental diseases are brain diseases" (Geisteskrankheiten sind Gehirnkrankheiten)
• Founded the concept that psychiatry is part of neurology
• Coined the term "Einheitspsychose" (Unitary Psychosis) - all mental disorders are one disorder

Emil Kraepelin (Germany, 1856-1926) - THE MOST IMPORTANT NAME

• "Father of Modern Scientific Psychiatry" / "Father of Biological Psychiatry"
• In 1896/1899, made the most influential classification in psychiatric history:
  • Dementia Praecox (deteriorating course) → later renamed Schizophrenia by Bleuler
  • Manic-Depressive Insanity (episodic course)
• Used prognosis (outcome) as the basis for classification - revolutionary
• Wrote Lehrbuch der Psychiatrie (Textbook of Psychiatry) - 9 editions
• Founded the German Research Center for Psychiatry (Munich)
• Described Kraepelin's dichotomy - the two major psychoses
• Also described paranoia and paraphrenia as separate entities

Eugen Bleuler (Switzerland, 1857-1939)

• In 1911, renamed "Dementia Praecox" to "Schizophrenia" (schizein = split + phren = mind)
• Described 4 A's of Schizophrenia:
  • Affect (flattened)
  • Ambivalence
  • Autism
  • Association (loosening of)
• The above are "Fundamental/Primary symptoms" of schizophrenia
• Also described accessory symptoms: hallucinations, delusions (now considered primary in DSM-5)
• Coined the term "Autism" (1911)

• Affect, Autism, Ambivalence, Associations

Karl Jaspers (Germany, 1883-1969)

• Wrote "General Psychopathology" (1913) - bible of descriptive psychopathology
• Distinguished primary (not understandable, e.g., delusions) from secondary (understandable) symptoms
• Defined "un-understandable" as the hallmark of true psychosis

Kurt Schneider (Germany, 1887-1967)

• Described First-Rank Symptoms (FRS) of Schizophrenia (1959)
• 11 FRS: audible thoughts, voices arguing, voices commenting, somatic passivity, thought insertion, thought withdrawal, thought broadcasting, delusional perception, made affect, made impulse, made volition
• "If a FRS is present and no organic cause = Schizophrenia"

• Auditory hallucinations (3 types)
• Broadcasting of thought
• Commenting voices
• Delusion of perception
• Insertion/withdrawal of thought
• Made experiences (affect, impulse, volition)
• External control

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ERA 4 - Psychoanalytic Era (1890-1940)

Sigmund Freud (Austria, 1856-1939)

• Founded Psychoanalysis
• Key concepts:
  • Topographic model: Conscious, Preconscious, Unconscious
  • Structural model (1923): Id, Ego, Superego
  • Psychosexual stages: Oral → Anal → Phallic → Latency → Genital
  • Defense mechanisms: Repression, Projection, Displacement, etc.
  • Transference and Counter-transference
  • Free association technique
  • Dream analysis (Royal Road to the Unconscious)
• Key works: "The Interpretation of Dreams" (1900), "The Ego and the Id" (1923)
• Anna Freud (his daughter): developed ego psychology and defense mechanisms systematically

Carl Gustav Jung (Switzerland, 1875-1961)

• Broke from Freud
• Founded Analytical Psychology
• Key concepts: Collective Unconscious, Archetypes, Persona, Shadow, Anima/Animus
• Coined "Complex" and "Introvert/Extrovert"
• Word Association Test

Alfred Adler (Austria, 1870-1937)

• Broke from Freud
• Founded Individual Psychology
• Key concepts: Inferiority Complex, Compensation, Birth Order, Social interest
• Coined "Inferiority Complex" and "Superiority Complex"

Otto Rank (1884-1939) - Birth Trauma theory

Melanie Klein (1882-1960) - Object Relations Theory; paranoid-schizoid and depressive positions

Donald Winnicott (1896-1971) - "Good Enough Mother", Transitional Object

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ERA 5 - Biological/Pharmacological Revolution (1950-present)

1952 - Discovery of Chlorpromazine

• Henri Laborit (French surgeon) - noticed anti-anxiety properties during surgical anesthesia
• Jean Delay and Pierre Deniker - first used chlorpromazine to treat psychosis at Sainte-Anne Hospital, Paris
• "Thorazine" = brand name in USA
• This is considered the most important event in 20th century psychiatry
• Laborit described it as producing "artificial hibernation"
• Led to the Dopamine Hypothesis of Schizophrenia

1949 - Lithium

• John Cade (Australia) - discovered lithium's antimanic properties in 1949
• Mogens Schou (Denmark) - conducted first controlled trials, popularized use

1958 - Haloperidol

• Discovered by Paul Janssen (Belgium)

1958 - Imipramine (first TCA)

• Roland Kuhn (Switzerland) discovered imipramine's antidepressant effects
• Originally tested as antipsychotic

1952 - MAOIs

• Nathan Kline and John Crane - discovered iproniazid (first MAOI) had antidepressant effects (1957)
• Iproniazid originally an anti-TB drug

1960 - Chlordiazepoxide (Librium)

• Leo Sternbach (Roche) - first benzodiazepine
• Followed by diazepam (Valium, 1963) - became most prescribed drug in the world

1987 - Fluoxetine (Prozac)

• First SSRI, discovered by Bryan Molloy and David Wong at Eli Lilly
• Transformed treatment of depression globally

1990 - Clozapine revival

• Originally synthesized 1958, withdrawn 1975 due to agranulocytosis
• Reintroduced 1990 as "atypical" antipsychotic for treatment-resistant schizophrenia

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ERA 6 - Deinstitutionalization Era (1960-1980)

