Question

Lack of insight is not a feature of

• A. Panic disorder.
• B. Schizophrenia.
• C. Mania.
• D. Reactive psychosis.

Hint:

Psychotic disorders, schizophrenia, mania, reactive psychosis, impair insight; panic disorder, a neurotic condition, does not.

Answer 1

The Correct Option is A

Insight is the patient's own recognition that they are ill. This question asks which of the four listed conditions usually leaves that recognition intact.

1. Panic disorder: This is an anxiety condition, not a psychotic one. During an attack the person is terrified, but they still know they are having a panic attack and are not losing touch with reality. Insight stays intact, making this the exception.
2. Schizophrenia: A classic psychotic disorder. Delusions and hallucinations feel completely real to the patient, so they commonly do not believe they are ill. Insight is usually poor.
3. Mania: Especially in severe episodes, patients often see their racing thoughts, grand plans, or reduced need for sleep as normal or even a sign of being unusually capable, not as illness. Insight is often reduced.
4. Reactive psychosis: By definition a psychotic state triggered by severe stress. Like other psychoses, it usually comes with a loss of accurate self awareness about being unwell.

Three of the four options are psychotic conditions, and psychosis as a category tends to blur a patient's own sense that something is wrong. Panic disorder does not carry that reality distortion.

Let's summarize:

• Loss of insight is a hallmark of psychotic conditions: schizophrenia, mania, and reactive psychosis.
• Panic disorder keeps reality testing intact, so patients usually stay aware they are anxious, not psychotic.

So the condition where lack of insight is not a usual feature is panic disorder.