Theme 3. Abnormality of emotions and mood.
1. Classification of emotional disorders.
2. Mood Disorders:
3. Depressive syndromes:
- classical (typical) depression
- depressive stupor
- agitated depression
- apathetic depression
- masked ( somatized) depression
2) Manic syndrome.
3) Comparative age characteristics of depressive and manic
syndromes.
4) Methods of Investigation
1. Select the most accurate definition of “emotion”:
a) it is a special kind of mental reaction that accompanies other mental processes
and gives them a sensual tone
b) it is a very intensive subjective experience
c) it is a complicated, more or less stable subjective state, tone of feelings
d) all listed
e) nothing listed
2. Features of emotional disorders according to sensitivity and intensity include all
listed, except:
a) sensitivity
b) emotional coldness
c) rigidity
d) irritability
e) nothing listed
3. How is abnormal readiness to anger called?
a) emotional coldness
b) irritability
c) rigidity
d) sensitivity
e) nothing listed
4. How is frequent anger and aggressive reactions, a tendency to bursting forth
violently for no serious reason called?
a) parathymia
b) explosion readiness
c) irritability
d) rigidity
e) nothing listed
5. What feature describes physiological affect?
a) the individual can understand their consequences
b) the individual has a command over his or her actions
c) the individual later remembers what has happened during his/her state of affect
d) emotion is usually more or less adequate to the situation
e) all listed
6. How is the symptom of anxiety or fear arising in relation to a specific stimulus
called?
a) anticipatory anxiety
b) phobia
c) anesthesia psychica dolorosa
d) all listed
e) nothing listed
7. Select the most accurate definition of “affect”:
a) it is a special kind of mental reaction that accompanies other mental processes
and gives them a sensual tone
b) it is a very intensive subjective experience
c) it is a complicated, more or less stable subjective state, tone of feelings
d) all listed
e) nothing listed
8. Features of emotional disorders according to stability include all listed, except:
a) anxiety
b) lability
c) rigidity
d) explosion readiness
e) nothing listed
9. How is a tendency to exaggerated affective responsiveness called?
a) sensitivity
b) irritability
c) lability
d) pathologic affect
e) nothing listed
10. How is the mental state when emotions remain constant in the face of
circumstances that normally call for changes in affect called?
a) emotional coldness
b) ambivalence
c) rigidity
d) parathymia
e) nothing listed
11. What feature describes pathological affect?
a) the individual can understand their consequences
b) the individual has the situation
c) the individual later remembers what has happened during his/her state of affect
d) emotion is usually more or less adequate to the situation
e) nothing listed
12. What symptoms describe the typical depressive (Krepelin’s) triad?
a) lowering of mood-tone, slowing down of thinking and psychomotor retardation
b) feelings of painful dejection, difficulty in thinking and anticipatory anxiety
c) lowering of mood-tone, feelings of despair and guilt
d) lack of emotions, difficulty in thinking and ideas of self-humiliation
e) lowering of mood-tone, feelings of guilt and a characteristic expression in which
the corners of the mouth are turned down and the centre of the brow has vertical
furrows
13. Select the most accurate definition of “mood”:
a) it is a special kind of mental reaction that accompanies other mental processes
and gives them a sensual tone
b) it is a very intensive subjective experience
c) it is a complicated, more or less stable subjective state, tone of feelings
d) all listed
e) nothing listed
14. Distortion of emotions include all listed, except:
a) ambivalence
b) hyperthymia
c) parathymia
d) pathologic affect
e) nothing listed
15. How is a diminution of normal emotional responsiveness called?
a) rigidity
b) ambivalence
c) parathymia
d) flattening of affect
e) nothing listed
16. How is the phenomenon when the person may look and feel happy when
thinking about a sad event called?
a) parathymia
b) pathologic affect
c) ambivalence
d) rigidity
e) nothing listed
17. What symptoms describe the Protopopov's triad?
a) lowering of mood-tone, slowing down of thinking and psychomotor retardation
b) lack of emotions, difficulty in thinking and ideas of self-humiliation
c) tachicardia, dryness in the mouth and low appetite
d) constipation, dilation of pupils, and tachicardia
e) dilation of pupils, tachycardia and decrease of weight
18. What following properties do emotions have?
a) sensitivity
b) mobility
c) amplitude
d) content
e) all listed
19. Mood disorders include all listed, except:
a) euphoria (mania)
b) apathy
c) dysphoria
d) emotional coldness
e) nothing listed
20. How are marked mood changes, when one emotion quickly changes the other
called?
a) irritability
b) sensitivity
c) lability
d) ambivalence
e) nothing listed
21. How is the phenomenon if a patient experiences two opposite feelings towards
one object or circumstance called?
a) parathymia
b) pathologic affect
c) ambivalence
d) rigidity
e) nothing listed
22. How is mood which varies from day to day, and depends on the circumstances
called?
a) labile
b) hyperthymic
c) dysthymic
d) euthymic
e) nothing listed
23. What symptoms describe the typical manic triad?
a) lowering of mood-tone, slowing down of thinking and psychomotor retardation
b) tachicardia, dilation of pupils, and constipation
c) hyperthymia, increased psychomotor activity, increased speed of thinking and
speech
d) hypermnesia, increased psychomotor activity, increased speed of thinking and
speech
e) hyperthymia, increased appetite, grows sexual activity
Clinical task 1.