• 1963 - Community Mental Health Centers Act (USA, signed by President Kennedy)
• Mass discharge of psychiatric patients from state hospitals
• Led to "transinstitutionalization" - from hospitals to prisons and homeless shelters
• Thomas Szasz (1961) - "The Myth of Mental Illness" - controversial anti-psychiatry movement
• R.D. Laing (UK) - anti-psychiatry; schizophrenia as a "sane response to an insane world"

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3. CLASSIFICATION SYSTEMS - HISTORY

DSM History (USA)

ICD History (WHO)

• Gaming Disorder added (6C51)
• Complex PTSD added
• Prolonged Grief Disorder added
• "Schizophrenia" retained but changed duration criteria
• Personality disorders completely reorganized
• Gender incongruence moved OUT of mental disorders section (to sexual health)
• Removed intellectual disability as "mental retardation"

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4. INDIAN PSYCHIATRY HISTORY

Key Institutions

Key Indian Psychiatrists

• Indian Psychiatric Society (IPS) founded in 1947 (same year as Indian independence)
• Indian Journal of Psychiatry - oldest psychiatry journal in Asia
• Mental Healthcare Act 2017 - replaced Mental Health Act 1987; gives patients rights and autonomy; defines mental illness based on WHO principles

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5. FAMOUS EXPERIMENTS & CASES

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6. NOBEL PRIZES RELATED TO PSYCHIATRY

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7. KEY EPONYMS & SYNDROMES (Historical)

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8. KEY PSYCHOLOGICAL TESTS - HISTORICAL ORIGINS

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9. NEUROTRANSMITTER DISCOVERIES (Historical High-Yield)

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10. MENTAL HEALTH LAWS - HISTORICAL

• Gives every person right to access mental healthcare
• Prohibits electro-convulsive therapy (ECT) without anesthesia
• Decriminalizes suicide attempt (Section 115)
• Defines "mental illness" without using the term "mental disorder"
• Advance Directive allowed
• Nominated Representative concept
• Prohibits chaining of mentally ill persons
• Came into force: July 7, 2018

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11. TOP 20 HIGH-YIELD PEARLS - HISTORY OF PSYCHIATRY

1. "Psychiatry" coined by Johann Christian Reil (1808)
2. Hippocrates first proposed naturalistic theory of mental illness
3. Philippe Pinel unchained patients at Bicetre (1793) - moral treatment
4. Emil Kraepelin classified Dementia Praecox vs. Manic-Depressive Insanity (1896/1899)
5. Bleuler coined "Schizophrenia" (1911) + 4 A's
6. Schneider's FRS - First Rank Symptoms of schizophrenia
7. Freud's structural model - Id, Ego, Superego (1923)
8. Chlorpromazine first antipsychotic - Delay & Deniker (1952)
9. Lithium - John Cade (1949)
10. Imipramine - Roland Kuhn (1958) - first TCA
11. DSM-III (1980) = landmark; introduced criteria-based diagnosis
12. Homosexuality removed from DSM - 1973
13. DSM-5 (2013) - removed multi-axial; DSM-5-TR (2022) current
14. ICD-11 effective January 1, 2022
15. Nobel Prize - only psychiatrist: Wagner-Jauregg (1927) for malaria therapy
16. Rosenhan Experiment (1973) - "On Being Sane in Insane Places"
17. IPS (Indian Psychiatric Society) founded 1947
18. Mental Healthcare Act 2017 - suicide decriminalized, ECT without anesthesia prohibited
19. Ganser Syndrome - approximate answers (in prisoners)
20. Capgras, Cotard, Fregoli - three major delusional misidentification syndromes

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REVISION MNEMONICS

For Era Sequence: "Ancient People Reform Science Psycho Biology"

1. Ancient era
2. Pre-reform (Middle Ages)
3. Reform (Pinel, Tuke, Dix)
4. Scientific (Kraepelin, Bleuler)
5. Psychoanalytic (Freud, Jung, Adler)
6. Biological (Drugs, ECT)

For Chlorpromazine: "LDD - Laborit Discovers Delay Deploys"

• Laborit noticed it → Delay & Deniker deployed it clinically (1952)

For Kraepelin vs. Bleuler:

• Kraepelin = Kategorized (Dementia Praecox vs MDP)
• Bleuler = Baptized it Schizophrenia

For Nobel Prizes:

• Wagner-Jauregg = Worms (malaria parasites treated GPI) = 1927
• Moniz = Mutilated frontal lobe (lobotomy) = 1949

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PART 2: QUESTIONS (150 MCQs + SCENARIOS)

⚠️ DO NOT READ ANSWERS YET. ATTEMPT ALL QUESTIONS, THEN REPLY WITH YOUR ANSWERS.

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SECTION A: EASY MCQs (1-50)

• A) Hippocrates
• B) Johann Christian Reil
• C) Philippe Pinel
• D) Emil Kraepelin

• A) Salpetriere
• B) York Retreat
• C) Bicetre
• D) Bethlem Royal Hospital

• A) Emil Kraepelin
• B) Kurt Schneider
• C) Eugen Bleuler
• D) Karl Jaspers

• A) Kraepelin
• B) Bleuler
• C) Freud
• D) Jung

• A) Bleuler
• B) Kraepelin
• C) Kurt Schneider
• D) Jaspers

• A) Carl Jung
• B) Sigmund Freud
• C) Alfred Adler
• D) Otto Rank

• A) Haloperidol
• B) Lithium
• C) Chlorpromazine
• D) Imipramine

• A) Henri Laborit
• B) Jean Delay and Pierre Deniker
• C) Paul Janssen
• D) Roland Kuhn

