Psychiatric Symptoms & Signs
Behavioural Symptoms:
Motor Behaviours, Conation, Psychomotor Activity:
- Motor behaviour/activity expressing a person’s
impulses, drives, wishes, instincts, cravings &
motivation.
- Decreased (psychomotor retardation).
- Increased (psychomotor agitation).
Catatonia:
- Catatonic Rigidity
- Catatonic Posturing
- Waxy flexibility (catalepsy)
- Catatonic Stupor
- Akinesia
- Catatonic excitement
- Catatonic Mutism
Negatism: motiveless resistance against instruction,
questioning or to be moved.
Stereotyped Behaviour: repetitive fixed pattern of motor
behaviour.
Mannerisms & Tics:
- Habitual, ingrained, unconscious movements.
- Unconscious, spasmodic motor movements.
Echopraxia:
- Pathological imitation of another person’s
movement.
Ataxia:
- Muscle incoordination.
Tremor:
- Involuntary, rapid, rhythmical, alternating
movement.
Chorea:
- Involuntary, rapid, random, jerky, purposeless
movements.
Dyskinesia:
- Difficulty performing voluntary movements.
Dystonia:
- Sustained contractions of opposing muscle groups of
the trunk or limbs.
Akathisia:
- Subjective feeling of inner restlessness & muscle
tension secondary to antipsychotic medication,
presenting with pacing & other signs of
psychomotor agitation.
Speech:
Echolalia: Pathological imitation of another person’s speech.
Logorrhoea: increase in quantity of speech.
Poverty of Speech: decrease in quantity of speech.
Poverty of Speech content: adequate amount of speech, but lacks
information due to vagueness.
Pressure of Speech: rapid speech of increased quantity that is
difficult to interrupt.
Nonspontaneous Speech: speech only in response to questions.
Dysprosody: loss of normal melody/ prosody/ rhythm of speech.
Stuttering: frequent repetition/ prolongation of a sound/ syllable
leading to impaired speech fluency.
Dysarthria: problems with articulation (pronunciation, NOT
language).
Aphasia: difficulties with language output (language, NOT
pronunciation).
Mood & Affect:
Mood → pervasive & sustained emotion subjectively experienced.
➢ Dysphoric/ Melancholic – Unpleasant, low mood.
➢ Euthymic mood – normal range of mood.
➢ Ecstatic/ Elevated/ Euphoric/ Elated – abnormally increased
‘high’ mood state.
➢ Depressed – psycho-pathologically sad, dysphoric,
melancholic mood state.
➢ Mania – mood characterised by elation, hyperactivity,
hypersexuality, as well as pressured speech & thought.
➢ Irritable – easily angered.
➢ Labile – oscillations between depression & elation.
➢ Alexithymic – inability to be aware of/describe ones
emotions.
➢ Anhedonic – loss of interest in all pleasurable activities.
Affect is the objectively observed expression of emotion:
- Restricted: severe reduction observable expression of
emotion.
- Blunted: even greater reduction in observable expression of
emotion.
- Flat: absence/near absence of observable expression of
emotion.
- Appropriate: observable expression of emotion is in harmony
with the mood described.
- Inappropriate: observable expression of emotion isn’t in
harmony with the mood described.
Anxiety & Related
Symptoms:
Anxiety: feeling of
apprehension caused by
anticipation of danger.
Fear: anxiety caused by a
real/ realistic danger.
Phobia: Persistent, irrational
exaggerated, pathological
dread of a specific
stimulus/situation.
Panic Attack: acute,
episodic, intense attack of
anxiety with autonomic
symptoms associated with
overwhelming feelings of
dread.
Obsession: pathological
persistence of an irresistible
thought or feeling that can’t
be eliminated from
consciousness by logical
effort (associated with
anxiety).
Compulsion: pathological
need to act on an impulse/
obsession that, if resisted,
produces anxiety.
Psychosis:
The Inability to distinguish
reality from fantasy.
3 Groups of Psychotic
Symptoms:
➢ Disordered thought
form (how we think) →
manifests as
disorganized speech.
➢ Disordered though
content (what we think
of) → delusions.
➢ Disordered perception:
hallucinations,
illusions.
Normal Thought Form:
Circumstantiality:
Tangentiality:
Derailment:
Loosening of Associations:
Inappropriate/ Irrelevant
Answer:
Thought Blocking:
Flight of Ideas:
Thought Form Disorders:
Overinclusiveness: speech containing unnecessarily excessive detail.
Perseveration: persisting response to a previous stimulus, even following a
new stimulus.
Verbigeration: meaningless repetition of specific words or phrases.
Word salad: incoherent mixture of words/ phrases.
Neologisms: made up words that don’t form part of any language.
Echolalia: pathological repeating of words/ phrases of one person be
another.
Delusions:
Fixed, false beliefs, based on incorrect inferences about external reality that
cannot be corrected by reasoning.
Types:
Delusions of Persecution: belief of being harassed, cheated or persecuted.
Delusion of Grandeur: belief of exaggerated importance, power or identity.
Delusion of Reference: belief of behaviour of others refers to him/herself.
Delusion of Poverty: belief of being bereft of all material possessions.
Nihilistic Delusion: Belief that one’s self, others or the world is non-existent
or is coming to an end.
Somatic Delusion: belief surrounding a part of the body.
Delusion of Control: belief of one’s will, thoughts or feelings are being
controlled by external forces.
Bizarre Delusion: absurd, totally implausible, strange belief.
Perceptual Disturbances:
Hallucination: false sensory perception not associated with real
external stimuli.
Types according to senses:
- Auditory hallucination: perception of sound, usually voices.
- Visual hallucination: perception of seeing images.
- Olfactory hallucination: perception of smell.
- Gustatory hallucination: perception of taste.
- Tactile hallucination: perception of touch.
Other Hallucinations:
- Cenesthetic Hallucination: perception of sensation in an organ
unable to experience sensation.
- Hypnagogic Hallucination: non-pathological perception
occurring while falling asleep.
- Hypnopompic Hallucination: non-pathological perception
occurring while awake from sleep.
Illusion: Misperception/ misinterpretation of real external sensory
stimuli.