L2: Psychiatric Symptoms & Signs Flashcards
(124 cards)
1
Q
Definition of perception
A
- The process by which sensory stimuli are given a meaning (i.e. transferring physical stimulation into psychological information).
2
Q
Disorders of perception
A
- Illusions
- Hallucinations
- Depersonalization & Derealisation
3
Q
Characters of Illusions
A
- May affect any sensory modality (auditory, visual, …).
- May occur in normal or pathological condition (e.g delirium).
3
Q
Def of Illusions
A
- Misinterpretation of a real external sensory stimuli e.g.: mistaking a robe for a snake and mirage phenomenon.
4
Q
Def of Hallucinations
A
False perception in absence of any external stimuli.
5
Q
classification of hallucinations, according to complexity
A
Elementary:
- Hallucination are ill formed stimuli e.g. noises, flashes of light
Complex:
- Hallucination are more sophisticated and relatively meaningful stimuli e.g. voices, music, faces, scenes
5
Q
what are Hallucinations classified according to?
A
- complexity
- Sensory modality
6
Q
what is the most common type of hallucinations?
A
Auditory hallucination
6
Q
Classification of hallucinations, according to sensory modality
A
- Auditory Hallucinations
- Visual hallucinations
- Tactile hallucinations
- Olfactory and Gustatory hallucinations
- Somatic hallucinations
7
Q
where do Auditory hallucination mainly occur?
A
- They mainly occur in psychotic disorders especially schizophrenia.
8
Q
Varieties of Auditory hallucination
A
9
Q
where is visual hallucination most common?
A
- Most common in organic mental disorders (e.g delirium, substance intoxication or withdrawal).
- May occur in schizophrenia, severe mood disorder or dissociative disorder.
10
Q
what are Tactile hallucination?
A
- False perception of touch e.g phantom limb (from amputated limb)
- Crawling sensation on or under the skin in cocaine intoxication or withdrawal.
11
Q
where is Olfactory (smell) or gustatory (taste) hallucination most common?
A
- Most common in organic disorders e.g temporal lobe epilepsy.
- May occur also in: schizophrenia or severe mood disorders.
12
Q
what are Somatic hallucinations?
A
- False sensation of things occurring in the body (mostly visceral).
13
Q
Examples of Somatic hallucinations
A
- complaint that a snake is wondering in the abdomen and complaint of buming pain in the brain.
14
Q
where do Somatic hallucinations occur?
A
- They usually occur in psychotic disorders especially schizophrenia.
15
Q
Hallucination can occur in normal conditions such as ……
A
- While getting into sleep (hypnagogic).
- During awakening (hypnopompic).
- After physical stimulation of a sense organ (flashes of light after pressing the eye ball).
16
Q
what is Depersonalization & Derealisation?
A
Disturbed perception of oneself or the surrounding environment.
17
Q
Def of Depersonalization
A
- The person perceive himself, his body or parts of his body as different, unreal or unfamiliar.
18
Q
Def of Derealization
A
- The person perceive the external world, objects or people as different, strange or unreal.
19
Q
where do Depersonalization and derealization occur?
A
- Depersonalization and derealization can occur in normal person during stress, in anxiety disorders, mood disorder, schizophrenia and in organic disorders e.g. temporal lobe epilepsy.
20
Q
what are disorders of thinking classified into?
A
- Disorders of the form of thinking
- Disorders of the stream of thinking
- Disorders of the content of thinking
21
Q
Characters of Disorders of
The form of thinking
A
- They are also called formal thought disorders.
- They are abnormalities in the logical structure and association of thoughts.
- They lead to failure in producing coherent and logically connected meanings.
- Formal thought disorders usually occur in psychotic disorders and in organic mental disorders.
22
what are types of **Disorders of
The form of thinking**?
- Loosening of associations
- Incoherence
- Word Salad
- neologism
- Verbigration
- Perservation
- Clang Associations
- Irrelevance
- Circumstatiality
- Tangentiality
- Derailment
23
Def of **Loosening of associations**
Mild degree of loosening between ideas rather than words or group of words.