• A) Mogens Schou
• B) John Cade
• C) Nathan Kline
• D) Paul Janssen

• A) Roland Kuhn
• B) Nathan Kline
• C) Leo Sternbach
• D) Bryan Molloy

• A) Diazepam
• B) Alprazolam
• C) Chlordiazepoxide
• D) Lorazepam

• A) Paul Janssen
• B) Roland Kuhn
• C) Leo Sternbach
• D) Nathan Kline

• A) Removed homosexuality
• B) Introduced diagnostic criteria
• C) Added multi-axial system
• D) Both B and C

• A) 1952
• B) 1968
• C) 1973
• D) 1980

• A) DSM-IV-TR
• B) DSM-5
• C) DSM-5-TR
• D) DSM-6

• A) January 1, 2019
• B) January 1, 2021
• C) January 1, 2022
• D) January 1, 2023

• A) Wagner-Jauregg
• B) Egas Moniz
• C) Eric Kandel
• D) Arvid Carlsson

• A) Schizophrenia with insulin coma
• B) Depression with ECT
• C) GPI (neurosyphilis) with malaria
• D) Mania with lithium

• A) Obedience to Authority
• B) On Being Sane in Insane Places
• C) The Stanford Prison Experiment
• D) The Milgram Study

• A) 1945
• B) 1947
• C) 1950
• D) 1954

• A) Sigmund Freud
• B) Alfred Adler
• C) Carl Jung
• D) Melanie Klein

• A) Freud
• B) Adler
• C) Jung
• D) Rank

• A) Kraepelin
• B) Pinel
• C) Hippocrates
• D) Bleuler

• A) Dorothea Dix
• B) Philippe Pinel
• C) William Tuke
• D) Benjamin Rush

• A) Freud
• B) Griesinger
• C) Kraepelin
• D) Bleuler

• A) 1905
• B) 1916
• C) 1921
• D) 1935

• A) Herman Rorschach
• B) Henry Murray
• C) David Wechsler
• D) Alfred Binet

• A) 1900
• B) 1905
• C) 1916
• D) 1943

• A) 1896
• B) 1899
• C) 1911
• D) 1923

• A) Belief one is dead
• B) Delusion of parasitosis
• C) Belief a person is replaced by an impostor
• D) Approximate answers to questions

• A) Morbid jealousy
• B) Nihilistic delusions (belief one is dead)
• C) Shared delusions
• D) Visual agnosia

• A) Visual hallucinations
• B) Approximate answers (Vorbeireden)
• C) Morbid jealousy
• D) Nihilistic delusions

• A) 1975
• B) 1980
• C) 1987
• D) 1992

• A) Jean Delay
• B) Roland Kuhn
• C) Paul Janssen
• D) Leo Sternbach

• A) Aaron Beck
• B) Martin Seligman
• C) B.F. Skinner
• D) Ivan Pavlov

• A) 1912
• B) 1987
• C) 2017
• D) 2018

• A) Allowed in emergencies
• B) Prohibited
• C) Allowed for children
• D) Allowed with patient consent

• A) Two doctors diagnosing the same patient differently
• B) A shared delusional disorder between two people
• C) A patient with two personalities
• D) Double-blind study in psychiatry

• A) Food in attachment
• B) Contact comfort in attachment
• C) Peer relationships
• D) Operant conditioning

• A) Stanley Milgram
• B) Philip Zimbardo
• C) Solomon Asch
• D) Leon Festinger

• A) Calcutta (1817)
• B) Madras (1787)
• C) Bombay (1745)
• D) Ranchi (1918)

• A) N.S. Vahia
• B) L.P. Varma
• C) Vidya Sagar
• D) M.V. Govindaswamy

• A) ICD-4
• B) ICD-6
• C) ICD-8
• D) ICD-9

• A) DSM-5
• B) DSM-5-TR
• C) ICD-10
• D) ICD-11

• A) Etiology
• B) Pathology
• C) Prognosis/course
• D) Symptoms at onset

• A) "Mind doctor"
• B) "Soul healer"
• C) "Brain physician"
• D) "Nerve specialist"

• A) Freud
• B) Jung
• C) Melanie Klein
• D) Erik Erikson

• A) Melanie Klein
• B) Donald Winnicott
• C) Anna Freud
• D) John Bowlby

• A) Malaria
• B) Tuberculosis
• C) Hypertension
• D) Epilepsy

• A) The role of contact comfort
• B) Obedience to authority
• C) Social conformity
• D) Learned helplessness

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SECTION B: MODERATE MCQs (51-100)

• A) Age of onset
• B) Symptom profile
• C) Long-term prognosis and course
• D) Response to treatment

• A) Hallucinations, delusions, thought disorder, catatonia
• B) Affective flattening, ambivalence, autism, association disturbance
• C) Auditory hallucinations, passivity phenomena, thought alienation
• D) Negative symptoms, positive symptoms, cognitive symptoms

• A) Thought insertion
• B) Audible thoughts
• C) Visual hallucinations
• D) Somatic passivity

• A) Classification of psychoses
• B) General Psychopathology and descriptive phenomenology
• C) Psychoanalytic theory
• D) Introduction of rating scales

• A) Kraepelin
• B) Griesinger
• C) Bleuler
• D) Morel

• A) Bleuler
• B) Griesinger
• C) Morel (as "démence précoce")
• D) Pinel

• A) Freud and Jung
• B) Thomas Szasz and R.D. Laing
• C) Kraepelin and Bleuler
• D) Delay and Deniker

• A) Franklin Roosevelt
• B) Harry Truman
• C) John F. Kennedy
• D) Lyndon Johnson

• A) His results could not be replicated
• B) Deliberate infection with malaria is now considered unethical
• C) He shared it with another psychiatrist
• D) It was based on animal experiments

