Psychiatric Disorders: General Symptomatology

• Psychiatric disorders' general symptomatology will be reviewed.
• The outlines include the difference between signs and symptoms, composition of the mind, and disturbances relating to each mind's composition.

Signs vs. Symptoms

• Signs are objective findings observed by a clinician.
• Symptoms are subjective evidence described by the patient.
• In psychiatry, symptoms are an evident reaction of disease, including subjective and objective data.

Composition of the Mind

• The mind is composed of three interrelated spheres that represent aspects of mental function, which include:
  • Intellect
  • Affect
  • Behavior

Intellect

• The intellect consists of the:
  • Process of thought
  • Perception
  • Orientation
  • Memory
  • Consciousness
  • Attention and concentration
  • Judgement
  • Insight
  • Knowledge
  • Intelligence

Affect

• Affect denotes the emotional state or condition.
• Affect is the inner feeling or experience of the individual.

Behavior

• Behavior denotes the conduct of the individual.

Disorders of the Intellect

• Processes of thought can be classified as thought disorders.
• Thought disorders include:
  • Formal thought disorders,
  • Disorders of stream of thinking,
  • Disorders of content of thought.

Formal Thought Disorder

• Formal thought disorders include:
  • Concrete thinking
  • Autistic thinking
  • Looseness of association
  • Incoherence
  • Word salad
  • Clang association
  • Neologisms

Concrete Thinking

• Concrete thinking is when the patient uses literal thinking without understanding the implicit meaning behind a sentence.
• Concreteness is the opposite of abstractness.
• People who live in glass houses should not throw stones is an example of a proverb to test the ability to abstract.
• A concrete answer would be: if you threw stone on the houses, you can break a window and shutter the glass.
• An abstract would be: do not criticize people for faults you may have on yourself.

Autistic Thinking

• Autistic thinking gratifies unfulfilled desire but disregards reality.
• Autistic thinking is an egocentric (self-centered) fantasy.

Looseness of Association

• Looseness of association includes thinking that is haphazard, illogical, and confused; the connection of thought is interrupted.
• Looseness of association appears mostly in schizophrenic disorder.
• Example: When the wind comes, the shoe laces were un-tight.

Incoherence

• Incoherence is a mixture of phrases without meaning.

Word Salad

• A word salad is a mixture of words that have no meaning.
• Example: Birds...fishes...stars...

Clang Association

• Clang association is the meaningless rhythm of words.
• Example: On the track...have a big Mac...or get the sack.

Neologism

• Neologism occurs when a person creates or invents new words.
• These new words only have meaning to the person who creates them.

Disorders of Stream of Thinking

• Disorders of stream of thinking include:
  • Tangentiality
  • Circumstantially
  • Flight of idea
  • Pressure of speck
  • Poverty of speech
  • Retardation
  • Blocking
  • Preservation
  • Pallilalia
  • Echolalia
  • Irrelevant answer

Tangentiality

• Tangentiality occurs when the client goes off-topic and does not return to it, failing to reach the goal.

Circumstantially

• Circumstantially is when the patient gives countless details and explanations before getting to the point or answering the question.

Flight of Idea

• Flight of idea is rapid jumping from one idea to another.
• The connection between ideas occurs through stimuli from the last idea or external stimuli.
• For example: Tell me how's it going...going to my sister to get some money...money, honey...bees give honey...honey is sweat.

Pressure of Speech

• Pressure of speech occurs as forceful, rapid speech that increases in amount and is difficult to interrupt but remains coherent and logical.

Poverty of Speech

• Poverty of speech is the restriction in the amount of speech ranging from brief to one-word answers.

Retardation

• Retardation refers to slow speech and prolonged latent period before speech.

Blocking

• Blocking is the sudden cessation of thought in the middle of a sentence.
• Blocking causes the person cannot to continue the train of thought.

Preservation

• Preservation is a psychopathological repetition of the same word or idea in response to different questions.

Irrelevant Answer

• The irrelevant answer is an answer not in harmony with the question asked.
• For example:
  • Nurse: Tell me your name.
  • Client: My mother is alive.

Pallilalia

• Pallilalia is the psychopathological repetition of the last word said by the person.
• For example: My name is Ahmed, Ahmed, Ahmed, Ahmed.

Echolalia

• Echolalia is the psychopathological repetition of speech of another person.
• For example:
  • Nurse: Tell me your name.
  • Client: Tell me your name.

Disorders of Content of Thought

• Disorders of content of thought include:
  • Delusion
  • Obsession
  • Preoccupation
  • Suicidal ideation

Delusion

• A delusion is a false, fixed belief that does not align with the patient's educational and cultural background and cannot be corrected by logic or reason.

Types of Delusions

• Delusions are classified according to the theme:
  • Paranoid delusion.
  • Delusion of influence.
  • Depressive delusion.
  • Hypochondriacal delusion

Paranoid Delusion

• A paranoid delusion is an intense and strongly defended irrational suspicious belief.

Examples of Paranoid Delusions

• Examples of paranoid delusions include:
  • Delusion of grandeur, which is a false fixed belief that one is a very powerful and important person.
  • Delusion of persecution, which is a false fixed belief that one is attacked, chased, or persecuted by others.
  • Delusion of reference, which is a false fixed belief that the behavior of others refers to oneself.
  • Erotic delusion, which is a false fixed belief that there is a love story between oneself and a famous person.
  • Delusion of jealousy, which is a conviction that the spouse has some definite relation with someone else.
  • Delusion of infidelity, which is a false belief derived from pathological jealousy that one's lover is unfaithful.
  • Litigious delusion, in which the patient writes complaints and sends them to a responsible person.