General symptomatology & psychopathology

of psychiatric disorder

Objectives:

At the end of the session the student will be able to:

Explain general symptomatology of psychiatric disorder.

Component of mind.( disorders of thought –disorder of emotion-disorder of behavior ) Type of disorder:

1-Thought disorder 2-Disturbance in perception.3- Unreality states. 4- Disorder of memory.

5- Orientation , disorientation. 6- Judgment.7- Insight. 8- Attention and

concentration.9- Disorder of consciousness. 10- Disorder of affect.

11- Disorder of behavior.

Out line:

1-disorder of thought

formal

stream

content

1-Concrete thinking

2-autistic thinking

5-clang association

6-incoherence or word salad

8-poverty of speech

7-pressur of speck

9-Retardation

10-Blocking

11-preservation

12-pallilalia

13-Echolalia

14-Irrelevant answer

15-Neologisms

4-flight of idea

3-loseness of association

2-circumstantially

1-tangentiality

1-delusion.

2-obsession

3-peroccuption.

4-suicidal ideation.

1-Concrete thinking:1-Concrete thinking: when the patient use literal thinking with out understanding the implicit meaning behind sentence &it is verse abstract

A-formal thought disorder:A-formal thought disorder:

clinical manifestationclinical manifestation::

عالحديدة؟؟؟

وين الحديدة

ما اشوفها

تصدقين ...صرت عالحديدة

2-autistic thinking:2-autistic thinking: thinking that gratifies unfulfilled desire but has no regard for reality, egocentric (self -centred) fantasy.

• 1-tangentiality:1-tangentiality: • Occur when The speaker goes off the topic

and dos not return to the it.

B-disorder of stream of thinking:

عند الصبح االحد يوم رحتالمكتب في الله عبد ابو

...........................و

ال مطعم في اليوم تعشيتيفوتك

• 2-circumstantially:2-circumstantially:• Before getting the point or answering the

question the patient gets caught up in countless details and explanation.

بدا متىااللم؟؟؟؟

من قمت السبت يوموجهي وغسلت النومومربى جبنه وافطرت

قليل وحليب توتجينز ولبست الدسم

احمر شيرت وتي ازرقلكن السيارة وركبتمخلص كان البنزين

ورحت ..... ..... االثنين..... ويوم و و

وجعني الغدى بعد بطني

• 3-loseness of association:3-loseness of association:• Thinking haphazard , illogical and confused,

connection of thought is interrupted appear mostly in schizophrenic disorder.

هذي اكيدعطشانة

كذا عشانفي قاعدةالموية

• 4-flight of idea:4-flight of idea:• Rapid jumping from one idea to another, the

connection b\t idea is through stimuli from last idea or external stimuli.

والدنيا بديع الجوربيع

كل على قفلالمواضيع

55--clang association:clang association: meaningless rhyming of word

البحر رحتالقمر وشفتسمر ليلة في

• 6-incoherence or word salad: mixture of word and phrases that have no meaning.

العشى نمتالباب داخل

7-pressur of speck: Forceful energy heard in a manic people frantic jumbled speech as he or she struggles to keep pace with racing thought.

بروحاليومالمالهيمعامي

واخويواختيخالتيوخالوولدخالتي ي

• 8-poverty of speech:8-poverty of speech: the speech is brief and uncommunicate.

9-Retardation:9-Retardation: refer to slow speech and prolonged latent period before response.

من خابطك فراسك؟؟

راحت!!

وش فيك

ما عسىشر؟؟

....................

....................

....................راسي..... مصدع

1010--BlockingBlocking::Sudden cessation of thought in the middle of sentence & person is unable to continue bis train of thought.

11-preservation :11-preservation : psychopathological repetition of the same word or idea in response to the different question

اليوم رحتوشفت السوق

لونه فستان

معاي بتروح؟

ايه.

ايهبتجلس؟؟

12-pallilalia:12-pallilalia:

pathological repetition of the last word said.

1313--Echolalia:Echolalia: repeating the speech of another person.

عند اليوم كنتخالتي

وبناتها . عليك يسلمون

يسلمون عليك

يسلمون عليك

عليك يسلمون

بركب الخيلبركب الخيل

الخيل بركب

بركب الخيل

14-Irrelevant answer:14-Irrelevant answer: answer hat is not in harmony with question

asked.

1515--NeologismsNeologisms:: word a person Mack up that only. have meaning for

the person.

اش تشربي؟

الكتاب امل عند

هاكون متاتا

C-disorder of content of thought:It is include:

1-delusion. 2-obsession.