• A) Tardive dyskinesia
• B) Agranulocytosis
• C) Seizures
• D) Prolonged QT interval

• A) Repression
• B) Displacement
• C) Projection
• D) Reaction formation

• A) Oral
• B) Anal
• C) Phallic
• D) Genital

• A) Hoarding Disorder
• B) Prolonged Grief Disorder
• C) Gaming Disorder
• D) Binge Eating Disorder

• A) Mental and behavioral disorders
• B) Conditions related to sexual health
• C) Neurological conditions
• D) Endocrine disorders

• A) Indian Lunacy Act 1912
• B) Mental Health Act 1987
• C) Mental Healthcare Act 2017
• D) IPC Section 309

• A) Schizophrenia is caused by low socioeconomic status
• B) People with schizophrenia drift down the social ladder due to illness
• C) Social factors cause schizophrenia more than genetic factors
• D) Urban migration causes schizophrenia

• A) Frontal lobe
• B) Parietal lobe
• C) Temporal lobe (bilateral)
• D) Occipital lobe

• A) In Fregoli, different people are same person; in Capgras, same person is replaced
• B) Fregoli is a mood disorder; Capgras is a psychosis
• C) Fregoli involves visual hallucinations; Capgras does not
• D) Capgras is culture-bound; Fregoli is not

• A) Kanner (for childhood autism)
• B) Asperger (for high-functioning autism)
• C) Bleuler (as a symptom of schizophrenia)
• D) Freud

• A) Discovery of serotonin
• B) Discovery of dopamine and its role in Parkinson's disease
• C) Development of SSRI drugs
• D) Discovery of endorphins

• A) Ethical guidelines for psychiatrists
• B) Treatment based on religion and morality
• C) Humane, non-restraint treatment emphasizing dignity
• D) Legal/court-ordered treatment

• A) 1921
• B) 1935
• C) 1943
• D) 1955

• A) Monkeys with surrogate mothers
• B) Dogs unable to escape unavoidable shocks
• C) Rats in maze tests
• D) Humans in prison simulations

• A) First hospital to use chlorpromazine
• B) It was one of the earliest hospitals for mental illness and became synonymous with chaotic conditions
• C) Pinel unchained patients here
• D) First hospital to offer psychoanalysis

• A) Indian Penal Code Section 309 (2018 amendment)
• B) Mental Healthcare Act 2017, Section 115
• C) Criminal Procedure Code amendment 2016
• D) NDPS Act

• A) Bleuler
• B) Kraepelin
• C) Schneider
• D) Jaspers

• A) Drosophila
• B) Aplysia (sea slug)
• C) Rhesus monkeys
• D) Mice

• A) Ivan Pavlov
• B) John Watson
• C) B.F. Skinner
• D) Albert Bandura

• A) Alfred Binet
• B) William Stern
• C) Lewis Terman
• D) David Wechsler

• A) 2
• B) 3
• C) 4
• D) 5

• A) Freud
• B) Jung
• C) Otto Rank
• D) Adler

• A) John Bowlby
• B) Mary Ainsworth
• C) Melanie Klein
• D) Donald Winnicott

• A) Aaron Beck
• B) Albert Ellis
• C) B.F. Skinner
• D) Joseph Wolpe

• A) Skinner
• B) Bandura
• C) Joseph Wolpe
• D) Beck

• A) Aaron Beck
• B) Albert Ellis
• C) Albert Bandura
• D) Martin Seligman

• A) Mumbai
• B) Chennai
• C) Hyderabad
• D) Bangalore

• A) EEG findings
• B) Effects of chlorpromazine and amphetamine
• C) MRI brain studies
• D) Genetic linkage studies

• A) 25%
• B) 40%
• C) 65%
• D) 80%

• A) Life instinct (Eros)
• B) Death instinct/drive
• C) Sexual energy (libido)
• D) Anxiety

• A) Contains only repressed memories
• B) Is unique to each individual
• C) Is shared across humanity and contains archetypes
• D) Is accessible through free association

• A) Adolescence
• B) First 3 months of life
• C) Ages 2-3 years
• D) School age

• A) 1938
• B) 1948
• C) 1955
• D) 1960

• A) Conversion Disorder
• B) Somatic Symptom Disorder
• C) Illness Anxiety Disorder
• D) Functional Neurological Symptom Disorder

• A) 6C51
• B) F63.0
• C) 6A20
• D) F91.0

• A) Founding first psychiatric institution in USA
• B) Advocating for humane treatment, leading to establishment of 32 state hospitals
• C) Developing first psychometric test
• D) Discovering chlorpromazine

• A) Freud
• B) William Cullen (1769)
• C) Kraepelin
• D) Bleuler

• A) Ugo Cerletti and Lucio Bini (1938)
• B) Ladislas Meduna (1934, using camphor)
• C) Manfred Sakel (1927, insulin coma)
• D) Egas Moniz (1936)

• A) Ugo Cerletti
• B) Manfred Sakel (1927)
• C) Ladislas Meduna
• D) Freeman and Watts

• A) Egas Moniz
• B) Walter Freeman and James Watts (1936)
• C) Ugo Cerletti
• D) John Fulton

• A) Walter Freeman (USA)
• B) Egas Moniz (Portugal, 1935)
• C) John Fulton (UK)
• D) Manfred Sakel (Austria)

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SECTION C: DIFFICULT MCQs (101-150)

• A) 3rd edition (1889)
• B) 5th edition (1896) - first introduction of dementia praecox
• C) 6th edition (1899) - manic-depressive vs dementia praecox
• D) Both B and C are correct for different aspects