24
Def of **Incoherence**
- Severe degree of loosening of association to the extent that thoughts and words seem to run together without logical or grammatical rules or connection.
25
Def of **Word Salad**
- Extreme loosening of association in which the speech become haphazard mixing of words and phrases.
26
Def of **Neologism**
- Fragmentation of words into sounds or syllables that results in a complete jargon of insensible sounds
although the patient may look like speaking a foreign language.
27
Def of **Verbigration**
- Spontaneous repetition of specific words or phrases without any apparent meaning or motivation.
28
Def of **Perservation**
- Occur when the patient repeats the same response despite changing the stimulus.
29
Def of **Clang association**
- Association of words according to their tone, sound or rhyme, but not according to meaning.
30
Def of **Irrelevance**
- In which the patient responds to a specific stimulus by a response that is not related to the stimulus.
31
Def of **Circumstatiality**
- The patient gives unnecessary details but ultimately reaches the goal.
32
Def of **Tangentiality**
- Ideas are poorly connected to each other around a basic central theme.
- Ideas look as if going beside each other just touching part of the adjacent idea and only moving along periphery of the goal to be reached.
33
Def of **Derailment**
- Sudden deviation of the train of thought; the patient suddenly change the subject of speech
- If derailment is preceded by a period of silence, it is called thought block.
34
what are disorders of the **stream** of thinking?
35
what are disorders of the **content** of thinking?
- These are abnormalities in the ideas or beliefs contained in the thought.
- They include:
1. Delusions.
2. Obsessions.
36
Def of **Delusions**
- False fixed belief based on incorrect inferences about reality
37
Characters of **Delusions**
- It is not consistent with the patient cultural background.
- It cannot be corrected by logic or reasoning.
38
Types of **Delusions**
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Types of delusions according to the theme
- Delusion of persecution
- Delusion of grandeur or grandiosity
- Delusion of reference
- Delusion of guilt or self accusation
- Nihilistic delusion
- Hypochondriacal delusion
- Delusion of infidelity (delusional jealousy)
- Erotomania (delusion of love)
- Delusion of influence and control (passivity phenomena)
40
Delusion of persecution
- The patients believe that people are harassing them, chasing them, spying on them or trying to kill them.
41
Delusion of grandeur or grandiosity
- The patient believes that he has special power or high religious position.
42
Delusion of reference
- The patient believes that the usual events have a special (usually dangerous) significance in reference to him e.g. people are starring at him, talking about him
- Sometimes he believe that people in TV are talking about him or talking directly to him.
43
Delusion of guilt or self accusation
- False belief of remorse and gui
44
Nihilistic delusion
- The patient denies the existence of one organ or may deny the existence of the whole person.
45
Hypochondriacal delusion
- The patient believes that he has a serious illness despite the absence of medical evidence.
46
Delusion of infidelity (delusional jealousy)
- The belief that one's spouse is unfaithful despite no supporting evidence.
47
Erotomania (delusion of love)
- The belief that someone usually inaccessible and in higher social class is in love with the patient.
48
Types of **Delusion of influence and control (passivity phenomena)**
**Thought insertion:** patient believes that thoughts are being implanted in his mind by external force.
**Thought withdrawal:** patient believes that thoughts are being taken out of his mind.
**Thought broadcasting:** patient believes that their thoughts are available to others through radio or TV.
48
Delusion of influence and control
(passivity phenomena)
- False belief that a person's will, thoughts or feelings are being controlled by external forces.
48
Compare between obsessions & Compulsions
49
what are disorders of **Speaking**?
- Volubility
- Poverty of Speech
- Poverty of Content of Speech
- Stuttering & Stammering
- Hurried Speech
- Monotounus Speech
- Dysarthria
- Mutism
- Aphasia
50
Def of **Volubility**
- Increase in the amount of speech.
51
Def of **Poverty of speech**
- Sppech is scanty
52
Def of **Poverty of content of speech**
- speech that is adequate in amount but conveys little information because of vagueness, emptiness or stereotyped phrases.
