Sign and Symptom of Mental Disorder

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 intuitiveابداعي حدسي understanding by
drawing of clinical skills
high understand of human behavior
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 elucidateيوضح a 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 persecutoryاضطهادي delusion 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 :-
it is formulated to explain the observed changes and then tested in further experience .
e g ( Rachman ) work on depression ,pavlop work on classical conditioning
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 antecedentلها الاسبقية , 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

Edietic imagery الصورة الحية :- visual imaging which is so tense , detailed that has photographic quality .
unlike perception , imagery can be called up or terminated .
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 الاشباح
misconception of external stimuli , they occur in
less clarity
high emotional
conscious deterioration as delirium
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 .
nation is experienced as originated in out side world ( or within ones own body ) . like percept and nation within mind like imagery .
hallucination is not restricted to the mentally ill . few normal people experience them especially when tried .
hypnagogic>>> hallucination also occur in healthy people during the transition between sleep and awake .
hypnopompic>>> hallucination occur while calling to sleep .
Pseudohallucinations
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 .
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
elementary
complex
2 – according to sensory modality
auditory
visual
olfactory
gustatory
somatic ( tactile )
3 – according to special features
A – auditory >> second person , third person , cchodehamps , Gedenkenlauteudea
B - visual
4 – autoscopic hallucination
Type of hallucination
hallucination can be described in the term of complexity is used such as bangsصوت فرقعة , whistleصفير , flashوميض .
complex hallucination :- experience such as hearing voice , music , seeing face , scene .
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 :-

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
delusion
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

include both the amounts and speed of thoughts
at one extreme there is pressure of thoughts , mean unusual abundance وفرة and pass the mind rapidly
at other extreme , poverty of speed when the patient have only few and seem to move slowly within mind
the experience of pressure and thoughts occur in mania
while poverty occur with depression
sudden interruption of thoughts occur in schizophrenia ( blank mind ) which important Dx .
other reason for sudden interruption
1 – momentary gap ( normal )
2 – anxious
3 – thoughts withdrawal
4 – schizophrenia ( Dx )