3-peroccuption. 4-suicidal ideation.

Definition It is false fixed belief not consist with patient educational

and cultural back ground that cannot be corrected by logic or reasons.

Delusion divide into:**Systematized : when they form a coherent system and

appear to be logical ,e.g.: paranoid delusion.

*un systematized delusion: group of delusion that not related to each other or in a haphazard relation.Another category of delusion:

1-paranoid delusion. 2-delusion of influence.3-depressive delusion. 4-hypochondriacal

delusion

1-Delusion

11--paranod delusionparanod delusion::

it is an intense and strongly defended irrational suspicious belief.

It include: It include: A-Delusion of grandeur:A-Delusion of grandeur: false

belief that one is a very powerful and important person.

B-Delusion of persecution:B-Delusion of persecution: false belief that one is chased by other.

C-Delusion of reference:C-Delusion of reference: false belief that the behavior of other refers to one self (people in street, radio, news paper are referring to him) .

برج شفتانا المملكة

بنيته اللي

D-Erotic delusion:D-Erotic delusion: false belief that there is a love story between one self and famous person.

E-delusion of jealousy:E-delusion of jealousy: conviction that the spouse has some

definite relation with someone else.

f-delusion of infidelity: f-delusion of infidelity: false belief derives from pathological

jealousy that one lover is unfaithful (it is an extreme of the jealousy delusion)

g-litigious delusion:g-litigious delusion: patient write complaint and sends

them to responsible person.

22--delusion of influence (delusion delusion of influence (delusion of control)of control)

false belief that one is being controlled by other or agencies.

انا اصالكذا اسوي

جهاز فيه النامريكا في

يتحكم بتصرفاتي

33--deprssive delusiondeprssive delusion::

A-delusion of self-blame, guilt A-delusion of self-blame, guilt or sin:or sin: in which the patient that he is wicked, full of sins and unfit to live with other people (unworthiness).B-delusion of poverty:B-delusion of poverty: false belief that he lost everything in life.C-Nihilistic delusion:C-Nihilistic delusion: false belief that a part of this body doesn't exist or he doesn't exist(dead)

انا اصالوجودي انا غلط

على عالهالمجتمع وامريكا دخلت العراق بسببي . ما انا يدي وين

يد عندي

44--hypochondriacal delusionhypochondriacal delusion::

Patient has false belief that he has physical disease e.g. cancer stomach that is not based on real organic pathology.

مريض!!! انافشل وعندي

كلوي!!!

2-obsessive of thought:

Are intrusive of thought invading the conscious awareness against the resistance of the person in an involuntary way that if fully aware that they un necessary and absurd. If the patient 's resistance succeeds to temporarily or partially control this intrusion, tension accumulates until it reaches an intolerance degree that completes the individual to yield and act out the obsessive behavior.

33--preoccupationpreoccupation::Centring of thought content around a particular idea associated with strong affective tone.

44--suicidal ideationsuicidal ideation::It is the recurrent idea affecting the individual to put an end by himself to his own life

2-disturbance in perception:

1-hallucination:False perception for which no external stimuli exist. Hallucination can have an organic or a functional etiology.

Visual: seeing thing that are not there.

Auditory: hearing voice when none are present.

Olfactory: smelling smells that do not exist

Tactile: feeling touch sensation in the absent of stimuli.

Gustatory: experiencing taste in the absence of stimuli.

2-illusion :It is a false perception with an external stimulus.

N.B. it may affect any of the special senses ( auditory, olfactory….,etc)

1-hallucination:2- illusion:

False perception for which no external stimuli exist. Hallucination can have an organic or a functional etiology.

It is a false perception with an external stimulus.

3-unreality states:

1-depersonalisation: A phenomenon whereby a person experience a sense of unreality or self –estrangement.

2-derealization: the false perception by a person that his or her environment has changed also they can be categorized under affect and perception.

4-disorder of memory:

1-amnesia: is loss of memory and may be partial or complete.

type of amnesia:

1-Anterograde amnesia:

2-Retrograde amnesia:

3-Total amnesia:

4-Circumscribedamnesia:

1-Anterograde amnesia: loss of memory for recent event.2-retrograde amnesia : loss of memory for remote event.

3-Total amnesia: loss of memory for recent and remote event.

4-Circumscribed amnesia: loss of memory for limited time.

2-par amnesia: it denotes false recall.

a-confabulation: patient fills the

gaps in his memory by

fabrication.

b-falsification patient adds fraises details

to a true memory.