53
Def of **Stuttering and stammering**
54
Def of **Monotonous speech**
- A speech lacking resonance and emotional inflections, It can be a trait or may be due to flattening of emotion.
54
Def of **Hurried speech**
- Rapid utterance of coherent goal directed speech.
55
Def of **Dysarthria**
It is a disorder of articulation that may be organic as in post stroke patient and slurred speech in drug. intoxication.
56
Def of **Mutism**
- The patient can't speak any words, occur in conversion disorder, catatonia and in some neurological diseases.
57
Def of **Aphasia**
58
what are disorders of **Emotions**?
The clinical study and evaluation of emotion is concerned with two main aspects: Mood & Affect
59
Compare between mood & affect
59
what are emotions?
Emotion is a complex feeling state with psychic, somatic and behavioral components.
60
what are disorders of mood?
- Pleasant & Unpleasant moods
61
Types of Pleasant mood
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Types of unpleasant mode
63
what are disorders of **Affect**?
- Constricted or restricted affect
- Blunted affect
- Apathy
- Indifference
- Inappropriate affect (incongruity)
- Ambivalence
- Lability of affect (emotional incontinence)
64
what is **Apathy**?
- loss of emotion or lack of feeling (there is loss of both emotional expression and experience).
65
what is **Indifference**?
lack of objective emotional response. (there is loss of emotional expression but emotional experience is preserved).
66
Incidence of **Indifference**
More in females
67
where does **Lability of affect (emotional incontinence)** occur?
- It occurs in gross organic lesions of the brain e.g. the pseudobulbar syndrome.
67
what is **la belle indifference**?
occurs in hysteria when the patient feels happy in spite of his disability.
68
Def of **Inappropriate affect (incongruity)**
- Disharmony between the emotional experience, expression or feeling tone with the coexisting idea or situation.
69
Def of **Ambivalence**
- The presence of two opposing emotions towards the same person at the same time (e.g love and hate).
70
Def of **Lability of affect (emotional incontinence)**
The emotional Change from one extreme to the other with no obvious cause (laughing & Weepig & Crying)
71
what are examples of disorders of **Motor Behaviour**?
- Psychomotor retardation
- Agitation
- Excitment
- Stereotypy
- Mannerism
- Perservation
- lack of violation
- Catatonic Symptoms
72
Def of **Psychomotor retardation**
- Diminished motor activity, occur in depression.
73
def of **Agitation**
- The patient is moving around, moving his limbs and head, wrinkling his fingers and cannot stay for some time in one place.
74
Def of **Excitment**
- occurs in primary psychiatric disorders e.g mania and schizophrenia and in organic mental disorders e.g drug addiction and temporal lobe epilepsy.
75
Def of **Stereotypy**
Means monotonous repetition e.g touching the nose.
76
Def of **Mannerism**
- Repeated movements, which may continue for hours or days without cessation.
- And Keeping with the thought (eg a patient with paranoia salutes repeatedly in a grandiose manner.)
77
Def of **Perservation**
- Repetition of the same movement inspite of the patient's effort or desire to do a new one (eg during a meal the patient continues to put the spoon in the plate and up to his mouth, even after the plate gets empty) (may happen in dementia).
78
Def of **Lack of Violation**
- Lack of initiation and reduction of spontaneous movements (e.g. shaking hands).
- The patient has no desire or well to perform acts.
79
what are catatonic symptoms?
- Catalepsy
- Catatonic posturing
- Catatonic rigidity
- Waxy flexibility
- Catatonic Stupor
- Catatonic excitement
- Negativism
- Automatic obedience
- Echolalia
- Echopraxia
79
Def of **Catalepsy**
- the term refers to immobile relatively lasting position.
80
Def of **Catatonic posturing**
- acquiring an inappropriate bizarre posture.
80
Def of **Catatonic rigidity**
- assuming a rigid (but normal) posture and holding it against all effort to change it.
81
def of **Waxy flexibility**
- the patient can be modeled in any position induced by the examiner maintaining such posture beyond the physiological fatigue.
