PSYCHIATRIC SYMPTOMS

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PSYCHIATRIC SYMPTOMS SIGNS
DR GIAN LIPPI
CONSULTANT PSYCHIATRIST
UNIVERSITY OF PRETORIA WESKOPPIES
HOSPITAL FORENSIC UNIT


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CONTENTS
BEHAVIOURAL SYMPTOMS
ABNORMALITIES OF SPEECH
MOOD AFFECT
ANXIETY RELATED SYMPTOMS
PSYCHOSIS, DISORDERED THOUGHT PERCEPTION
- THOUGHT FORM DISORDER WITH ITS DIFFERENT TYPES
- DISORDERED THOUGHT CONTENT, INCLUDING DELUSIONS
- PERCEPTUAL ABNORMALITIES, INCLUDING
HALLUCINATIONS
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BEHAVIOURAL SYMPTOMS
MOTOR BEHAVIOUR, CONATION, PSYCHOMOTOR ACTIVITY
- MOTOR BEHAVIOUR / ACTIVITY EXPRESSING A
PERSONS IMPULSES, DRIVES, WISHES,
INSTINCTS, CRAVINGS MOTIVATIONS
- DECREASED (PSYCHOMOTOR RETARDATION)
- INCREASED (PSYCHOMOTOR AGITATION)
CATATONIA
- CATATONIC RIGIDITY
- CATATONIC POSTURING
- WAXY FLEXIBILITY (CATALEPSY)
- CATATONIC STUPOR
- AKINESIA
- CATATONIC EXCITEMENT
NEGATIVISM
- MOTIVELESS RESISTANCE AGAINST INSTRUCTION,
QUESTIONING OR TO BE MOVED
STEREOTYPED BEHAVIOUR

- REPETITIVE FIXED PATTERN OF MOTOR BEHAVIOUR
MANNERISMS TICS
- INGRAINED, HABITUAL, UNCONSCIOUS MOVEMENTS
- UNCONSCIOUS, SPASMODIC MOTOR MOVEMENTS
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BEHAVIOURAL SYMPTOMS
ECHOPRAXIA
- PATHOLOGICAL IMITATION OF ANOTHER PERSONS
MOVEMENT
ATAXIA
- MUSCLE INCOORDINATION
TREMOR
- INVOLUNTARY, RAPID, RHYTHMICAL, ALTERNATING
MOVEMENT
CHOREA
- INVOLUNTARY, RAPID, RANDOM, JERKY, PURPOSELESS
MOVEMENT
DYSKINESIA
- DIFFICULTY PERFORMING VOLUNTARY MOVEMENTS
DYSTONIA
- SUSTAINED CONTRACTIONS OF OPPOSING MUSCLE
GROUPS OF THE TRUNK OR LIMBS
AKATHISIA
- SUBJECTIVE FEELING OF INNER RESTLESSNESS
MUSCLE TENSION
SECONDARY TO ANTIPSYCHOTIC MEDICATION,
PRESENTING WITH
PACING OTHER SIGNS OF PSYCHOMOTOR AGITATION
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SPEECH
LOGORRHOEA
- INCREASE IN QUANTITY OF SPEECH
POVERTY OF SPEECH
- DECREASE IN QUANTITY OF SPEECH
POVERTY OF SPEECH CONTENT
- ADEQUATE AMOUNT OF SPEECH, BUT LACKS
INFORMATION DUE TO VAGUENESS
PRESSURE OF SPEECH
- RAPID SPEECH OF INCREASED QUANTITY THAT IS
DIFFICULT TO INTERRUPT
NONSPONTANEOUS SPEECH
- SPEECH ONLY IN RESPONSE TO QUESTIONS
DYSPROSODY
- LOSS OF NORMAL MELODY / PROSODY / RHYTHM OF
SPEECH
STUTTERING
- FREQUENT REPITITION / PROLONGATION OF A SOUND /
SYLLABLE LEADING TO
IMPAIRED SPEECH FLUENCY
DYSARTHRIA
- PROBLEMS WITH ARTICULATION (PRONOUNCIATION, NOT
LANGUAGE)
APHASIA
- DIFFICULTIES WITH LANGUAGE OUTPUT
(LANGUAGE, NOT PRONOUNCIATION)
