CracKING Community Medicine Spotters-Module 20: Mental Health

##Spotter Set: Lessons 1–3 (Problem, Assessment & Causes)

Q1. What is the prevalence of mental health disorders in Nepal? (0.5)

• Answer: Approximately 13.2% among the adult population (National Mental Health Survey 2020).

Q2. Differentiate between Illusion and Hallucination. (1)

• Illusion: Misinterpretation of a real external stimulus (e.g., rope seen as a snake).

• Hallucination: Perception in the absence of an external stimulus (e.g., hearing voices in a silent room).

Q3. Classify the causes of mental illness. (0.5)

1. Biological: Genetics, biochemical (neurotransmitters), organic (brain injury).

2. Psychological: Emotional trauma, personality traits.

3. Social/Environmental: Poverty, isolation, unemployment.

##Spotter Set: Lessons 4–6 (Types, Development & Retardation)

Q1. Classify Mental Illnesses into two broad categories. (0.5)

1. Psychosis: Loss of contact with reality, lack of insight (e.g., Schizophrenia).

2. Neurosis: Contact with reality maintained, insight present (e.g., Anxiety, OCD).

Q2. Define Mental Retardation and its IQ classification. (1.5)

• Definition: A condition of arrested or incomplete development of the mind.

• Classification:

  • Mild: IQ 50–70

  • Moderate: IQ 35–49

  • Severe: IQ 20–34

  • Profound: IQ < 20

##Spotter Set: Lessons 7–9 (Conversion, Schizophrenia & Depression)

Q1. List the four "A's" (Bleuler’s signs) of Schizophrenia. (1)

1. Affective flattening

2. Autism (Social withdrawal)

3. Association looseness

4. Ambivalence

Q2. What is Beck’s Cognitive Triad in Depression? (1)

1. Negative view of Self.

2. Negative view of the World.

3. Negative view of the Future.

Q3. Mention one hallmark of Conversion Reaction (Dissociative Disorder). (0.5)

• Answer: La belle indifférence (a surprising lack of concern about severe physical symptoms like paralysis).

##Spotter Set: Lessons 10–12 (Addiction, Suicide & Gender)

Q1. Enlist the CAGE Questionnaire for Alcoholism. (1)

• C: Have you felt you should Cut down?

• A: Have people Annoyed you by criticizing your drinking?

• G: Have you felt Guilty about drinking?

• E: Have you had an Eye-opener drink in the morning?

Q2. List three high-risk factors for Suicide. (1)

1. History of previous attempts.

2. Presence of a severe mental disorder (e.g., Depression).

3. Social isolation or recent life crisis.

Q3. Define Gender Identity Disorder. (0.5)

• Answer: A strong and persistent cross-gender identification and discomfort with one's assigned sex.

##Spotter Set: Lessons 13–15 (Prevention, Services & Epilepsy)

Q1. Give examples of levels of prevention in Mental Health. (1)

• Primary: Mental health education, stress management.

• Secondary: Early screening (CAGE), prompt treatment of depression.

• Tertiary: Vocational rehabilitation, social reintegration.

Q2. Name the national suicide prevention hotline in Nepal. (0.5)

• Answer: 1166.

Q3. Differentiate between Grand Mal Epilepsy and a Conversion Fit. (1)