PSYCHIATRIC SYMPTOMS & SIGNS
DR GIAN LIPPI
CONSULTANT PSYCHIATRIST
UNIVERSITY OF PRETORIA & WESKOPPIES HOSPITAL
FORENSIC UNIT
CONTENTS
BEHAVIOURAL SYMPTOMS
ABNORMALITIES OF SPEECH
MOOD & AFFECT
ANXIETY & RELATED SYMPTOMS
PSYCHOSIS, & DISORDERED THOUGHT & PERCEPTION
- THOUGHT FORM DISORDER WITH ITS DIFFERENT TYPES
- DISORDERED THOUGHT CONTENT, INCLUDING DELUSIONS
- PERCEPTUAL ABNORMALITIES, INCLUDING HALLUCINATIONS
BEHAVIOURAL SYMPTOMS
MOTOR BEHAVIOUR, CONATION, PSYCHOMOTOR ACTIVITY
- MOTOR BEHAVIOUR / ACTIVITY EXPRESSING A PERSON’S IMPULSES, DRIVES, WISHES,
INSTINCTS, CRAVINGS & MOTIVATIONS
- DECREASED (PSYCHOMOTOR RETARDATION)
- INCREASED (PSYCHOMOTOR AGITATION)
CATATONIA
- CATATONIC RIGIDITY
- CATATONIC POSTURING
- WAXY FLEXIBILITY (CATALEPSY)
- CATATONIC STUPOR
- AKINESIA
- CATATONIC EXCITEMENT
NEGATIVISM
- MOTIVELESS RESISTANCE AGAINST INSTRUCTION, QUESTIONING OR TO BE MOVED
STEREOTYPED BEHAVIOUR
- REPETITIVE FIXED PATTERN OF MOTOR BEHAVIOUR
MANNERISMS & TICS
- INGRAINED, HABITUAL, UNCONSCIOUS MOVEMENTS
- UNCONSCIOUS, SPASMODIC MOTOR MOVEMENTS
BEHAVIOURAL SYMPTOMS
ECHOPRAXIA
- PATHOLOGICAL IMITATION OF ANOTHER PERSON’S MOVEMENT
ATAXIA
- MUSCLE INCOORDINATION
TREMOR
- INVOLUNTARY, RAPID, RHYTHMICAL, ALTERNATING MOVEMENT
CHOREA
- INVOLUNTARY, RAPID, RANDOM, JERKY, PURPOSELESS MOVEMENT
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
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 REPITITION / PROLONGATION OF A SOUND / SYLLABLE LEADING TO
IMPAIRED SPEECH FLUENCY
DYSARTHRIA
- PROBLEMS WITH ARTICULATION (PRONOUNCIATION, NOT LANGUAGE)
APHASIA
- DIFFICULTIES WITH LANGUAGE OUTPUT
(LANGUAGE, NOT PRONOUNCIATION)
MOOD & AFFECT
MOOD IS A PERVASIVE AND 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 (PSYCHOPATHOLOGICALLY SAD / DYSPHORIC / MELANCHOLIC MOOD STATE)
- MANIA (MOOD CHARACTERIZED 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 ONE’S OWN 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 IRRESISTABLE 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
PSYCHOSIS IS THE INABILITY TO DISTINGUISH REALITY FROM
FANTACY
3 GROUPS OF PSYCHOTIC SYMPTOMS
DISORDERED THOUGHT FORM (HOW WE THINK)
- MANEFESTS AS DISORGANIZED SPEECH
DISORDERED THOUGHT CONTENT (WHAT WE THINK OF)
- DELUSIONS
DISORDERED PERCEPTION
- HALLUCINATIONS
- ILLUSIONS
THOUGHT FORM DISORDER
NORMAL THOUGHT FORM
THOUGHT FORM DISORDER
CIRCUMSTANTIALITY
THOUGHT FORM DISORDER
TANGENTIALITY
THOUGHT FORM DISORDER
DERAILMENT
THOUGHT FORM DISORDER
LOOSENING OF ASSOCIATIONS
THOUGHT FORM DISORDER
INAPPROPRIATE / IRRELEVANT ANSWER
THOUGHT FORM DISORDER
THOUGHT BLOCKING
THOUGHT FORM DISORDER
FLIGHT OF IDEAS
THOUGHT FORM DISORDER
OVERINCLUSIVENESS
- SPEECH CONTAINING UNNECESSARILY EXCESSIVE DETAIL
PERSEVERATION
- PERSISTING RESPONSE TO A PREVIOUS STIMULUS, EVEN FOLLOWING A NEW STIMULUS
VERBIGERATION
- MEANINGLESS REPITITION 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 BY
ANOTHER
DELUSIONS
DELUSION
- FIXED FALSE BELIEFS, BASED ON INCORRECT INFERENCES ABOUT EXTERNAL REALITY,
& THAT CANNOT BE CORRECTED BY REASONING
DIFFERENT TYPES
DELUSION OF PERSECUTION
- BELIEF OF BEING HARRASSED, CHEATED OR PERSECUTED
DELUSION OF GRANDEUR
- BELIEF OF EXAGERRATED IMPORTANCE, POWER OR IDENTITY
DELUSION OF REFERENCE
- BELIEF OF BEHAVIOUR OF OTHERS REFERS TO HIMSELF / HERSELF
DELUSION OF POVERTY
- BELIEF OF BEING BEREFT OF ALL MATERIAL POSSESSIONS
NIHILISTIC DELUSION
- BELIEF THAT ONE’S SELF, OTHERS OR THE WORLD IS NONEXISTENT 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 IMPLAUSABLE, STRANGE BELIEF
PERCEPTUAL DISTURBANCES
HALLUCINATION
- FALSE SENSORY PERCEPTION NOT ASSOCIATED WITH REAL EXTERNAL STIMULI
TYPES CATAGORIZED ACCORDING TO SENSES INVOLVED:
- 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 (NONPATHOLOGICAL PERCEPTION OCCURRING
WHILE FALLING ASLEEP)
- HYPNOPOMPIC HALLUCINATION (NONPATHOLOGICAL PERCEPTION OCCURRING
WHILE AWAKENING FROM SLEEP)
ILLUSION
- MISPERCEPTION / MISINTERPRETATION OF REAL EXTERNAL SENSORY
STIMULI
THE END