3-hyperamnesia: it's excessive memory, the patient mention even unnecessary details.

4-deja vu phenomena (already seen): in which new situation is experienced as previously

5-jamais vu phenomena: in which familiar

situation is experienced as novel.

6-judgment:

It is the ability to assess a situation correctly and act appropriately within that situation.

7-insight:

It is the ability to under stand the objective condition of his illness.

N.B. A patient with no insight will have poor judgment towards his social , financial and domestic problem.

8-attention and concentration:

It Is the direction of the focus of awareness and perception to a particular stimulus .

*distractibility: inability to maintain attention, shifting from one area or topic to another with minimal provocation.

9-Disorder of consciousness:

Between conscious and unconscious there are various degree of disturbed consciousness, some of them are:

1-confusion:There is dimming or clouding of consciousness. All mental processes are slow.

2-delirium: There is clouding of consciousness .the mental function show quantitative change:

a-intellect: Hallucination ,illusion and disorientation. B-affect: fear and apprehension.

c-behavior: restlessness.

3-stupor: there is complete suppression of motor activity, the patient doesn't respond to any stimuli neither of external or internal.

4-twilight state: is state of restricted consciousness including ideation perception

and association emotional state .

5-fugue: it involves memory loss, as does psychogenic amnesia, but it also including traveling away from home or from one's usual

work locale .Therefore, fugue involves flight as well as forgetfulness.

10-disorder of affect:

A-inadequate affect:

1-apathy: it's the absence of

emotional experience and expression.

2-indifference: absence of both emotional but

experience is present.

B-inappropriate affect

)incongruity (it is a disharmony of affect and ideation.

الف مبروك نجحتي

؟؟؟؟

c-Ambivalence:

the holding at the same time of tow opposing emotions, attitudes,

ideas or wishes toward the same person, situation

or objectأحبـــــــــــــ

ك...

أكرهــــــــــــــــــك...

D-depressive affect:

1-grief or mourning:

it's feeling of sadness

appropriate to a real

loss.2-depression:

it's a psychopathological

feeling of sadness.

E-pleasurable

affect:1-euphoria:

it is a heightened feeling of psychological well being inappropriate to

apparent event.

2-elation: it is feeling of happiness

with air of confidence and

enjoyment associative with increase

motor activity.

F-anxiety, apprehension ,fear and

phobia

1-Anxiety: a state of feeling ,uneasiness ,uncertainty or dread resulting from a real or perceived

threat whose actual source is unknown or unrecognized.

Type of anxiety:

2-tension: unpleasant feeling

associated with physical

and psychological tightness.

1-free floating anxiety:it is sever, generalized and pervasive. Fear not attached to any idea.

3-panic:

sudden, overwhelming anxiety of such intensity that it produce disorganization of the personality

2-Apprehension :intense fear of any non-fearful stimuli.

Fear of externals danger e.g. car accident.

3-fear: A reaction to specific danger.

4-phopias: An intense irrational fear of an object, situation or place .the fear persist even thought the object of the fear is perfectly harmless and the person is aware of the irrationality.

14-Disorder of behavior( conation):

a-hyperactivity:

it include:

1-Agitition: it's some from of

hyperactivity characterized by pacing and accompanied with restlessness

2-Excitement: it's sever form of

hyperactivity, excessive purposeless motor

activity and the patient may destruct himself or other

B-Compulsion:

un controllable impulse to perform an act repetitively.

c-Repetitive activity:

1-stereotypy: it is a monotonous repetition of

certain movement with out purpose.

4-waxy flexibility: it is the maintenance of imposed postures

however abnormal they may be the absence of fatigue

in such cases is remarkable )e.g. raising the heal of the patient from the

pillow or the arm up.(

2-mannerism :it is a repeated movement ,

which isn't monotonous and keeping with the personality

character.

D - Echopraxia

imitating the movement of another person: .

E - Negativism

frequent opposition to suggestion, e.g.

a-in motor sphere when was asked to look up he looked down.

b-in speech : when he asked question he didn't answer.

c- retention of saliva, urine or feces.

f-Automatic obedience:

the performance of all simple commands in a robot-like fashion may be present in catatonic.

G-Impulsiveness:

is an action that is sudden , abrupt , unplanned and directed toward immediate gratification.

H-psychomotor retardation:

Extremely slow and different movement that in the extremes can entail complete inactivity and incontinence

BY: NORAH&

ENAS