General symptomatology & psychopathology of psychiatric disorder

1. MRS. J.JULIET SUJATHA,M.Sc(N)
MENTAL HEALTH NURSING
PROFESSOR
GANGA COLLEGE OF NURSING
COIMBATORE
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2. General symptomatology
& psychopathology
of psychiatric disorder

3. Objectives:
At the end of the session the student will
be able to :
Explain general symptomatology of psyc
hiatric disorder.

4. Component of mind.( disorders of thought –dis
order of emotion-disorder of behavior )
Type of disorder:
1-Thought disorder 2-Disturbance in percept
ion.
3- Unreality states. 4- Disorder of memory.
5- Orientation , disorientation. 6- Judgment.
7- Insight. 8- Attention and concent
ration.
9- Disorder of consciousness. 10- Disorder of affect.
11- Disorder of behavior.
Out line:

5. 1-disorder of thought
formal
stream
content
1-Concrete
thinking
2-autistic
thinking
5-clang association
6-incoherence or word salad
8-poverty of speech
7-pressure of speech
9-Retardation
10-Blocking
11-preservation
12-pallilalia
13-Echolalia
14-Irrelevant answer
15-Neologisms
4-flight of idea
3-loseness of association
2-circumstantially
1-tangentiality
1-delusion.
2-obsession
3-peroccuption.
4-suicidal ideation.

6. 1-Concrete thinking: when the patient use
literal thinking with out understanding the
implicit meaning behind sentence &it is
verse abstract
A-formal thought disorder:
clinical manifestation:
Hodeidah
???
Wayne
Hodeidah,
what I see
You believe ...
I became new

7. 2-autistic thinking: thinking that gratifies
unfulfilled desire but has no regard for
reality, egocentric (self -centred)
fantasy.

8. • 1-tangentiality:
• Occur when The speaker goes off the topic
and does not return to the it.
B-disorder of stream of thinking:
On Sunday morning, I went
to Abu Abdullah in the office
...........................
And
Dined today in a restaurant
you can't miss

9. • 2-circumstantially:
• Before getting the point or answering the
question the patient gets caught up in
countless details and explanation.
When did
the pain
start
On Saturday, I fell asleep,
washed my face, broke my
cheese, blueberry jam, and
low-fat milk, wore blue
jeans and a red T-shirt,
and got into the car, but
the gasoline was sincere
and I went ..... and ..... and
..... On Monday after lunch,
my stomach fell to pain

10. • 3-loseness of association:
• Thinking haphazard , illogical and confused,
connection of thought is interrupted appear
mostly in schizophrenic disorder.
Sure, this is
thirsty so
as to base
in the Moya

11. • 4-flight of idea:
• Rapid jumping from one idea to another, the
connection bt idea is through stimuli from
last idea or external stimuli.
The atmosphere is
wonderful and the world is
spring
Lock on all threads
5-clang association: meaningless rhyming of word
The sea turned
up and I saw
the moon on a
dark night

12. • 6-incoherence or word salad: mixture o
f word and phrases that have no meani
ng.
Ashi grew inside
the door
7-pressur of speck: Forceful energy heard in a manic
people frantic jumbled speech as he or she struggles to
keep pace with racing thought.
In my spirit today, my
theme park
My brothers, my sister, my
brother, and my son

13. • 8-poverty of speech: the speech is brief
and uncommunicate.
9-Retardation: refer to slow speech and prolonged
latent period before response.
Who messed you
with your bed ??
She
went !!
What is
wrong
with you?
...........................
.......................
...............I have
a headache

14. 10-Blocking:
Sudden cessation of thought in the middle of
sentence & person is unable to continue bis
train of thought.
11-preservation : psychopathological repetition of
the same word or idea in response to the different
question
Today I went to the
market and I saw a
dress of its color
Will you go
with me?
Verse.
Do you sit
??
Verse
.