82
Def of **Catatonic stupor**
marked retardation of motor activity to the point of immobility.
82
Def of **Negativism**
- the patient does exactly the opposite of what he is asked to do.
83
Def of **Catatonic excitement**
- extreme degree of motor hyperactivity, intense, not related to a provo stimulus in the surrounding environment.
84
Def of **Automatic obedience**
- the patient exactly and readily responds to the orders performing them in full details regardless their odd content.
85
Def of **Echolalia**
- the patient repeat the same words of the question or the last word.
85
Def of **Echopraxia**
- the patient imitates the movement of another person e.g. the examiner.
86
What is **Memory**?
Memory is the psychological function by which information stored in the brain is later recalled in consciousness.
87
what are levels of memory?
- Immediate memory: Capacity to retain information for about 0.5 second
- Recent (short term) memory: 15-20 seconds.
- Recent past memory: 5 minutes.
- Remote (long term): Long lasting storage.
88
what are disorders of memory?
- Amnesia
- Hypermnesia
- Paramnesia
89
Def of **Amnesia**
memory loss
90
Types of **Amnesia**
91
Def of **Hyperamnesia**
- Abnormally pronounced memory when life events can be registered and recalled in details.
(Occur in hypomania)
92
Def of **Paramnesia**
falsification or distortion of recalled memories.
93
Types of **Paramnesia**
- Confabulation
- Retrospective falsification
- Déjà vu
- Jamais vu
94
Def of **Confabulation**
- filling the amnestic gaps by fabricated events and untrue experiences, this occur beyond the conscious awareness. (Occur in alcoholics)
95
Def of **Retrospective falsification**
unintended distortion of memory that includes selective omission, additions and biased reorganization of memory to fit the present goal
96
Def of **deja vu**
feeling that the present situation, person or information has been seen before while it is actually new. (may occur normally)
97
def of **Jamais Vu**
definitely familiar person or situation is perceived as seen for the first time. (may occur normally)
98
Compare between attention & Concentration
99
what are disorders of **Attention**?
**Distractibility:** failure to sustain attention to one object. Occur mainly in mania and in hypomania.
**Selective inattention:** while heightened attention is directed toward some specific target and neglecting almost all others.
**Hypervigilance (hyperprosexia):** a state of heightened attention, can occur in paranoid states and occasionally
100
what is **Orientation**?
Awareness of time, place and persons.
101
What is **Disorientation**?
- Disturbed orientation to time, place and persons.
- It is usually related to disturbed consciousness.
102
most common symptoms indicating disturbances in consciousness, orientation, memory and attention highly suggest an ......
organic mental disorder e.g. delirium.
103
Def of **consciousness**
the general state of awareness of the self and the environment.
103
what are disorders of **consciousness**?
- Lethargy
- Confusion
- Somnolence
- Stupor
- Coma
104
Def of **lethargy**
- The patient is drowsy and less aware or less interested in the surrounding.
105
Def of **Confusion**
The patient is easily distracted and may be slow to respond and may be disoriented to time, place and persons.
106
Def of **Somnolence**
- The patient is sleeping and can't stay awake unless someone or something wakes him up.
- He can usually talk and follow directions.
107
Def of **Stupor**
- He is in deep sleep unless something loud or painful wakes him up.
- He may not be able to talk or follow directions.
108
Def of **Coma**
The patient can't be awakened at all.
109
NB: disorders of consciousness are usually due to ...... etiology.
Organic
110
Disorders of Judgement
- Judgment is the ability to assess a situation rationally and to act appropriately within that situation.
- It has several aspects (cultural, social, moral, etc...) that should be considered in order to be assessed by the clinician.
111
Disorders of Insight
- In psychiatry, insight refers to the patient's conscious recognition of his condition, i.e. awareness that:
a) He is disturbed or ill.
b) His illness is psychiatric in nature.
c) He should seek professional help.
d) He should cooperate with the offered treatment.
- Full or partial awareness of these aspects indicates the degree of his insight.
