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SIGNS AND SYMPTOMS OF MENTAL DISORDERS
psychiatry can be practiced only if psychiatrist developed two capacities
1- capacity of data collection objectively and accurately through MSE , history
taking in balance way .
2 – capacity for intuitive ابداعي حدسيunderstanding by
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drawing of clinical skills
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high understand of human behavior
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to gain insight of each individual
both capacities can be developed by accumulating experience of talk with
patient
PSYCHOPATHOLOGY
the study of abnormal state of mind known as psychopathology . the term
donate three approaches
1 - phenomenological psychopathology ( phenomenology ) :-
it concerned with objective description of abnormal state in mind it avoid
preconceived theories . it aim to elucidate يوضحa basic data in psychiatry by
defining the essential quality of morbid experience at conscious level and
observable behavior .
2 – psychodynamic psychopathology
originate in psychoanalytically investigation . it goes beyond description and
seek to explain the cause of mental disorder at unconscious level for e g
persecutory اضطهاديdelusion in first school , it refer how it differ from normal
belief .
while psychoanalytic school explain its unconscious mechanic in term of
repression , projection .
3- experimental psychopathology :-
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it is formulated to explain the observed changes and then tested in further
experience .
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e g ( Rachman ) work on depression ,pavlop work on classical conditioning
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this usage include studies of animal as well as of human being .
THE SIGNIFICANCE OF INDIVIDUAL SYMPTOMS important
symptoms are more likely to be indicative of mental disorder :-
1 – when they are intense persistent
2 – accumulate with other symptoms like hallucination and delusion (
Grouped in syndrome )
3 – time of symptoms :- low mood continuous all the day mean depression
4 – PRIMARY AND SECONDARY SYMPTOMS
primary mean antecedent لها االسبقية, first temporal , it is direction express of the
pathological process e g human delusion .
secondary :- subsequent , causal , it react with primary symptoms e . g . primary
delusion .
THE FORM AND CONTENT SYMPTOMS
we should distinguish between form and content , best example if patient say
that he hear voice called him as homosexual . the former experience el
auditory halucination .
homosexual :- is content
5 – DISORDER OF PERCEPTION
perception and imagery
perception :- is the process of becoming aware of what is presented through
the sense organ ( 5 modulation )
imagery : is an experience within mind usually without sense of reality
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Edietic imagery الصورة الحية:- visual imaging which is so tense , detailed that
has photographic quality .
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unlike perception , imagery can be called up or terminated .
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pareidelia : state which real and unreal perception exist side by side , with
later being recognize as unreal it can occur in TLE , organic disorders , fever
, people can induce it delibnately
ALTERATION IN PERCEPTION
alteration in intensity , quality . there is individual variation e g like a various
person hear noise voice of door shutting than normal person.
e g depress patient may see colour less intense
e g schizophrenia >>> disturbed color
>>> taste as bitter
>>> burning smell
ILLUSION االشباح
misconception of external stimuli , they occur in
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less clarity
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high emotional
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conscious deterioration as delirium
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affective illusion :- it occur where attention is not focus on sensory modality
or when there is strong affective state .
CAPGRAS SYNDROME
:- illusion of double ( it is being delusion under
paranoid schizophrenia
HALLUCINATION :- it is a percept experienced in the absence of an
external stimuli to the sense organ and with stimuli quality to a true percept .
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nation is experienced as originated in out side world ( or within ones own body
) . like percept and nation within mind like imagery .
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hallucination is not restricted to the mentally ill . few normal people experience
them especially when tried .
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hypnagogic>>> hallucination also occur in healthy people during the transition
between sleep and awake .
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hypnopompic>>> hallucination occur while calling to sleep .
Pseudohallucinations
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this term has been to abnormal phenomenon that don’t meet the above
criteria for hallucination and are of less diagnostic significance .
1 - adapted by Jasper ( 1913 ) in the book that pseudohallucination are especially
kind of mental image i.e. lack quality of external reality and seem within mind
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2 – the second meaning of pseudohallucination is experience of perceiving
something as in external ward , while recognized that there is no ( external
correlate ) to experience .
description of hallucination
1 – according to complexity
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elementary
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complex
2 – according to sensory modality
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auditory
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visual
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olfactory
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gustatory
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somatic ( tactile )
3 – according to special features
A – auditory >> second person , third person , cchodehamps , Gedenkenlauteudea
B - visual
4 – autoscopic hallucination
Type of hallucination
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hallucination can be described in the term of complexity is used such as
bangs صوت فرقعة, whistleريفص , flashضيمو .
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complex hallucination :- experience such as hearing voice , music , seeing face
, scene .
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hallucination >>> may be auditory , visual , gustatory , olfactory , tactile or
deep sensation .
Tactile ( haptic )hallucination
may be experience as sensation being touched or pulled strangulated , picked
small creature by brewing the tissue .
Deep hallucination
may occur as feeling and vesera as being pulled .
Autoscopic hallucination
is the experience of seeing ones own body projected on to external space ,
usually for short period .
Doppet ganger :-
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experience may convince يقنعthe person had douple , theme occur in several
novel ( dystevesr ) . the douple or seen TLE
Reflex hallucination
stimulation on one sensory modality result in another modality stimulation .
PERCEPTION AND MEANING
perception has meaning to the person with experience and it is in some
pshychiatric disorder , an abnormal meaning may associated with normal
perception
delusional perception
in some neurological disorders and schizophrenia, perception lose their meaning ,
this called agnosia .
DISORDERS OF THINKING
1 – particular kind of abnormal thought
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delusion
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obsession
2 – disorders of stream of thought ( speed and rate )
3 – disorders of form of thought
4 – abnormal belief about the possession of thought .
Disorders of thinking
it is usually recognized from speech and writing , they inferred for the inability to
perform task … it is a wide group include
1 – delusion and obsession
2 – group disorder of stream
3 - formal thoughts disorder
4 – abnormal belief of thoughts possession
DISORDERS OF STREAM OF THOUGHTS
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include both the amounts and speed of thoughts
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at one extreme there is pressure of thoughts , mean unusual abundance وفرةand pass the
mind rapidly
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at other extreme , poverty of speed when the patient have only few and seem to move
slowly within mind
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the experience of pressure and thoughts occur in mania
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while poverty occur with depression
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sudden interruption of thoughts occur in schizophrenia ( blank mind ) which important Dx
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other reason for sudden interruption
1 – momentary gap ( normal )
2 – anxious
3 – thoughts withdrawal
4 – schizophrenia ( Dx )