General SymptomatologyGeneral Symptomatology by Prof. Dr. Elham Fayadby Prof. Dr. Elham Fayad
Objectives :Objectives :
At the end of the session the At the end of the session the student will be able to :-student will be able to :-
Explain General symptomatology Explain General symptomatology of psychiatric disorder .of psychiatric disorder .
Contents :Contents :
General symptomatology of psychiatric General symptomatology of psychiatric disorders .disorders .
a- Composition of mind a- Composition of mind
1- Disorders of Intellect .1- Disorders of Intellect .
2- Disorders of Affect.2- Disorders of Affect.
3- Disorders of Behaviour .3- Disorders of Behaviour .
I- Disorder of ThoughtI- Disorder of Thought
a- Formal thought disordera- Formal thought disorder
Clinical manifestations of formal thought Clinical manifestations of formal thought disorderdisorder
11 - -Concrete thinkingConcrete thinking-: -:
Concreteness versus abstractnessConcreteness versus abstractness
22 - -Autistic thinkingAutistic thinking
Autistic versus realisticAutistic versus realistic
Disorders of the stream of thinkingDisorders of the stream of thinking
11 - -TangentialityTangentiality
22 - -CircumstantiallyCircumstantially
33 - -Looseness of associationLooseness of association
44 - -Flight of ideasFlight of ideas
55 - -Clang associationClang association
66 - -Incoherence or word saladIncoherence or word salad
77 - -Pressure of speechPressure of speech
88 - -Poverty of speechPoverty of speech
CONT. STREAM OF THOUGHTCONT. STREAM OF THOUGHT
99 - -RetardationRetardation
1010 - -BlockingBlocking
1111 - -PreservationPreservation
1212 - -PalilaliaPalilalia
1313--EcholaliaEcholalia
1414 - -Irrelevant answerIrrelevant answer
1515 - -NeologismsNeologisms
C- Disorder of the content of C- Disorder of the content of thoughtsthoughts: :
It includes:
1 -Delusion
2 -Obsession
3 -Preoccupation
4 -Suicidal ideation
11 - -DelusionDelusion
Definition Definition : It is false fixed : It is false fixed believe, not consistent with believe, not consistent with patient’s educational and patient’s educational and cultural background, that cannot cultural background, that cannot be corrected by logic or reasonsbe corrected by logic or reasons
Categorization of delusions:
1 -Paranoid delusions . .
2 -Delusion of influence
3 -Depressive delusion .
4 -Hypochondria cal delusion
11 - -Paranoid delusionParanoid delusion: :
a- a- Delusion of grandeurDelusion of grandeur
b- Delusion of persecutionb- Delusion of persecution
c-c- Delusion of reference Delusion of reference
d- d- Erotic delusionErotic delusion
e-e- Delusion of jealousy Delusion of jealousy
f-f- Delusion of infidelity Delusion of infidelity
g- g- Litigious delusionLitigious delusion
22 - -Delusion of influence Delusion of influence (delusion of control) false (delusion of control) false
belief that one is being belief that one is being controlled by others controlled by others
or agencies or agencies..
33 - -Depressive delusionDepressive delusion
a-a- Delusion of self-blame, guilt or sin Delusion of self-blame, guilt or sin
b- b- Delusion of povertyDelusion of poverty
c- c- Nihilistic delusionNihilistic delusion
44 - -Hypochondria cal delusionHypochondria cal delusion
Patient has false belief that he Patient has false belief that he has physical disease e.g. has physical disease e.g.
cancer stomach ,that is not cancer stomach ,that is not based on real organic based on real organic
pathology.pathology.
22 - -Obsessive thoughtsObsessive thoughts
Obsessive thoughts are intrusive Obsessive thoughts are intrusive thoughts invading the conscious thoughts invading the conscious awareness against the awareness against the resistance of the person in an resistance of the person in an involuntary way that is fully involuntary way that is fully aware that they are aware that they are unnecessary and absurdunnecessary and absurd
II- Disturbance in perceptionII- Disturbance in perception
11 - -HallucinationsHallucinations.. 22 - -IllusionIllusion..
TYPESTYPES::Visual: Seeing things that are not thereVisual: Seeing things that are not there..
Auditory : Hearing voices when none are Auditory : Hearing voices when none are presentpresent..Olfactory : Smelling smells that do not existOlfactory : Smelling smells that do not exist..
Tactile : Feeling touch sensations in the absence Tactile : Feeling touch sensations in the absence of stimuliof stimuli..
Gustatory: Experiencing taste in the absence of Gustatory: Experiencing taste in the absence of stimulistimuli. .
