General symptomatology

of psychiatric disorder
 Objectives:
At the end of the session the student will be
able to :
Explain general symptomatology of psychiatric
disorder.
 Learning Objectives:
At the end of this lecture, each student
will be able to:
• Identify the signs and symptoms of
mental illness
• Describe the symptoms and as presented
by the patient
 Out line:

Component of mind.( disorders of thought –disorder of

emotion-disorder of behavior )
Type of disorder:
1-Thought disorder 2-Disturbance in perception.
3- Disorder of mood 4- Disorder of memory.
5- Orientation , disorientation. 6- Judgment.
7- Insight. 8- Attention and concentration.
9- Disorder of consciousness. 10- Disorder of general
behavior.
 Disorder of
behavior( conation):

a-hyperactivity:

1-Agitition:
2-Excitement:
it's some from of it include: it's severe form of
hyperactivity characterized
hyperactivity, excessive
by pacing (speed) and
purposeless motor
accompanied with
activity and the patient may
restlessness
destruct himself or other
• 2- psychomotor retardation
• Slowing down of mental and physical activity.
The extreme of it will end by complete
inactivity and incontinence
3- Compulsion:

un controllable impulse to perform an act repetitively.

4-Repetitive activity:

1-stereotypy: 2-mannerism:
it is a monotonous repetition of it is a repeated movement,
certain movement with which isn't monotonous and
out purpose. keeping with the
personality character.

3-waxy flexibility:
it is the maintenance of imposed postures
however abnormal they may be
the absence of fatigue
in such cases is remarkable
(e.g. raising the head of the patient from the
pillow or the arm up).
• Catatonic posturing: Voluntary adoption of an
unusual or bizarre bodily posture continuously for a
long time (e.g. standing on one leg).

• Catatonic rigidity: Voluntary assumption of a rigid

posture held against all efforts to be moved.
D - Echopraxia

imitating the movement of another person :.

E - Negativism

frequent opposition to suggestion, e.g.

a.in motor sphere when was asked to look

up he looked down.

b.in speech : when he asked question he

didn't answer.
f-Automatic obedience:

the performance of all simple commands in

a robot-like fashion may be present in
catatonic.

Tics: Involuntary, irregular, repeated movements involving •

a group of muscles. (E.g. raising one shoulder or turning
the head). Often related to stress or anxiety, rarely organic
disease.
 1-disorder of thought

Stream/ rate
Formal/form 1-tangentiality content
2-circumstantially
1-Concrete
3-flight of idea
thinking
4-pressur of speech 1-delusion.
5-poverty of speech
2-loseness of association
6-Retardation
7-Blocking 2-obsession
3-ncoherence &
word salad 8-preservation
4-Clang association 9-Echolalia
5-Neologisms 10-Irrelevant
answer
 A-formal thought disorder:

clinical
manifestation:
1-Concrete thinking: when the patient use literal
thinking without understanding the implicit meaning
behind sentence &it is verse abstract

...‫قدصت‬L‫ٌن‬ ‫؟؟؟ةدٌدحالع‬
‫رص‬LL‫ةدٌدحالع ت‬ ‫ةدٌدحال ٌنو‬
‫اهفوشا ام‬
5-clang association: meaningless words have the
same sound (play, clay)

‫تفشو رحبلا تحر‬

‫رمس ة ٌلل ًف رمقال‬

Loosening of associations: Shifting between unrelated &

unconnected ideas and subjects. Thinking appears vague
and illogical.
incoherence : Severe degrees of loosening of
associations thought or words run together with
no logical or grammation resulting in
disorganization.

‫بابلا لخاد ىشعلا تمن‬

• word salad: mixture of word and phrases that

have no meaning.
Neologisms:
word that a person make up. have meaning for the
person only.

‫اتاتم نوكاه‬

Verbigration:
Meaningless & stereotyped repetition of specific
word or phrases.
 B-disorder of stream of thinking:

• 1-tangentiality:
• Occur when The speaker goes off the topic and
dos not return to it and not reach the goal.

ً ‫ف هللادبع وبا دنع حبصلا دحالا مٌو تحر‬

‫بتكمال‬
...........................
‫و‬
‫مولا ٌتشعت‬ٌ ‫ف ال معطم ًف‬ٌ ‫كتو‬
‫‪• 2-circumstantially:‬‬
‫‪• Before getting the point or answering the question,‬‬
‫‪the patient gets caught up in countless details and‬‬
‫)‪explanation. (reach the goal‬‬

‫تلسغو مونلا ن‪L‬م تمق تبسلا موٌ توت‬

‫ىبرمو هنبج ترطفاو ً هجو زٌنج تسبلو‬
‫مسدلا ٌللق ٌبلحو تبكرو رمحا تٌرش‬ ‫ملالا ادب ىتم‬
‫ًتو قرزا صلخ م ناك ٌنزن لبا نكل‬ ‫؟؟؟؟‬
‫موو‪.....‬و‪.....‬و ‪ .....‬تحرو‬ ‫ةر ٌاسال ٌ‬
‫نطب ًنعجو ىدغال دعب ٌننث االً‬
• 4-flight of idea:
• Rapid jumping from one idea to another, the
connection between idea is through stimuli from
last idea or external stimuli.