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MOOD AFFECT
MOOD IS A PERVASIVE AND SUSTAINED EMOTION
SUBJECTIVELY EXPERIENCED
- DYSPHORIC / MELANCHOLIC (UNPLEASANT LOW MOOD)
- EUTHYMIC MOOD (NORMAL RANGE OF MOOD)
- ECSTATIC / ELEVATED / EUPHORIC / ELATED
(ABNORMALLY INCREASED / HIGH
MOOD STATE)
- DEPRESSED (PSYCHOPATHOLOGICALLY SAD / DYSPHORIC
/ MELANCHOLIC MOOD STATE)
- MANIA (MOOD CHARACTERIZED BY ELATION,
HYPERACTIVITY, HYPERSEXUALITY, AS
WELL AS PRESSURED SPEECH THOUGHT)
- IRRITABLE (EASILY ANGERED)
- LABILE (OSCILLATIONS BETWEEN DEPRESSION
ELATION)
- ALEXITHYMIC (INABILITY TO BE AWARE OF /
DESCRIBE ONES OWN EMOTIONS)
- ANHEDONIC (LOSS OF INTEREST IN ALL PLEASURABLE
ACTIVITIES)
AFFECT IS THE OBJECTIVELY OBSERVED EXPRESSION OF
EMOTION
- RESTRICTED (SEVERE REDUCTION OBSERVABLE
EXPRESSION OF EMOTION)
- BLUNTED (EVEN GREATER REDUCTION IN OBSERVABLE
EXPRESSION OF EMOTION)
- FLAT (ABSENCE / NEAR ABSENCE OF OBSERVABLE
EXPRESSION OF EMOTION)
- APPROPRIATE (OBSERVABLE EXPRESSION OF EMOTION
IS IN HARMONY
WITH THE MOOD DESCRIBED)
- INAPPROPRIATE (OBSERVABLE EXPRESSION OF EMOTION
ISNT IN
HARMONY WITH THE MOOD DESCRIBED)
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ANXIETY RELATED SYMPTOMS
ANXIETY
- FEELING OF APPREHENSION CAUSED BY ANTICIPATION
OF DANGER
FEAR
- ANXIETY CAUSED BY A REAL / REALISTIC DANGER
PHOBIA
- PERSISTENT, IRRATIONAL, EXAGGERATED,
PATHOLOGICAL DREAD OF A SPECIFIC
STIMULUS / SITUATION
PANIC ATTACK
- ACUTE, EPISODIC, INTENSE ATTACK OF ANXIETY WITH
AUTONOMIC SYMPTOMS
ASSOCIATED WITH OVERWHELMING FEELINGS OF DREAD
OBSESSION
- PATHOLOGICAL PERSISTENCE OF AN IRRESISTABLE
THOUGHT OR FEELING THAT CANT
BE ELIMINATED FROM CONSCIOUSNESS BY LOGICAL
EFFORT (ASSOCIATED WITH ANXIETY)
COMPULSION
- PATHOLOGICAL NEED TO ACT ON AN IMPULSE /
OBSESSION THAT, IF
RESISTED, PRODUCES ANXIETY
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PSYCHOSIS
PSYCHOSIS IS THE INABILITY TO DISTINGUISH REALITY
FROM FANTACY
3 GROUPS OF PSYCHOTIC SYMPTOMS
DISORDERED THOUGHT FORM (HOW WE THINK)
- MANEFESTS AS DISORGANIZED SPEECH
DISORDERED THOUGHT CONTENT (WHAT WE THINK OF)
- DELUSIONS
DISORDERED PERCEPTION
- HALLUCINATIONS
- ILLUSIONS
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THOUGHT FORM DISORDER
NORMAL THOUGHT FORM
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THOUGHT FORM DISORDER
CIRCUMSTANTIALITY
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THOUGHT FORM DISORDER
TANGENTIALITY
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THOUGHT FORM DISORDER
DERAILMENT
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THOUGHT FORM DISORDER
