Dr. Fahad Al-WahhabiMBBS, FRCPC

Psychopathology(Signs & Symptoms in Psychiatry)

Definition

• Psychopathology refers to problematic patterns of thought, feeling, and behavior:

– Disrupted functioning at home, work, and in the person’s social

life– Patterns that cause distress in the person or in others– Psychopathology literally means sickness of the mind

• Psychopathology varies between and within cultures

Introduction

Most exist on a spectrum/continuum

Diagnosis is made on patterns not on single sx

To elicit is to be skillful

Clusters of symptoms

Psychiatric problems are classified based on signs and symptoms into disorders:

– Signs are observable phenomena (hallucinations)

– Symptoms are reports from patients (feeling anxious)

Categories of psychopathology

Behavior & movementEmotionsSpeechThinkingPerceptionAwareness of self and othersCognitionJudgmentInsightBiological rhythms

Abnormalities of behavior and movement

Slow Retarded Normal

HyperactiveAgitated

Abnormalities of Cognition

Attention

Memory

Distractibility Hypervigilance

Amnesia Hyperamnesia

Abnormalities of speech

Mute Pressured speech

Normal

Abnormalities of mood and emotions

Very depressed

Elated

Fearless Very Fearful

Relaxed Anxious, irritable

Abnormalities of thought

Process

Content

Organized

Preoccupied, Worries, Overvalued ideas, Delusions ,

Flight of ideas

Loose association

Abnormalities of perception

• Illusions

• Hallucinations

Abnormalities of awareness of self and others

Depersonalization

Derealization

Abnormalities of insight

• Degree of awareness of current situation e.g. being mentally ill.

No insight Good insight

Abnormalities of judgment

• Ability to understand, appreciate a situation and act based on knowledge of risks and benefits.

Poor judgment

Good judgment

Abnormalities of biological rhythms

• Sleep

• Appetite

Insomnia Hypersomnia

Anorexia Hyperphagia

Clinical Description (brief discription)

1. Begins with the Presenting Problem

2. Description Aims to

– Distinguish clinically significant dysfunction from common human experience

3. Describe Onset

4. Describe Course

5. Associated symptoms

How is psychopathology summarized?

• Depressive sx• Psychotic sx• Anxiety sx• Dissociative sx• Cognitive sx• Substance abuse sx• Somatoform sx• Personality sx