‫عدب وجلا‬ ٌ ‫عر ٌاندلاو‬

‫ٌب‬
‫عٌضاوملا لك ىلع لفق‬
7-pressur of speech: Forceful energy heard in a manic
people as he or she struggles to keep pace with racing
thought.

ً‫ماعمٌهالمالموٌالحورب‬
ً‫الخوٌتالخٌتخاوٌوخاو‬
ً‫تالخدلوو‬
• 8-poverty of speech: the speech is brief and
uncommunicate.

‫م‬L‫كطباخ ن‬
!‫حار‬LL‫ت‬ ‫؟؟كسارف‬
!

9-Retardation: refer to slow speech and prolonged

latent period before response.
.................... ‫ٌكف شو‬
.................... ‫م ىسع‬L‫ا‬
....................
‫عدصم ًسار‬.....
‫؟؟رش‬
10-Blocking:
Sudden cessation of thought in the middle of sentence
& person is unable to continue his train of thought.

‫قوسلا موٌال تحر‬

‫هنول تانسف تفشو‬

11-preservation : psychopathological repetition of

the same word or idea in response to the different
question
.‫ا‬E‫ٌه‬ ‫؟ ياعم حورتب‬

‫ا‬EE‫ٌه‬ ‫؟؟سل تجب‬

12-pallilalia:
pathological repetition of the last word said.

‫نوملس ٌكلع‬
ٌ ‫ٌكلع‬ ً ‫موال تنك‬
ٌ ‫تالخ دنع‬
‫نوملس‬
ٌ ‫نوملس ٌكلع‬
ٌ ‫نوملس اهتانبو‬
ٌ
.L‫لع‬L‫ٌك‬

13-Echolalia: repeating the speech of

another person.
‫ٌلخال بكرب‬
‫ٌلخلا بكرب‬
‫ٌلخلا بكرب ٌلخال‬
‫بكرب‬
14-Irrelevant answer:
answer hat is not in harmony with question
asked.

‫دنع باتكال‬ ‫ً؟برشت شا‬

‫ا‬L‫م‬L‫ل‬

Volubility (Logorrhea)
excessive speech but coherent and logical
speech.
.
• Aphasia
Disturbances in comprehension or expression of
language caused by brain lesion. (motor and
sensory)

Mutism
Organic or functional absence or reduction of
the amount of speech

.
 C-disorder of content of thought:
It is include:

1-delusion. 2-obsession.
.
 1-
Definition
De l u s i
D e lus io n

on
It is false fixed belief not consist with patient educational and

cultural back ground that cannot be corrected by logic

or reasons.

Delusion divide into:

1-paranoid delusion. 2-delusion of influence.
3- delusion of sin/ guilt. 4-hypochondriacal delusion
 1-paranod delusion:

It include:
A-Delusion of grandeur: false belief that
one is a very powerful and
important person.
B-Delusion of persecution: false belief
that one is chased by other.
C-Delusion of reference: false belief that
the behavior of other refers to one
self (people in street, radio, news
paper are referring to him) .

‫ةكل م ملا جرب تفش‬

‫ٌهتنب ًلال انا‬
D-Erotic delusion: false belief that there
is a love story between one self
and famous person.

f-delusion of infidelity:
false belief derives from pathological
jealousy that one lover is unfaithful
 2-delusion of influence (delusion
of control)

false belief that one is being

controlled by other or agencies.

‫اذك يوسا انا الصا‬

ً‫ج هٌ ف‬L‫ه‬L‫ا‬L‫ف ز‬
‫مكحت ا ٌكرما‬
ٌ ‫نال‬
ً‫صب‬ ‫افتر ت‬
 2-delusion of influence (delusion
of control)
• Thought insertion: Delusion that thoughts are
being implanted in one's mind by other people or
forces.
• Thought withdrawal: Delusion that thoughts are
being removed from one's mind by other people
or forces.
• Thought broadcasting: Delusions that one's
thoughts can be heard by others, as thought they
were being broad cast into the air.
 3-deprssive
delusion:
A-delusion of self-blame, guilt or
sin:
‫انا الصا‬
in which the patient that he is ‫طلغ يدوجو‬
wicked (bad), full of sins and ‫ىلع هلاع انا‬
unfit to live with other people ‫عمتجمال‬
(unworthiness). ‫او‬E‫تلخد ا ٌكرم‬
ً‫سب قارعال‬ ‫بب‬
B-delusion of poverty: false .
belief that he lost everything in
life. ‫ام انا ي ٌد نٌو ٌد‬
‫يدنع‬
C-Nihilistic delusion: false belief
that a part of this body doesn't
exist or he doesn't exist(dead)
 4-hypochondriacal delusion:

Patient has false belief that he has

physical disease e.g. cancer stomach
that is not based on real organic
pathology.
!!!‫ انا‬L‫م‬L‫ر‬L‫ض‬
ٌ
‫لشف يدنعو‬
!!!‫ولك‬LL‫ي‬
 2-obsessive of
thought:
. Recurrent, persistent thought, impulses or images
that cannot be eliminated from consciousness by
logic or reasoning though the person is aware that
they are unreasoned, illogical and alien to him .
They are associated with anxiety which increases
when the person resists them.
 2-disturbance in perception:

Perception

Mental process by which sensory stimuli are

brought to awareness and given a meaning
(i.e. transferring physical stimulation into
psychological information).
 2-disturbance in perception:

1-hallucination:
False perception for which no external
stimuli exist.
 Visual: seeing
thing that are
not there.