15. 12-pallilalia:
pathological repetition of the last word
said.
13-Echolalia: repeating the speech of
another person.
Today I was with my
aunt
And her daughters
greet you.
they said hello to you
they said hello to you
they said hello to you
Riding a horse
Riding a horse
Riding a horse
Riding a
horse

16. 14-Irrelevant answer:
answer hat is not in harmony with
question asked.
15-Neologisms:
word a person Mack up that only. have meaning for
the person.
U drinkThe book
is hopeful
Hakone is
dead

17. C-disorder of content of thought:
It is include:
1-delusion. 2-obsession.
3-peroccuption.4-suicidal ideation.

18. Definition
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:
*Systematized : when they form a coherent system and
appear to be logical ,e.g.: paranoid delusion.
*un systematized delusion: group of delusion that not
related to each other or in a haphazard relation.
Another category of delusion:
1-paranoid delusion. 2-delusion of
influence.
3-depressive delusion. 4-hypochondriacal delusion
1-Delusion

19. 1-paranod delusion:
it is an intense and strongly
defended irrational suspicious
belief.
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) . I saw the Kingdom
Tower, which I
built

20. D-Erotic delusion: false belief that
there is a love story between
one self and famous person.
E-delusion of jealousy:
conviction that the spouse has
some definite relation with
someone else.
f-delusion of infidelity:
false belief derives from
pathological jealousy that one
lover is unfaithful (it is an
extreme of the jealousy
delusion)
g-litigious delusion:
patient write complaint and sends
them to responsible person.

21. 2-delusion of influence (delusion
of control)
false belief that one is being cont
rolled by other or agencies.
I am equalizing this,
because a chapter of
any device in America
controls my behavior

22. 3-deprssive delusion:
A-delusion of self-blame, guilt
or sin:
in which the patient that he
is wicked, full of sins and
unfit to live with other
people (unworthiness).
B-delusion of poverty: false
belief that he lost
everything in life.
C-Nihilistic delusion: false
belief that a part of this
body doesn't exist or he
doesn't exist(dead)
Originally,
my
existence
is wrong, I
am above
society and
America
entered
Iraq
because
of me.
Where are my
hands, I don't
have a hand

23. 4-hypochondriacal delusion:
Patient has false belief that he ha
s physical disease e.g. cancer s
tomach that is not based on rea
l organic pathology.
I am equalizing this,
because a chapter of
any device in America
controls my behavior

24. 2-obsessive of thought:
Are intrusive of thought invading the con
scious awareness against the resistanc
e of the person in an involuntary way
that if fully aware that they un necessar
y and absurd. If the patient 's resistanc
e succeeds to temporarily or partially c
ontrol this intrusion, tension accumulat
es until it reaches an intolerance degre
e that completes the individual to yield
and act out the obsessive behavior.

25. 3-preoccupation:
Centring of thought content arou
nd a particular idea associated
with strong affective tone.
4-suicidal ideation:
It is the recurrent idea affecting the
individual to put an end by himself
to his own life

26. 2-disturbance in perception:
1-hallucination:
False perception for which no external
stimuli exist. Hallucination can have
an organic or a functional etiology.

28. Visual: seeing
thing that are
not there.
Auditory:
hearing voice
when none are
present.
Olfactory:
smelling
smells that do
not exist
Tactile: feeling
touch
sensation in the
absent of
stimuli.
Gustatory:
experiencing
taste in the
absence of
stimuli.

29. 2-illusion:
It is a false perception with an
external stimulus.
N.B. it may affect any of the
special senses ( auditory,
olfactory….,etc)

30. 1-hallucination: 2- illusion:
False perception for which
no external stimuli exist.
Hallucination can have an
organic or a functional
etiology.
It is a false perception
with an external
stimulus.

31. 3-unreality states:
1-depersonalisation: A phenomenon whereby a
person experience a sense of unreality or self –
estrangement.

