Rosh Psychiatry Board Practice Exam

If a patient believes they are dead and predicts a natural disaster, how should this be recorded?

1. Erotomanic delusions

2. Grandiose delusions

3. Nihilistic delusions

4. Persecutory delusions

The correct answer is: Nihilistic delusions

Nihilistic delusions are characterized by a conviction that one is dead, does not exist, or that a catastrophe is imminent. In this case, the patient's belief that they are dead aligns closely with nihilistic delusions, as these reflect a denial of existence or a sense of impending doom. When a patient expresses such beliefs, including the prediction of a natural disaster, it further reinforces the nihilistic nature of their thoughts. This type of delusion often involves a belief in personal or existential annihilation, illustrating an extreme level of hopelessness or despair. Understanding this classification is vital for clinicians as it helps to differentiate the nature of the delusion being presented, which can inform appropriate treatment strategies and interventions for the patient.