At the psychiatric department the patient is lively and cheerful, her eyes shine, and
her mood is elevated almost all the time. Her clothes look rather extraordinary: the
slippers are decorated with bows and a lot of cotton wool balls are sewn all over her
jersey. Her hair is made into a strange coiffure, her lips are painted with bright lipstick.
The patient is excessively energetic and restless, she intrudes into every activity going on
at the department, dances, sings, makes sexually advances to male visitors of the department. Seems never to get tired, sleeps only for 3 or 4 hours at night, her appetite is
increased. Speaks very quickly, with no pauses, can't keep one line of conversation, and
constantly "skips" from one topic to another.
1. What signs of mental disorders does the patient have?
2. What psychic sphere is disturbed?
3. What symptoms does the patient have?
4. What is the syndromal diagnosis?
Clinical task 2
The patient is excited and restless, incessantly walks around the room, wrings her
hands, weeps and groans. There is an expression of fear on her face. Asks the people
around her to save her family, which is sure to be in great danger. Promises to give
the people much money for rescuing her relations. The personnel can't dissuade her:
the patient stays extremely anxious. Couldn't sleep for two nights, and hasn't eaten
any food for three days, saying, "How can I eat, when my dear ones are dying?"
Tried to commit suicide.
1. What signs of mental disorders does the patient have?
2. What psychic sphere is disturbed?
3. What symptoms does the patient have?
4. What is the syndromal diagnosis?
Clinical task 3
Patient A., female, 30 years old, at the psychiatric inpatient department lies all the
time in bed, without changing her posture. Manifests no reaction to the changes in the
environment, presence of other people, and sounds. Is absolutely devoid of activity.
Doesn't eat on her own, has to be fed from the spoon. When a doctor or some other
person speaks to her, the patient doesn't answer, but seems to listen and sometimes tears
appear in her eyes. Her facial expression is constantly sad. Her muscular tonus is
somewhat increased.
1. What signs of mental disorders does the patient have?
2. What psychic sphere is disturbed?
3. What symptoms does the patient have?
4. What is the syndromal diagnosis?
Clinical task 4
A male patient, 37 years old, became too cheerful for no particular reason, he has a
subjective feeling of high creative abilities, enthusiasm, elation and increased
productivity, in spite of manifest disability to concentrate (impaired attention); his
speed of thinking processes is too high. He is uncritical to his state, and finds it
normal.
1. What signs of mental disorders does the patient have?
2. What psychic sphere is disturbed?
3. What symptoms does the patient have?
4. What is the syndromal diagnosis?
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6.
List of recommended literature
Basic literature.
Concise Oxford Textbook of Psychiatry. M. Gelder, D. Gath, R.Mayou. –
Oxford; New York; Tokyo; Oxford University Press, 2007. – 953 p.
Modern Synopsis of Psychiatry. A.M. Freedman, H.I. Kaplan, B.J. Sadock. –
USA, 1982. – 433 p.
Psychiatric Dictionary / 5th ed. R.J. Campbell. – Oxford; New York; Oxford
University Press, – 1981. – 693 p.
Psychopatology and addictive Disorders / Ed. By Meyer. - New York; London,
1986. – 283 p.
Psychiatry: course of lecture /Ed.by V.S. Bitensky. – Odessa, 2005. – 336 p.
Zimbardo Ph.G. Psychology and Life. - USA, 19991. – 189 p.
Additional literature.
Brundtland G.H. Mental health in the 21st century // Bulletin of the World Helth
Organization. – 2000. - №87. – Р. 411.
2.
Desjarlais R., Eisenberg L., Good B. et al. World Mental Health: Problems
and Priorities in Low-Income Countries. – New York: Oxford University Press,
1.
3.
4.
5.
6.
7.
8.
9.
1995. – 144 p.
Marsella A., Kleinman A., Good B. Cross-cultural studies of depressive
disorders. An overview. Culture and depression. – Berkley: University of
California Press, 1985. – 213 p.
Mulrow C.D., Williams J.W. Jr., Trivedi M., et al. Treatment of depression:
newer pharmacotherapies. Rockville, MD: Agency for Health Care Policy and
Research, 1999. – 253 р.
Murray C.J.L., Lopez A.D. The global burden of disease: a comprehensive
assessment of mortality and disability from disease, injuries and risk factors in
1990 and projected to 2020. Cambridge, MA: Harvard University Press, 1996. –
68 p.
Kielholz P. Masked Depression. — Berne, 1973. – 97 p.
Lopez-Ibor J. J. The Present Status of Psychotropic Drugs / Ed. by A. Cerletti,
F. J. Bove. - New York, 1999. - 519 p
Preskorn, S.H. Outpatient management of depression: A guide for the Primarycare practitioner/ S.H. Preskorn. - Wichita; Kansas: Professional
Communications,Inc., 1994. - 147 p.
Ustun T.B., Sartorius N. Mental Illness in General Health Care. An
International Study. – Chichester: John Willey @ Sons Ltd, 1995. – 336 p.