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Symptomatology
Chapter four
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Symptomatology
Symptom What the patient narrates in related to illness
Objective refers to features of observe during an interview.
N.B. The term is usually use when the psychiatrist wants to compare with the patient describing the symptoms.
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Perception = Sensation + Meaningful
Perception is the process of becoming aware of what is presented through the sense organs.
Imagery is the awareness of a percept that has been generated within the mind
Example-
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Abnormalities of Perception
1) Illusion : illusion is misperception of external stimuli. It happens in an organic syndrome eg.
Example : roap > snake
2 ) Hallucination
- A hallucination is a percept that is experienced in the absence of an external stimulus to the corresponding sense organ. It differs from an illusion in being experienced as originating in the outside world or from within the person’s body.
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Types of Hallucination according to sensory modalities
Auditory Hallucination e.g ----------
Visual Hallucination e.g ----------
Olfactory Hallucination e.g ----------
Gustatory Hallucination e.g ----------
Somatic/Tactile Hallucination e.g
----------
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Diagnostic Associations
Severe depressive
disorder
Severe manic disorder
SchizophreniaOrganic disorders
Dissociate states
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Thinking
- Is very vital and extensive mental/psychological process
- It covers two kinds of phenomenon:
- 1) Disturbance of thoughts
- 2) Disturbance of thinking process
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1) Disturbance of thoughts
Delusion – False believe, Unshakeable and Not Shared by the Community
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2 )Disturbance of thinking process
Pressure of thought Poverty of thought Thought block Perseveration Flight of ideas Loosening association – This denotes a loss of the normal
structure of thinking.
A) In Talking Past the Point (the patient seems always about to get to the end of the topic)
B) Knight’s Move or Derailment (refers to a transition from one topic to another with no logical relationship)
C) Verbigeration (is said to be present when speech is reduced to the senseless repetition of sounds, words or phrases)
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Types of Delusion According to Theme
1) Delusion of Persecutory – Belief is being harassed and cheated
2) Delusion of Reference – Behavior of other refer to the patient
3) Delusion of Grandiose – Exaggerated conception of ones importance
4) Delusion of Guilt & Worthlessness – Blaming self without any reason of past
5) Delusion of Nihilistic – Non existing or ending
6) Delusion of Jealous – Belief unfaithful
7) Delusion of Amorous – Belief she is loved by higher class
8) Delusion of Control – Thought/ feeling controlled by others
9) Delusion of Thought Broadcasting – Unspoken thought are known to others
10) Delusion of Withdrawal & Insertion – Certain thought implanted by outside agency or withdrawn by other agency
11) Shared Delusion
12) Delusion of Religion -
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Diagnostic Association
Schizophrenia
Delusional Disorders
Severe Depressive Disorders
Rarely in Manic
Syndrome
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Obsession
Obsessions are recurrent persistent thoughts, impulses or images that enter into the mind despite the person efforts to exclude them.
Diagnostic Association
- Obsessive Compulsive Disorder (OCD)
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Phobia
Phobia is a persistent irrational fear of and with to avoid the specific object, activity or situation
Diagnostic Association - Phobia Anxiety Disorder
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Motor Symptoms and Sign
Tics are irregular repeated movements involving a group of
muscles
Mannerisms are repeated movements that appear to have
some functional significance
Stereotypies are repeated movements that are regular and
without obvious significance
Catatonia is a state of increased muscle tone that affects extension
and flexion
Catelepsy is detected when a patient’s limbs can be placed in a position in which they remain for
long periods while at the same time muscle tone is uniformly increased
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Motor Symptoms and Sign (Cont…)
Posturing is the adaption of unusual bodily posture continuously for a long
time. The posture may have a symbolic meaning.
Grimacing denotes pouting of the lips to bring them closer to the nose.
Negativism patients are said to show negativism when the do the opposite of
what is asked.
Echopraxia occurs when the patient imitates the interviewer’s movement
automatically
Migehen the patient’s limbs can be moved into any position with the slightest
pressure
Ambitendence the patients are said to exhibit ambitendence when they alternate
between the arm to shake hands then withdrawing it, extending it again, -
repeatedly
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Disorders of Emotion
Emotion is a complex inner feeling with psychic somatic and behavior components that related to affect and mood.
- Affect : Transit emotion is called affect - Mood : A pervasive and sustained
emotion subjectly experienced and reported by patient
- Normal Mood : Euthymic mood
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Abnormal Mood
Dysphonic Mood
Expansive
Irritable Mood
Elevated Mood
Euphoric Mood
Depression Mood
Labile Mood
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disturbance of Memory
Amnesia Failure of memory
Paramnesia Distortion of memory
Definition of Memory:
Memory is a function by which information stored In the brain and recall to consciousness
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Stages of memory
Immediate Memory : concern the retention of information over a period in minuteExample -
Recent Memory : concern events that have taken place in the last few daysExample –
Long term Memory : concerns events that have occurred over longer period of time
Example -
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Disturbance of Recognition
Jamais vu: is the failure to recognize events that have encounter before.
Déjà vu : is the conviction that an event is repeating one that has not been experienced in the past when in fact it is novel.
Confabulation : is the confident recounting of quite false
memory for the recent events [amnesia]
Psychogenic Amnesia: is thought to result from an active process of repression which prevent the recall of memories that would otherwise evoke unpleasant emotions
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Attention & Concentration
Definition : is the ability to focus on the matter in hand
Assessment : sever serial test Insight : Defined as awareness of one’s own mental condition
-Defense mechanism : unconscious intrapsychic processes that provide relief from emotional conflicts and anxiety.
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Thank You
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