PSYCHOPATHOLOGY. Descriptions of Symptoms & Signs. Dr. Janaka Pushpakumara Department of Psychiatry FMAS/RUSL

Size: px

Start display at page:

Download "PSYCHOPATHOLOGY. Descriptions of Symptoms & Signs. Dr. Janaka Pushpakumara Department of Psychiatry FMAS/RUSL"

Stewart Watkins
5 years ago
Views:

1 PSYCHOPATHOLOGY Descriptions of Symptoms & Signs Dr. Janaka Pushpakumara Department of Psychiatry FMAS/RUSL

2 Symptoms & Signs In General Medicine, there is a clear definition of, and separation between, a symptom & a sign. In Psychiatry, the situation is different.

3 Symptoms & Signs Most of the diagnostic information coming from the History and Observation of patients appearance and behaviour.

4 Disturbances of emotions & Mood

5 Mood mood refers to the emotional state that prevails in a person, at any given time. However, in psychiatry the term mood is often used to describe the emotional state that has lasted for a period of time

6 Emotion An emotion is a complex multi-component episode that creates a readiness to act. E.g.: Anger Anxiety Fright Guilt Shame Sadness Envy Jealousy Disgust Happiness Pride Relief Hope Love Compassion

7 Disturbances of emotions & Mood May be abnormal in 3 ways Nature may be altered Fluctuate more or less than usual Inconsistent with thoughts/actions/ current circumstances.

8 Disturbances of emotions & Mood Nature Anxious Depressed Elated Irritable Angry

9 Disturbances of emotions & Mood Fluctuate more or less than usual Lability of mood - variation Emotional incontinence - extreme variation Blunting/flattening - variation Apathy severe flattening

10 Disturbances of emotions & Mood Inconsistent with thoughts/actions/ current circumstances. Incongrous/Inappropriate

11 Disturbances of perception

12 Disturbances of perception Perception Is the process of becoming aware of what is presented through the sense organs. Imagery Is the awareness of a percept that has been generated within the mind.

13 Disturbances of perception Illusion Misperception of external stimuli. A stimulus from a perceived object is combined with a mental image to produce a false perception.

14 Illusion A stimulus from a perceived object is combined with a mental image to produce a false perception.

15 Disturbances of perception Hallucinations Percept is experienced in the absence of an external stimulus to the corresponding sense.

17 Hallucinations Different sense modalities: Auditory hallucinations Visual hallucinations Olfactory hallucinations (of smell) Gustatory hallucinations (of taste) Tactile hallucinations (of touch)

18 Auditory Hallucinations (AH) Auditory hallucinations are common. They could occur in normal people (e.g. when falling asleep/waking up)

19 Auditory Hallucinations (AH) Elementary Bangs Whistles Complex Noises / Music Voices Indistinct Clear 2 nd person AH the patient hears a voices talking to him/commanding to him. 3 rd person AH the patient hears several voices, talking about hem (among themselves).

20 Visual Hallucinations (VH) Elementary Flashes of light Complex Faces Scenes

21 Autoscopic Hallucinations Seeing one s own body projected into external space. Reflex Hallucination Stimulus in one sensory modality results in a hallucination in another.

22 How to Differentiate a Hallucinations from an Imagery

23 Disturbances of Thought

24 Types of thinking Fantasy thinking produces ideas which have no external reality. Imaginative thinking Rational (conceptual) thinking attempts to resolve a problem through the use of logic, excluding fantasy.

25 Delusions This is a firmly held belief, which is not based on logic and not amenable to logical argument, which cannot be explained in terms of a patient s social or cultural back ground

26 Delusional Experiences & Themes Delusional Perception Delusional memory Shared delusions Persecutory Delusions Delusions of reference Grandiose delusions Nihilistic delusions

27 Delusional Experiences & Themes Cont. Hypochondriacal delusions Delusion of jealousy Sexual or amorous delusions Delusions of control

28 Delusions concerning possession of thoughts Thought insertion Thought withdrawal Thought Broadcasting

29 Overvalued idea Isolated, acceptable, comprehensible idea pursued by the patient beyond the bounds of reason Differs from Delusions Understandable when background is known culturally common & acceptable shakable

30 Obsessional & compulsive symptoms

31 Obsessional & compulsive symptoms Obsessional thoughts repeated & intrusive words / phrases upsetting the patient Obsessional ruminations complex repeated worrying themes Obsessional doubts repeated themes expressing uncertainty about previous actions Obsessional impulses repeated urges to carry out actions

32 Disturbances of Thinking processes

33 Disturbances of Thinking processes Disturbance of the stream of thoughts Pressure of thoughts ideas arise in unusual variety & abundance & pass through the mind rapidly Poverty of thoughts has few thoughts Thought block

34 Disturbances of Thinking processes Disturbance of the form of thoughts Perseveration persistent & inappropriate repetition of the same thought Flight of ideas speech move one topic to another quickly normal logical sequence of ideas is generally preserved loosening of association

35 Disturbances of Thinking processes Other Neologism

36 Depersonalization & Derealization

37 Motor symptoms & Sings Tics irregular repeated movements of group of muscles Mannerisms repeated movements that appear to have some functional significance Stereotypies repeated, regular, no obvious significance Catatonia muscle tone affecting flexion & extension & abolished by voluntary movements. Catalepsy/Waxy flexibility

38 Disturbances of Memory Immediate Recent Long term Disturbances of Recognition Jamais vu Déjà vu Confabulation

39 Insight

40 Thank You..!

PSYCHIATRIC MENTAL STATUS EXAMINATION. Jerry L. Dennis, M.D. Medical Director, ADHS/DBHS

PSYCHIATRIC MENTAL STATUS EXAMINATION Jerry L. Dennis, M.D. Medical Director, ADHS/DBHS Mental Status Examination General Considerations Based on Observations During the Assessment Process Spontaneity