33. 4-disorder of memory:
1-amnesia: is loss of memory and may be partial or complete.
type of amnesia:
1-Anterograde
amnesia:
2-Retrograde
amnesia :
3-Total amnesia:
4-Circumscribed
amnesia:

34. 1-Anterograde amnesia: loss of memory for recent event.
2-retrograde amnesia : loss of memory for remote event.
3-Total amnesia: loss of memory for recent and remote
event.
4-Circumscribed amnesia: loss of memory for limited time.
2-par amnesia: it denotes false recall.
a-confabulation:
patient fills the
gaps in his
memory by
fabrication.
b-falsification
patient adds
fraises details
to a true
memory.

35. 3-hyperamnesia: it's excessive memory, the
patient mention even unnecessary details.
4-deja vu phenomena (already seen): in which
new situation is experienced as previously
5-jamais vu phenomena: in which familiar
situation is experienced as novel.

36. 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.
N.B. A patient with no insight will have poor
judgment towards his social , financial and
domestic problem.

37. 8-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.

38. 9-Disorder of consciousness:
Between conscious and unconscious there are various degree of
disturbed consciousness, some of them are:
1-confusion:
There is dimming or clouding of consciousness. All mental
processes are slow.
2-delirium:
There is clouding of consciousness .the mental function show
quantitative change:
a-intellect: Hallucination ,illusion and disorientation.
B-affect: fear and apprehension.
c-behavior: restlessness.

39. 3-stupor: there is complete suppression of
motor activity, the patient doesn't respond to
any stimuli neither of external or internal.
4-twilight state: is state of restricted
consciousness including ideation perception
and association emotional state.
5-fugue: it involves memory loss, as does
psychogenic amnesia, but it also including
traveling away from home or from one's usual
work locale.
Therefore, fugue involves flight as well as
forgetfulness.

40. 10-disorder of affect:
A-inadequate
affect:
1-apathy :
it's the absence of
emotional experience
and expression.
2-indifference:
absence of both emotional but
experience is present.

41. B-inappropriate
affect
(incongruity) it is a disharmony of
affect and ideation.
Congratula
tions for my
success

42. c-Ambivalence:
the holding at the
same time of tow opposing emotions, attitudes,
ideas or wishes
toward the same person, situation
or object
I love you ...
I hate you ...

43. D-depressive
affect:
1-grief or
mourning:
it's feeling of
sadness
appropriate to
a real
loss.
2-depression:
it's
a psychopathological
feeling of
sadness.

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

45. F-anxiety,
apprehensio
n ,fear and
phobia
1-Anxiety:
a state of feeling ,uneasiness ,uncertainty
or dread resulting from a real or perceived
threat whose actual source is unknown or unrecognized.

46. Type of anxiety:
2-tension:
unpleasant feeling
associated with
physical
and psychological
tightness.
1-free floating anxiety:
it is severe, generalized
and pervasive. Fear not
attached to any idea.
3-panic:
sudden,
overwhelming anxiety
of such intensity that
it produce
disorganization of the
personality

47. 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.

48. 14-Disorder of behavior( conation):
a-hyperactivity:
it include:
1-Agitition:
it's some from of
hyperactivity
characterized by pacing
and accompanied with
restlessness
2-Excitement:
it's severe form of
hyperactivity, excessive
purposeless motor
activity and the patient may
destruct himself or other

49. B-Compulsion:
un controllable impulse to perform an act repetitively.
c-Repetitive activity:
1-stereotypy:
it is a monotonous repetition of
certain movement with
out purpose.
4-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 heal of the patient from the
pillow or the arm up).
2-mannerism:
it is a repeated movement,
which isn't monotonous and
keeping with the personality
character.

50. 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.
c- retention of saliva, urine or feces.

51. f-Automatic obedience:
the performance of all simple commands in
a robot-like fashion may be present in catatonic.
G-Impulsiveness:
is an action that is sudden , abrupt , unplanned
and directed toward immediate gratification.
H-psychomotor retardation:
Extremely slow and different movement that in the
extremes can entail complete inactivity and incontinence

52. ADMISSION
S
SLOT
NOW