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.
Out line:
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.
1-disorder of thought
stream
formal
1-tangentiality
content
2-circumstantially
3-loseness of association
1-Concrete
thinking
4-flight of idea
1-delusion.
5-clang association
6-incoherence or word salad
2-autistic
thinking
7-pressur of speck
2-obsession
8-poverty of speech
9-Retardation
10-Blocking
3-peroccuption.
11-preservation
12-pallilalia
13-Echolalia
14-Irrelevant answer
15-Neologisms
4-suicidal ideation.
A-formal thought disorder:
clinical manifestation:
1-Concrete thinking: when the patient use literal
thinking with out understanding the implicit
meaning behind sentence &it is verse abstract
... ‫تصدقين‬
‫صرت عالحديدة‬
‫عالحديدة؟؟؟‬
‫وين الحديدة‬
‫ما اشوفها‬
2-autistic thinking: thinking that gratifies
unfulfilled desire but has no regard for
reality, egocentric (self -centred) fantasy.
B-disorder of stream of thinking:
• 1-tangentiality:
• Occur when The speaker goes off the topic
and dos not return to the it.
‫رحت يوم االحد الصبح عند ابو عبد هللا في‬
‫المكتب‬
...........................
‫و‬
‫تعشيت اليوم في مطعم ال يفوتك‬
‫‪• 2-circumstantially:‬‬
‫‪• Before getting the point or answering the‬‬
‫‪question the patient gets caught up in‬‬
‫‪countless details and explanation.‬‬
‫متى بدا االلم‬
‫؟؟؟؟‬
‫يوم السبت قمت من النوم وغسلت‬
‫وجهي وافطرت جبنه ومربى توت‬
‫وحليب قليل الدسم ولبست جينز‬
‫ازرق وتي شيرت احمر وركبت‬
‫السيارة لكن البنزين كان مخلص‬
‫ورحت ‪ .....‬و‪.....‬و‪.....‬ويوم‬
‫االثنين بعد الغدى وجعني بطني‬
• 3-loseness of association:
• Thinking haphazard , illogical and confused,
connection of thought is interrupted appear
mostly in schizophrenic disorder.
‫اكيد هذي‬
‫عطشانة عشان‬
‫كذا قاعدة في‬
‫الموية‬
• 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.
‫الجو بديع والدنيا ربيع‬
‫قفل على كل المواضيع‬
5-clang association: meaningless rhyming of word
‫رحت البحر وشفت‬
‫القمر في ليلة سمر‬
• 6-incoherence or word salad: mixture of
word and phrases that have no meaning.
‫نمت العشى داخل الباب‬
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
‫واخويواختيخالتيوخالي‬
‫وولدخالتي‬
• 8-poverty of speech: the speech is brief
and uncommunicate.
!‫راحت‬
!
‫من خابطك‬
‫فراسك؟؟‬
9-Retardation: refer to slow speech and prolonged
latent period before response.
....................
....................
....................
‫راسي مصدع‬.....
‫وش فيك‬
‫عسى ما‬
‫شر؟؟‬
10-Blocking:
Sudden cessation of thought in the middle of
sentence & person is unable to continue bis
train of thought.
‫رحت اليوم السوق‬
‫وشفت فستان لونه‬
11-preservation : psychopathological repetition of
the same word or idea in response to the different
question
.‫ايه‬
‫ايه‬
‫بتروح معاي ؟‬
‫بتجلس؟؟‬
‫‪12-pallilalia:‬‬
‫‪pathological repetition of the last word said.‬‬
‫كنت اليوم عند خالتي‬
‫وبناتها يسلمون‬
‫عليك‪.‬‬
‫يسلمون عليك‬
‫يسلمون عليك‬
‫يسلمون عليك‬
‫‪13-Echolalia: repeating the speech of‬‬
‫‪another person.‬‬
‫بركب الخيل‬
‫بركب الخيل‬
‫بركب الخيل‬
‫بركب الخيل‬
14-Irrelevant answer:
answer hat is not in harmony with question
asked.
‫الكتاب عند‬
‫امل‬
‫اش تشربي؟‬
15-Neologisms:
word a person Mack up that only. have meaning for
the person.
‫هاكون متاتا‬
C-disorder of content of thought:
It is include:
1-delusion.
3-peroccuption.
ideation.
2-obsession.
4-suicidal
1-Delusion
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-paranod delusion:
it is an intense and strongly
defended irrational suspicious
belief.
It include:
A-Delusion of grandeur: false
belief that one is a very powerful
and important person.
B-Delusion of persecution: false
belief that one is chased by
other.
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) .
‫شفت برج المملكة‬
‫انا اللي بنيته‬
D-Erotic delusion: false belief that
there is a love story between one
self and famous person.
E-delusion of jealousy:
conviction that the spouse has some
definite relation with someone
else.
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:
patient write complaint and sends
them to responsible person.
2-delusion of influence (delusion
of control)
false belief that one is being
controlled by other or
agencies.
‫اصال انا اسوي كذا‬
‫الن فيه جهاز في‬
‫امريكا يتحكم‬
‫بتصرفاتي‬
3-deprssive delusion:
A-delusion of self-blame, guilt
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: false
belief that he lost everything in
life.
C-Nihilistic delusion: false
belief that a part of this body
doesn't exist or he doesn't
exist(dead)
‫اصال انا‬
‫وجودي غلط‬
‫انا عاله على‬
‫المجتمع‬
‫وامريكا دخلت‬
‫العراق بسببي‬
.
‫وين يدي انا ما‬
‫عندي يد‬
4-hypochondriacal delusion:
Patient has false belief that he has
physical disease e.g. cancer
stomach that is not based on real
organic pathology.
‫!!!انا مريض‬
‫وعندي فشل‬
!!!‫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.
3-preoccupation:
Centring of thought content around
a particular idea associated with
strong affective tone.
4-suicidal 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
Gustatory:
experiencing
taste in the
absence of
stimuli.
Tactile: feeling
touch
sensation in the
absent 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.
4-disorder of memory:
1-amnesia: is loss of memory and may be partial or complete.
3-Total amnesia:
1-Anterograde
amnesia:
type of amnesia:
2-Retrograde
amnesia :
4-Circumscribed
amnesia:
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 object
...‫أحبـــــــــــــك‬
..‫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.
1-euphoria:
it is a heightened feeling
of psychological well
being inappropriate to
apparent event.
Epleasurable
affect:
2-elation:
it is feeling of happiness
with air
of confidence and
enjoyment
associative with increase
motor activity.
F-anxiety,
apprehensio
n ,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.
1-free floating anxiety:
it is sever, generalized
and pervasive. Fear not
attached to any idea.
2-tension:
unpleasant feeling
associated with
physical
and psychological
tightness.
3-panic:
Type of anxiety:
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:
1-Agitition:
it's some from of
hyperactivity
characterized by pacing
and accompanied with
restlessness
it include:
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.
2-mannerism:
it is a repeated movement,
which isn't monotonous and
keeping with the personality
character.
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).
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