Auditory: Gustatory:
hearing voice experiencing
when none are taste in the
present. absence of
stimuli.

Olfactory: Tactile: feeling

smelling touch
smells that do sensation in the
not exist absent of
stimuli.
 2-illusion:
It is a false perception with an
external stimulus.
N.B. it may affect any of the
special senses ( auditory,
olfactory….,etc)
 4-disorder of
memory:

1-amnesia: is loss of memory and may be partial or complete.

1-Anterograde 3-Total amnesia:

amnesia:
type of amnesia:

2-Retrograde
amnesia : 4-Circumscribed
amnesia:
 1-Anterograde amnesia: loss of memory for recent
event. 2-retrograde amnesia : loss of memory for remote
3-Total amnesia: loss of memory for recent and remote
event.
event.
4-Circumscribed amnesia: loss of memory for limited
time.

2-par amnesia: it denotes false recall.

b-falsification
a-confabulation: patient
patient fills the adds false
gaps in his details to a
memory by true memory.
fabrication
 Disorder of
1): Mood: emotion
A sustained and pervasive emotion (or emotional
tone) subjectively experienced and reported by
the patient and observed by other (e.g.
depression, elation, anger).
(2): Affect:
Usually used to indicate the external observed
expression of emotion.
Also used to indicate the subjective and immediate
(short lived) experience of emotion attached to
ideas or persons.
 disorder of
affect:
A-inadequate
affect:

1-apathy :
it's the absence of
emotional experience
and expression

2-indifference:
absence of emotional expression
but experience is present.
 disorder of affect
• Constricted or affect:
restrictedintensity of externalized feeling
Reduced
tone (is expression & responsiveness).
affective
•
• Blunted affect: Severe reduction in the
intensity of affective expression and
responsiveness.
 B-inappropriate
affect

(incongruity) it is a disharmony of
affect and ideation
‫كوربم فال‬
ً‫تحجن‬

‫؟؟؟؟‬
 c-Ambivalence:

the holding at the

same time of two opposing emotions,
attitudes, ideas or wishes
toward the same person, situation
or object
...‫ـــــ‬L‫ك‬
‫ــــــــبح‬
‫أ‬

..‫ـــــ‬L‫ك‬
‫ـــــــــــ‬
‫ركأ‬L‫ــه‬
.
Liability of affect. (Emotional incontinence):
Affective expression characterized by and
abrupt changes unrelated to external
abnormal.
•
Mood swings: Oscillation of a person's
emotional feeling tone between periods of
elation and periods of depression or other
mood states.
 Unpleasant
mood:

1-depression:
it's
a psychopathological
feeling of
sadness.
 Unpleasant mood
• Dysphoric mood: An unpleasant
mood. Dissatisfaction and restlessness.
•

• Anhedonia: Lack of the ability to experience

pleasure loss of interest in all
regular pleasurable activities
2-Apprehension:
intense fear of any non-fearful stimuli.
Fear of externals danger
e.g. car accident.

3-fear: A reaction to specific danger.

4-phopias: An intense irrational fear

of
an object,
situation or place .the fear
persist even thought the
object of the fear is perfectly
harmless and the person is aware of
the irrationality.
 E-
1-euphoria: pleasurable
feeling or state of extrem mood:
Happiness or confidence.

2-elation:
it is feeling of happiness
with air
of confidence and
enjoyment
associative with
increase
motor activity.
 pleasurable
Exaltation mood:
it is a heightened feeling
of psychological well
being inappropriate to
apparent event.

Ecstasy:
Feeling of intense
rapture
 6-
judgment:
It is the ability to assess a situation correctly and act
appropriately within that situation.

7-insight:

It is the ability to under stand the objective

condition of his illness.
 Insight
• Inpsychiatry: It to the
patient's
refers conscious recognition of his
conscious
condition awareness
i.e. that:

• 1- He is disturbed or ill
• 2- His illness is psychiatric in nature
• 3- He should seek professional help
• 4-He should cooperate with offere
the treatment. d
 attention and concentration:

It Is the direction of the focus of awareness and

perception to a particular stimulus.

*distractibility: inability to maintain attention,

shifting from one area or topic to another with
minimal provocation.
 attention and concentration:
• Selective inattention: Inattention only stimuli
that generate anxiety.

• Hypervigiance (Hyperprosexia): Excessive

attention and focus on all internal and
external stimuli. Prominent in delusional or
paranoid states & mania.
 Orientation:

• Disorientation: Disturbed orientation in time,

place and person .Usually related to disturbed
consciousness.