• A) It established community mental health centers
• B) It established criteria for involuntary commitment to psychiatric facilities
• C) It legalized ECT
• D) It decriminalized drug use for psychiatric patients

• A) Personality disorders (development) vs. Schizophrenia (process)
• B) Neurosis vs. Psychosis
• C) Depression vs. Mania
• D) Organic vs. Functional psychosis

• A) Freud
• B) Kraepelin
• C) Hubert Boirac (coined the term, 1876)
• D) Bleuler

• A) Pavlov
• B) Watson
• C) Skinner
• D) Bandura

• A) L.P. Varma
• B) M.V. Govindaswamy
• C) N.S. Vahia
• D) Vidya Sagar

• A) Freud
• B) Pierre Janet
• C) Kraepelin
• D) Bleuler

• A) To explain Kraepelin's dichotomy
• B) To reconcile genetic vulnerability with environmental triggers
• C) To explain the dopamine hypothesis
• D) To describe the effects of early trauma

• A) Bleuler (1911) → Kraepelin (1896) → Schneider (1959)
• B) Kraepelin (1896) → Bleuler (1911) → Schneider (1959)
• C) Schneider (1959) → Kraepelin (1896) → Bleuler (1911)
• D) Bleuler (1911) → Schneider (1959) → Kraepelin (1896)

• A) Sleep apnea in psychiatric patients
• B) Cyclical nature of bipolar disorder (Kraepelin's analogy)
• C) Anxiety-induced hyperventilation
• D) Terminal event in catatonia

• A) Founding the first American asylum
• B) Writing the first American textbook on psychiatry ("Medical Inquiries on Diseases of the Mind," 1812)
• C) Discovering lithium
• D) Founding the American Psychiatric Association

• A) National Institute of Mental Health (NIMH)
• B) American Psychological Association (APA)
• C) American Psychiatric Association (APA)
• D) American Academy of Child Psychiatry

• A) F00-F99
• B) 6A00-6E8Z
• C) 300-309
• D) Z00-Z99

• A) France
• B) USA
• C) Scotland (Sir Arthur Mitchell, 1864)
• D) Germany

• A) 10
• B) 38
• C) 100
• D) 450

• A) Transfer of patients between different psychiatric hospitals
• B) Movement of mentally ill from asylums to prisons and homeless shelters after deinstitutionalization
• C) International transfer of psychiatric patients
• D) Cross-cultural differences in psychiatric diagnosis

• A) Paul Broca
• B) Jean-Martin Charcot
• C) John Hughlings Jackson
• D) Pierre Janet

• A) Ida Bauer (Dora)
• B) Bertha Pappenheim
• C) Emma Eckstein
• D) Sabina Spielrein

• A) Freud
• B) George Miller Beard (1869)
• C) Janet
• D) Kraepelin

• A) Sublimation: directing unacceptable impulses to acceptable activities (CORRECT)
• B) Reaction Formation: unconsciously forgetting traumatic events
• C) Projection: expressing opposite of true feelings
• D) Displacement: attributing own feelings to others

• A) Aaron Beck
• B) Jerome Frank
• C) George Engel
• D) Thomas Szasz

• A) Freud
• B) George Engel (1977)
• C) Thomas Szasz
• D) Adolf Meyer

• A) Adolf Meyer
• B) Freud
• C) Kraepelin
• D) Griesinger

• A) 1947
• B) 1950
• C) 1961
• D) 1971

• A) During pregnancy only
• B) During pregnancy or within 4 weeks of delivery
• C) During the last trimester or within 4 weeks of delivery (previously; now: "during pregnancy or in the 4 weeks following delivery")
• D) Within 6 weeks of delivery only

• A) The patient's neurosis being transferred to the analyst
• B) Intensification of transference into a new artificial neurosis during analysis
• C) The analyst's emotional reaction to the patient
• D) A neurosis caused by transference

• A) ECT vs. pharmacotherapy
• B) Imipramine, CBT, IPT, and placebo
• C) Lithium vs. valproate
• D) SSRIs vs. TCAs

• A) Freud
• B) Kraepelin
• C) Bleuler
• D) Schneider

• A) Id, Ego, Superego
• B) Conscious, Preconscious, Unconscious
• C) Eros, Thanatos, Libido
• D) Primary process, Secondary process, Tertiary process

• A) Prosopagnosia
• B) Visual agnosia
• C) Alexithymia
• D) Anosognosia

• A) 5
• B) 12
• C) 20
• D) 30

• A) Indian Lunacy Act 1912
• B) Mental Health Act 1987
• C) Mental Healthcare Act 2017
• D) Both B and C

• A) Literal stone operations depicted by Hieronymus Bosch
• B) Ancient Greek surgical texts
• C) Medieval Islamic medicine
• D) Egyptian papyri

• A) Secure
• B) Anxious-avoidant
• C) Anxious-ambivalent
• D) Disorganized (Main & Solomon, 1986)

• A) Thomas Szasz
• B) Loren Mosher
• C) R.D. Laing
• D) David Rosenhan

• A) Kraepelin
• B) Benedict Morel (1857)
• C) Griesinger
• D) Bleuler

• A) Bleuler
• B) Kraepelin
• C) Kretschmer
• D) Schneider

• A) Explaining vs. Understanding (Erklären vs. Verstehen)
• B) Primary vs. Secondary symptoms
• C) Positive vs. Negative symptoms
• D) Axis I vs. Axis II disorders

• A) NIMH founding (1949)
• B) Kennedy's Community Mental Health Centers Act (1963)
• C) Dix's asylum reform (1840s)
• D) Mental Healthcare Act 2017

• A) "Madness and Civilization"
• B) "The Myth of Mental Illness"
• C) "Asylums" - described total institutions
• D) "Sanity, Madness and the Family"

