Phenomenology,
Phenomenology,
psychopathology in
psychopathology in
psychiatry
psychiatry
Dr Maha s Younis
Dr Maha s Younis
Assistant professor in psychiatry
Assistant professor in psychiatry
Signs and symptoms
Signs and symptoms
1
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abnormal emotions
2
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abnormal thinking
3
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abnormal movements
4
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abnormal speech
5
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abnormal consciousness
Consciousness ;state of awareness
-
full-alert ,vigil
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cloudy-incomplete clear –mindedness with disturbance in perception
and attitudes
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Twilight state ; disturbed consciousness with hallucinations
-
stupor ;lack of reaction to surroundings
-
loss –comma ,comma vigil (ready to be aroused
(
Disturbance of attention : attention is the amount of effort
Disturbance of attention : attention is the amount of effort
exerted in focusing on certain portions of an experience
exerted in focusing on certain portions of an experience
Concentration :,ability to sustain a focus on one activity
Concentration :,ability to sustain a focus on one activity
•
Distractibility ;inability to concentrate
•
Selective inattention : blocking out only things that
generate anxiety
Emotion
Emotion
It’s a complex feeling state with psychic ,somatic
It’s a complex feeling state with psychic ,somatic
,and behavioral components that is related to
,and behavioral components that is related to
affect and mood .
affect and mood .
Affect ; observed expression of emotion ,may be
Affect ; observed expression of emotion ,may be
inconsistent with patients description of emotion
inconsistent with patients description of emotion
mood : Is a pervasive and sustained emotion,
mood : Is a pervasive and sustained emotion,
subjectively experienced and reported by the
subjectively experienced and reported by the
patient and observed by others\,like depression
patient and observed by others\,like depression
,elation ,anger
,elation ,anger
.
.
Affect and mood
Affect and mood
•
Appropriate affect ; condition in which the emotional tone is in
harmony with the accompany idea ,thought, or speech (full affect
(.
•
-
In appropriate affect ;disharmony between the emotional feeling
tone and the idea ,thought ,or speech accompanying it
.
•
-
Blunted affect ; a disturbance in affect manifested by a sever
reduction in the intensity of tone
.
•
-
Restricted affect ;reduction in intensity of feeling tone less sever
than blunted affect but clearly reduced
•
-
flat affect ; absence or near absence of any signs of affective
expression ;voice monotonous ,face immobile
•
-
labile affect ;rapid and abrupt changes in emotional feeling tone
unrelated to external stimuli
Mood
Mood
•
Dysphoric mood : unpleasant
•
-
euthymic mood ;normal range of mood ,not depressed
not elevated mood
-
Expansive mood ;expression of ones feelings without
resraint,frequently with an overestimation of ones
significance or importance
-
Irritable mood ;easily annoyed and provoked to anger
-
mood swings ; rapid changes between high and low
-
Euphoria ; intense elation with feelings of grandeur
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depression; psychopathological feelings of sadness
-
Anhedonia; loss of interest in and withdrawal from all
regular and pleasurable activities often associated with
depression
Disorders of thinking
Disorders of thinking
•
Disorders of thinking process
;
•
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disturbance in the form of thought
•
-
loosing of association;
flow of thought in which ideas shift from one subject to
another in a completely unrelated way
•
-
Derailment ; gradual or sudden deviation in train of thought without blocking
•
-
flight of idea ;rapid ,continuous play in the words that produce shifting of ideas
apparently connected
•
-
Blocking ; abrupt interruption in train of thinking before a thought or idea is finished
•
-
Neologism; new word created by the patient, often by combining syllables of about
other words ,for idiosyncratic psychological reasons
•
-
word salad; incoherent mixture of word and phrases
•
-
Circumstantiality‘ ; indirect speech that is delayed in reaching the goal
•
-
•
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Tangentiality ; inability to have goal-directed
associations of thought
•
-
incoherence ; non understandable ,no logical
connection resulting in disorganization
•
-
perseveration ; persisting response to a prior
stimulus after a new stimulus has been
presented ,often associated with cognitive
disorders
•
-
•
-
•
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Echolalia ; pathologically repeating words and phrases
of one person by another
•
-
Disturbance of contents
•
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Poverty of thought ; little information from thoughts due
to vagueness ,obscure phrases
•
-
overvalued idea ; unreasonable ,sustained false or
sometimes logical belief ,emotionally charged. can be
shared by others of same group
•
-
Delusion ; fixed false belief ,based on incorrect
inference about external reality ,not consistent with
patient intelligent and cultural back ground ,that cant be
changed by argument or reasoning
Types of delusions
Types of delusions
•
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Bizarre delusion ;totally strange and odd
•
-
non bizarre ;apparently logical but its false in origin like
paranoid ,delusion of jealousy (systematized (well
formed
•
Another classification into
•
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primary ; arise suddenly without stimulation or previous
event
.
•
-
secondary ;like being secondary to drug abuse ,delusion
of guilt result from depression
,
Types of delusions
Types of delusions
•
According to its nature and form
•
1
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Nihilistic delusion ; thoughts of non existent or ending of body
,self ,others
•
-
delusion of grandiosity ;exaggerated conception of ones
importance ,power ,or identity
.
•
-
delusion of reference ; behavior of others refers to oneself ,non
significant object or stimulus will take a personal significance
•
-
delusion of guilt ; feelings of remorse self accusation for imagined
or small mistakes
•
-
delusion of control (passivity feelings( ; ones will ,thoughts or
feelings being controlled by external force
•
-
paranoid delusions; pathological feelings of persecution which take
many presentations
•
-
somatic delusion ; involve functioning of ones body
organs
.
•
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Thought insertion ; delusion that thoughts are being
implanted in ones mind by others or external force
•
-
thought withdrawal ; thoughts are being removed from
the brain
•
-
thought broadcasting ; ones thought can be heard by
others like broad casting in the air
•
-
delusion of love (erotomania( ; being loved by someone
who is usually difficult to be approached
•
-
delusion of infidelity ,delusional jealousy ;false thought
of spouse or partner unfaithfulness
•
-
Disorders of perception
Disorders of perception
•
Transferring physical stimulus into psychological
information
•
Hallucination; false sensory perception not associated
with real external stimuli
•
Types
;
•
Auditory hallucination
;
•
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Visual
•
-
olfactory
•
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gustatory
•
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Tactile
•
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somatic (inner perception
(
Types of hallucinations
Types of hallucinations
•
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Hypnagogic hallucination ; while falling asleep
•
-
Hypnopompic hallucination ; while awakening
•
Mood congruent ; in which the contents are consistent
with either depressed or elevated mood
•
-
mood in congruent ; in which the content is not
consistent with the mood
•
Pseudo hallucination – imaginary hallucination that’s
associated with emotional state and the patient is un
sure of its source usually of short duration
Disorders of motor movements
Disorders of motor movements
•
Echopraxia ; pathological imitations with another's
movement
•
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catatonia ; low or limited mobility constantly maintained
•
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Stereotypy; repetitive fixed pattern of physical action or
speech
•
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Mannerism ; habitual repetitive involuntary movements
that has significant meaning
•
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Negativism; resistance to all attempt to be moved by
instructions
•
Psychomotor agitation ; excessive motor overactivity
associated with inner tension