LOOSENING OF ASSOCIATIONS
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THOUGHT FORM DISORDER
INAPPROPRIATE / IRRELEVANT ANSWER
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THOUGHT FORM DISORDER
THOUGHT BLOCKING
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THOUGHT FORM DISORDER
FLIGHT OF IDEAS
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THOUGHT FORM DISORDER
OVERINCLUSIVENESS
- SPEECH CONTAINING UNNECESSARILY EXCESSIVE
DETAIL
PERSEVERATION
- PERSISTING RESPONSE TO A PREVIOUS STIMULUS,
EVEN FOLLOWING A NEW STIMULUS
VERBIGERATION
- MEANINGLESS REPITITION OF SPECIFIC WORDS OR
PHRASES
WORD SALAD
- INCOHERENT MIXTURE OF WORDS / PHRASES
NEOLOGISMS
- MADE UP WORDS THAT DONT FORM PART OF ANY
LANGUAGE
ECHOLALIA
- PATHOLOGICAL REPEATING OF WORDS / PHRASES OF
ONE PERSON BY
ANOTHER
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DELUSIONS
DELUSION
- FIXED FALSE BELIEFS, BASED ON INCORRECT
INFERENCES ABOUT EXTERNAL REALITY,
THAT CANNOT BE CORRECTED BY REASONING

DIFFERENT TYPES
DELUSION OF PERSECUTION
- BELIEF OF BEING HARRASSED, CHEATED OR
PERSECUTED
DELUSION OF GRANDEUR
- BELIEF OF EXAGERRATED IMPORTANCE, POWER OR
IDENTITY
DELUSION OF REFERENCE
- BELIEF OF BEHAVIOUR OF OTHERS REFERS TO
HIMSELF / HERSELF
DELUSION OF POVERTY
- BELIEF OF BEING BEREFT OF ALL MATERIAL
POSSESSIONS
NIHILISTIC DELUSION
- BELIEF THAT ONES SELF, OTHERS OR THE WORLD IS
NONEXISTENT OR IS COMING
TO AN END
SOMATIC DELUSION
- BELIEF SURROUNDING A PART OF THE BODY
DELUSION OF CONTROL
- BELIEF OF ONES WILL, THOUGHTS OR FEELINGS ARE
BEING
CONTROLLED BY EXTERNAL FORCES
BIZARRE DELUSION
- ABSURD, TOTALLY IMPLAUSABLE, STRANGE BELIEF
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PERCEPTUAL DISTURBANCES
HALLUCINATION
- FALSE SENSORY PERCEPTION NOT ASSOCIATED WITH
REAL EXTERNAL STIMULI
TYPES CATAGORIZED ACCORDING TO SENSES INVOLVED
- AUDITORY HALLUCINATION (PERCEPTION OF SOUND,
USUALLY VOICES)
- VISUAL HALLUCINATION (PERCEPTION OF SEEING
IMAGES)
- OLFACTORY HALLUCINATION (PERCEPTION OF SMELL)
- GUSTATORY HALLUCINATION (PERCEPTION OF TASTE)
- TACTILE HALLUCINATION (PERCEPTION OF TOUCH)
OTHER HALLUCINATIONS
- CENESTHETIC HALLUCINATION (PERCEPTION OF
SENSATION IN AN ORGAN
UNABLE TO EXPERIENCE SENSATION)
- HYPNAGOGIC HALLUCINATION (NONPATHOLOGICAL
PERCEPTION OCCURRING
WHILE FALLING ASLEEP)
- HYPNOPOMPIC HALLUCINATION (NONPATHOLOGICAL
PERCEPTION OCCURRING
WHILE AWAKENING FROM SLEEP)
ILLUSION
- MISPERCEPTION / MISINTERPRETATION OF REAL
EXTERNAL SENSORY
STIMULI
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THE END