• A) Complete symptomatic remission
• B) Medication adherence
• C) Living a meaningful life despite symptoms
• D) Returning to pre-morbid functioning

• A) 5HT2A antagonism
• B) Dopamine D2 receptor blockade
• C) Inhibition of dopamine synthesis
• D) Norepinephrine reuptake inhibition

• A) Kraepelin
• B) Zubin and Spring (1977)
• C) Bleuler
• D) Gottesman and Shields

• A) Insulin coma (1927) → ECT (1938) → Lobotomy (1935) → Chlorpromazine (1952)
• B) Lobotomy (1935) → Insulin coma (1927) → ECT (1938) → Chlorpromazine (1952)
• C) Insulin coma (1927) → Lobotomy (1935) → ECT (1938) → Chlorpromazine (1952)
• D) ECT (1938) → Insulin coma (1927) → Lobotomy (1935) → Chlorpromazine (1952)

• A) Who first discovered antimanic properties (Cade, 1949) vs. who proved efficacy in trials (Schou)
• B) Toxicity of lithium in different preparations
• C) The naming of lithium treatment
• D) Priority dispute over Nobel Prize

• A) Vaughn and Leff
• B) George Brown (1958) - original study; Vaughn & Leff (1976) - replicated
• C) Zubin and Spring
• D) Leff and Wing

• A) Schizophrenia is more common in developing countries
• B) Schizophrenia has a better prognosis in developing countries
• C) Schizophrenia is a culture-bound syndrome
• D) Schizophrenia is more severe in developed countries

• A) Strauss and Carpenter (1974)
• B) Timothy Crow (1980)
• C) John Hughlings Jackson (original concept)
• D) Both A and B, with Crow's Type I/II being the most quoted

• A) 1980s
• B) 1990-1999
• C) 2000s
• D) 2010-2019

• A) Only a family member
• B) A person appointed by the patient or a family member if patient cannot
• C) Only a doctor
• D) Only a lawyer

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SECTION D: CLINICAL SCENARIO QUESTIONS (151-200)

• A) Cotard syndrome - Jules Cotard (1880)
• B) Capgras syndrome - Joseph Capgras (1923)
• C) Fregoli syndrome - Courbon and Fail (1927)
• D) Ekbom syndrome - Karl-Axel Ekbom (1938)

• A) Mental Healthcare Act 2017, Section 115 - rebuttable presumption of mental illness in suicide attempt
• B) Mental Health Act 1987, Section 30
• C) IPC Section 84
• D) CrPC Section 328

• A) Bicetre, Paris
• B) Salpetriere, Paris
• C) Bethlem Royal Hospital (Bedlam), London
• D) York Retreat, England

• A) Allowed in life-threatening emergencies
• B) Absolutely prohibited in all circumstances
• C) Allowed if two psychiatrists agree
• D) Allowed if nominated representative consents

• A) Capgras syndrome
• B) Intermetamorphosis
• C) Fregoli syndrome
• D) Subjective doubles syndrome

• A) Malingering
• B) Pseudodementia
• C) Ganser syndrome (Vorbeireden)
• D) Factitious disorder

• A) Milgram Experiment (1963)
• B) Stanford Prison Experiment (1971) by Philip Zimbardo
• C) Rosenhan Experiment (1973)
• D) Harlow's Monkey Experiment (1950s)

• A) Wernicke-Korsakoff; mammillary bodies and thalamus
• B) Kluver-Bucy syndrome; bilateral temporal lobes (amygdala)
• C) Balint syndrome; bilateral parieto-occipital cortex
• D) Frontal lobe syndrome; bilateral prefrontal cortex

• A) Validity of psychiatric diagnoses
• B) Safety of psychiatric hospitals
• C) Ethics of ECT
• D) Effectiveness of antipsychotics

• A) Capgras syndrome
• B) Othello syndrome
• C) Cotard syndrome (le délire de négation)
• D) Folie à deux

• A) Paranoid schizophrenia in both
• B) Shared delusional disorder (Folie à deux)
• C) Paranoid personality disorder
• D) Delusional disorder, persecutory type, in both

• A) Dorothea Dix
• B) Benjamin Rush - "Medical Inquiries and Observations upon the Diseases of the Mind" (1812)
• C) Adolf Meyer
• D) William Tuke

• A) 1965
• B) 1970
• C) 1975
• D) 1980

• A) Freud won for psychoanalysis
• B) Kandel won for discovery of dopamine
• C) Wagner-Jauregg (1927) is the only psychiatrist to have won the Nobel Prize in Medicine
• D) Moniz won for ECT

• A) Second-rank symptom
• B) First-rank symptom - audible thoughts (Gedankenlautwerden)
• C) Fundamental symptom (Bleuler)
• D) Accessory symptom (Bleuler)

• A) iv, iii, ii, i
• B) iii, iv, ii, i
• C) iv, i, iii, ii
• D) ii, iii, iv, i

• A) From husband alone
• B) From woman herself (she has decisional capacity)
• C) From nominated representative
• D) From mental health review board

• A) Conditioning anxiety
• B) Learned helplessness (Martin Seligman) - model for depression
• C) Operant conditioning failure
• D) Anhedonia

• A) Vaughn and Leff (1976), originally proposed by George Brown (1958)
• B) Wing and Cooper
• C) Zubin and Spring
• D) Leff and Vaughn

• A) Epidemiological Catchment Area (ECA) Study
• B) International Pilot Study of Schizophrenia (IPSS, WHO, 1973)
• C) CATIE Trial
• D) National Comorbidity Survey

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SECTION E: IMAGE-BASED QUESTIONS (171-195)