III- Unreality statesIII- Unreality states
11 - -Depersonalisation : A phenomenon whereby a Depersonalisation : A phenomenon whereby a person experiences a sense of unrealityperson experiences a sense of unreality
or self -estrangementor self -estrangement. .
22 - -Derealization : The false perception by a Derealization : The false perception by a person that his or her environment has person that his or her environment has
changedchanged. .
Also they can be categorized under affect Also they can be categorized under affect and perceptionand perception. .
IV- Disorder of memoryIV- Disorder of memory
11 - -AmnesiaAmnesia types of amnesiatypes of amnesia: :
a-a- Anterograde amnesia :Anterograde amnesia : Loss of memory for Loss of memory for recent eventsrecent events..
b-b- Retrograde amnesia :Retrograde amnesia : Loss of memory for Loss of memory for remote eventsremote events. .
c-c- Total amnesia :Total amnesia : Loss of memory for recent and Loss of memory for recent and remote eventsremote events. .
d-d- Circumscribed amnesia :Circumscribed amnesia : Loss of memory for Loss of memory for limited timelimited time. .
22-- Par amnesia :Par amnesia : it denotes false recall it denotes false recall..a- Confabulation :a- Confabulation : Patient fills the gaps in his Patient fills the gaps in his
memory by fabricationmemory by fabrication. . b- Falsification :b- Falsification : Patient adds fraises details to a Patient adds fraises details to a
true memorytrue memory. . 33-- Hyperamnesia :Hyperamnesia : It’s excessive memory, the It’s excessive memory, the
patient mentions even unnecessary detailspatient mentions even unnecessary details..44-- Deja vu phenomena (already seen ) :Deja vu phenomena (already seen ) : in which in which
new situation is experienced as previouslynew situation is experienced as previously..55-- Jamais vu phenomena :Jamais vu phenomena : in which familiar in which familiar
situation is experienced as novelsituation is experienced as novel..
V- Orientation ,disorientationV- Orientation ,disorientation11 - -OrientationOrientation :: the ability to relate the self the ability to relate the self
correctly to time ,place and personcorrectly to time ,place and person..22 - -Disorientation :Disorientation : confusion and confusion and
impaired ability to identify time, place and impaired ability to identify time, place and personperson. .
VI- JudgementVI- Judgement: is the ability to assess a : is the ability to assess a situation correctly and act appropriately situation correctly and act appropriately within that situationwithin that situation..
VII - InsightVII - InsightIt is the ability to understand the objective It is the ability to understand the objective condition of his illnesscondition of his illness..
VIII- Attention and concentrationVIII- Attention and concentration It is the direction of the focus of awareness It is the direction of the focus of awareness and perception to a particular stimulusand perception to a particular stimulus..
* *Distractibility :Distractibility : inability to maintain inability to maintain attention, shifting from one area or topic to attention, shifting from one area or topic to
another with minimal provocationanother with minimal provocation. .
X- Disorder of affectX- Disorder of affect
a-a- Inappropriate affect Inappropriate affect : : (incongruity),it is a (incongruity),it is a disharmony of affect and ideationdisharmony of affect and ideation..
b- Pleasurable affectb- Pleasurable affect: :
11 - -EuphoriaEuphoria
22 - -ElationElation
33-- ExaltationExaltation
44-- EcstasyEcstasy
c- Depressive affectc- Depressive affect: : d- Inadequate affectd- Inadequate affect
11-- ApathyApathy 22 - -IndifferenceIndifference
e- Ambivalencee- Ambivalence
g- Anxiety .Apprehension, Fear and Phobiag- Anxiety .Apprehension, Fear and Phobia 11 - -Anxiety :A state of feeling, uneasiness , uncertaintyAnxiety :A state of feeling, uneasiness , uncertainty
22 - -Apprehension :-Apprehension :- Intense fear of any non-fearful Intense fear of any non-fearful
stimulusstimulus 33 - -Fear :Fear : A reaction to a specific dangerA reaction to a specific danger. .
44 Phobias :-Phobias :- An intense irrational fear of an object, An intense irrational fear of an object, situation or placesituation or place
XI- Disorder of behaviourXI- Disorder of behaviour
a-a- Hyperactivity :- Hyperactivity :- It includes It includes 11 - -AgitationAgitation
22-- ExcitementExcitement b-b- Psychomotor retardationPsychomotor retardation c-c- Repetitive activitiesRepetitive activities
11 - -StereotypyStereotypy 2- mannerism 2- mannerism 33 - -Preparation 4- Way flexibilityPreparation 4- Way flexibility
55 - -Catalepsy ( posturingCatalepsy ( posturing ) )