• A) Introduced chlorpromazine
• B) Described dementia praecox and manic-depressive insanity
• C) Unchained psychiatric patients
• D) Coined the term psychiatry (Answer relates to Kraepelin)

• A) York Retreat, England
• B) Bethlem Hospital, London
• C) Bicetre Hospital, Paris
• D) Charenton Hospital, Paris

• A) Kraepelin's Munich clinic
• B) Sigmund Freud's consulting room (psychoanalysis setting)
• C) A behavior therapy room
• D) A CBT session room

• A) Thematic Apperception Test
• B) Bender Gestalt Test
• C) Rorschach Inkblot Test
• D) MMPI

• A) Freud's topographic model only
• B) Freud's structural model combined with topographic model
• C) Jung's model of the psyche
• D) Adler's Individual Psychology model

• A) Haloperidol
• B) Clozapine
• C) Chlorpromazine
• D) Imipramine

• A) Frontal lobe syndrome
• B) Kluver-Bucy Syndrome
• C) Balint Syndrome
• D) Korsakoff Syndrome

• A) Anna Freud
• B) Melanie Klein
• C) Dorothea Dix
• D) Mary Ainsworth

• A) Classical conditioning
• B) Operant conditioning
• C) Systematic desensitization
• D) Social learning

• A) M00-M99
• B) 6A00-6E8Z
• C) G00-G99
• D) Z00-Z99

• A) Imprinting theory
• B) Operant conditioning (food = reinforcer)
• C) Contact comfort > food in attachment (Harlow's study)
• D) Social learning theory

• A) Classical fear conditioning
• B) Learned helplessness (Seligman)
• C) Punishment in operant conditioning
• D) Extinction of conditioned response

• A) 100,000 copies, sold immediately
• B) 600 copies, took 8 years to sell
• C) 5,000 copies
• D) 2,500 copies

• A) Schizophrenia with insulin
• B) General Paralysis of the Insane (GPI - neurosyphilis) with malaria fever
• C) Depression with ECT
• D) Catatonia with barbiturates

• A) National Institute of Mental Hygiene and Neurological Sciences
• B) National Institute of Mental Health and Neuro Sciences
• C) National Institute of Mood, Health And Neuro Sciences
• D) National Institute of Medical Health and Neuropsychiatric Studies

• A) Prohibited
• B) Allowed in emergencies
• C) Allowed in children with parental consent
• D) Allowed when patient is unconscious

• A) Insulin coma therapy
• B) Malaria fever therapy for GPI (Wagner-Jauregg)
• C) Hyperthermia for depression
• D) Typhoid fever therapy for schizophrenia

• A) First DSM to list mental disorders
• B) Introduced the multiaxial system and operationalized diagnostic criteria
• C) Removed the multiaxial system
• D) Added biological tests for diagnosis

• A) Introduction of ECT
• B) Moral treatment - removal of chains from mental patients (Bicetre, 1793)
• C) Discovery of chlorpromazine
• D) Deinstitutionalization movement

• A) MCI (Medical Council of India)
• B) IPS (Indian Psychiatric Society)
• C) ICMR
• D) Ministry of Health

• A) ICD-10
• B) ICD-11
• C) DSM-5-TR
• D) WHO Mental Health Action Plan

• A) It is faster than hypnosis
• B) Freud abandoned hypnosis after seeing its limitations, and used free association instead
• C) Patients refused hypnosis
• D) It is more ethical than hypnosis

• A) Carl Jung
• B) Alfred Adler
• C) Sigmund Freud
• D) Josef Breuer

• A) Delay and Deniker (1952)
• B) Carlsson and Lindquist (1963)
• C) Paul Janssen (1958)
• D) Seeman and Lee (1975)

• A) NIMHANS
• B) Indian Psychiatric Society
• C) Indian Journal of Psychiatry
• D) Indian Council of Medical Research

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PREVIOUS-YEAR / NEET-PG / INI-CET STYLE QUESTIONS (196-225)

• A) Delusion of reference
• B) Capgras delusion (delusional misidentification)
• C) Persecutory delusion
• D) Cotard delusion

• A) Believing one is dead
• B) Giving approximate/near-miss answers (Vorbeireden)
• C) Morbid jealousy
• D) Parasitosis delusion

• A) Auditory hallucinations are fundamental
• B) The 4 A's are Affect, Ambivalence, Autism, Associations
• C) Delusions are fundamental
• D) First-rank symptoms are Bleuler's contribution

• A) Haloperidol
• B) Reserpine
• C) Chlorpromazine
• D) Thioridazine

• A) Benjamin Rush
• B) Emil Kraepelin
• C) Philippe Pinel
• D) William Tuke

• A) IPC amendment 2014
• B) Mental Healthcare Act 2017, Section 115
• C) CrPC amendment 2016
• D) NDPS Act 2001

• A) Kraepelin
• B) Bleuler
• C) Morel (as démence précoce)
• D) Griesinger

• A) F63.0
• B) 6C51
• C) F91.8
• D) 6A20

• A) Lobotomy
• B) Malaria fever therapy for GPI
• C) Insulin coma therapy
• D) ECT

• A) 1975
• B) 1980
• C) 1987
• D) 1992

• A) Social conformity
• B) Obedience to authority
• C) Aggression under stress
• D) Bystander effect

• A) Appointed by court
• B) A registered psychiatric nurse
• C) A person appointed by patient to act on their behalf
• D) Always the next of kin

• A) It validated psychiatric diagnostic criteria
• B) It showed that psychiatric staff cannot distinguish sane from insane
• C) It proved ECT is effective
• D) It demonstrated high sensitivity of DSM-II

• A) Thought broadcasting
• B) Somatic passivity
• C) Visual hallucinations
• D) Made volition

1. Philippe Pinel → ?
2. Eugen Bleuler → ?
3. Emil Kraepelin → ?
4. Kurt Schneider → ?

• A) 1-Moral Treatment; 2-Schizophrenia & 4A's; 3-Dementia Praecox/MDP; 4-FRS
• B) 1-First antipsychotic; 2-Dementia Praecox; 3-Schizophrenia; 4-4A's
• C) 1-Psychoanalysis; 2-Moral Treatment; 3-FRS; 4-Schizophrenia
• D) 1-IQ testing; 2-Neurotransmitters; 3-EEG; 4-MRI

• A) Psychoanalysis → ECT → DSM-I → Chlorpromazine
• B) Psychoanalysis → DSM-I → ECT → Chlorpromazine
• C) ECT → Psychoanalysis → Chlorpromazine → DSM-I
• D) DSM-I → Psychoanalysis → ECT → Chlorpromazine

• A) Lobotomy (Moniz, 1949) - Moniz was a neurologist
• B) Malaria fever therapy - Wagner-Jauregg (1927) - psychiatrist
• C) Memory research - Eric Kandel (2000) - psychiatrist/neuroscientist
• D) MRI development - Lauterbur (2003)

• A) Grandiose delusion
• B) Capgras syndrome
• C) Cotard syndrome
• D) Nihilistic personality

• A) New York
• B) Geneva
• C) London
• D) Paris

• A) Mental and behavioral disorders (Chapter 6)
• B) Conditions related to sexual health (Chapter 17)
• C) Endocrine disorders (Chapter 5)
• D) Neurological conditions (Chapter 8)

• A) Ivan Pavlov
• B) John Watson
• C) B.F. Skinner
• D) Albert Bandura

• A) L.P. Varma
• B) Vidya Sagar (family involvement, Amritsar)
• C) N.S. Vahia
• D) M.V. Govindaswamy

• A) Placing mental patients in hotels
• B) Community placement of patients with families outside asylums
• C) Boarding schools for mentally ill children
• D) Treatment in general hospitals

• A) DSM-5 only
• B) ICD-11 (as a new category)
• C) DSM-5-TR
• D) ICD-10 revision

• A) Emil Kraepelin
• B) Karl Jaspers
• C) Eugen Bleuler
• D) Wilhelm Griesinger

• A) WHO
• B) American Psychological Association
• C) American Psychiatric Association
• D) National Institute of Mental Health

• A) Repressed childhood memories
• B) Sexual drives
• C) Universal inherited archetypes (Jung)
• D) Ego defense mechanisms

• A) Adolf Meyer (1917)
• B) George Engel (1977)
• C) Freud (1923)
• D) Thomas Szasz (1960)

• A) 1990
• B) 2000
• C) 2010
• D) 2020

• A) Always false beliefs
• B) "Un-understandable" from the patient's personality and circumstances (not derivable by empathy)
• C) Always accompanied by hallucinations
• D) Always mood-congruent

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ONE-PAGE RAPID REVISION SHEET - HISTORY OF PSYCHIATRY

ERAS: Ancient (humoral) → Reform (Pinel 1793) → Scientific (Kraepelin 1896) → 
      Psychoanalytic (Freud 1900) → Biological (Chlorpromazine 1952) → 
      Community (Kennedy 1963) → Modern (DSM-5 2013, ICD-11 2022)

KEY PEOPLE:
• Pinel (1793) = Unchained patients, Bicetre, Moral Treatment
• Kraepelin (1896/99) = Dementia Praecox vs MDP, prognosis-based
• Bleuler (1911) = Coined Schizophrenia, 4 A's, coined Autism
• Schneider = FRS (11 symptoms)
• Freud = Psychoanalysis, Id/Ego/Superego, Unconscious
• Jung = Collective Unconscious, Archetypes, Introvert/Extrovert
• Adler = Inferiority Complex
• Delay/Deniker (1952) = First use of Chlorpromazine
• John Cade (1949) = Lithium
• Roland Kuhn (1958) = Imipramine (first TCA)
• Paul Janssen (1958) = Haloperidol
• Leo Sternbach = Chlordiazepoxide (first BZD)

DRUGS (chronology):
Insulin coma (Sakel, 1927) → Lobotomy (Moniz, 1935) → ECT (Cerletti+Bini, 1938) → 
Lithium (Cade, 1949) → Chlorpromazine (1952) → Haloperidol (1958) → 
Imipramine (1958) → BZD (1960) → Fluoxetine (1987) → Clozapine re-intro (1990)

DSM: I(1952) → II(1968) → III(1980)★ → IIIR → IV(1994) → IVR → 5(2013) → 5-TR(2022)
ICD: ICD-6(1948, first mental) → ICD-10(1992) → ICD-11(2022★)

EPONYMS: Capgras=impostor, Cotard=dead, Fregoli=same person, Ganser=approx answers, 
         Ekbom=parasitosis, Othello=jealousy, Kluver-Bucy=bilateral temporal

LAWS: India: Lunacy(1858) → Indian Lunacy(1912) → MHA(1987) → MHCA(2017★)
      MHCA 2017: Suicide decriminalized(S.115), ECT without anesthesia BANNED

NOBEL: Wagner-Jauregg (1927) = ONLY psychiatrist = malaria for GPI
       Moniz (1949) = lobotomy (neurologist)
       Kandel (2000) = Aplysia/memory

IPS = 1947 | NIMHANS = Bangalore

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🎯 REPLY WITH YOUR ANSWERS NOW!

1. Check every answer
2. Explain WHY each correct answer is right
3. Explain WHY each wrong option is wrong
4. Give memory tricks for every answer

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