PSYCH - TYPICAL SIGNS AND SYMPTOMS OF PSYCHIATRIC ILLNESS

_____ are observations and objective clinical findings

Signs

a manifestation of disease that the physician perceives

signs

 Manifestation of disease apparent to patient himself aka “chief complaint”

symptoms

Subjective experiences expressed by the patient

symptoms

A condition characterized by a set of associated symptoms

Syndrome

A group of signs and symptoms that, together, make a recognizable condition

Syndrome

Mental illness where symptoms that are understandable (reality-based) and can be empathized with

Exaggerated forms of normal reactions to stressful events

Neurosis

•  No loss of contact with reality

•   Insight is usually maintained

•   May still significantly impair function

•   "nerves", anxiety

______ is an abnormal psychogenic reaction and is a maladaptive reaction to stress that reflect excessive and inappropriate use of defense mechanisms

Neurosis

2 components of Neurosis

• Vulnerable _________

• Stress factors triggering the reaction

Vulnerable personality

Stress factors triggering the reaction

Mental illness where there is loss of contact with reality

Symptoms, such as delusions or hallucinations, are not understandable and cannot be empathized with

Psychosis

•   Impairment of mental functions

•   "madness”

Neurotic & stress related disorders based on ICD 10

• Generalized anxiety disorder

• Mixed anxiety and depression

• Panic disorder

• Phobic disorders

• Agoraphobia

• Social phobias

• OCD

• PTSD

Fear of open spaces, crowds and difficulty of immediate easy escape

Agoraphobia

Anxiety is evoked only or predominantly by well-defined situations or objects external to the subject, which are not currently dangerous,

These are characteristically avoided or endured with dread

Phobic disorders

Fear or scrutiny by other people in comparatively small groups, leading to avoidance of social situations

Social phobias

Recurrent obsessional thoughts or compulsive acts

OCD (Obsessive Compulsive Disorder)

Delayed or prolonged response to stressful event or situation of threatening or catastrophic nature, likely to cause distress in anyone

PTSD (Post-Traumatic Stress Disorder)

Symptoms of both anxiety and depression are both present but neither predominates

Mixed anxiety and depression

Generalized and persistent anxiety symptoms with the following elements: Apprehension, motor tension, autonomic overactivity

Generalized anxiety disorder

Recurrent attacks of severe anxiety not restricted to any particular situation or set of circumstances; comparative freedom from anxiety between attacks

Panic disorder

2 aspects of consciousness

Arousal

Awareness

Sensory awareness, attention, perception, memory (learning), emotion and action

Primary consciousness

Self-conscious or awareness and the ability to experience oneself as autonomous with subjective feelings

Secondary consciousness

Conscious recognition that we are conscious beings

Secondary consciousness

3 aspects of Freud’s Topographical Model of the Mind

Conscious

Preconscious

Unconscious

what have pushed out of our conscious minds, through repression, making it inaccessible, although it continues to influence our thoughts, feelings and behaviors

unconscious

what we could become aware of quite easily if we switched our attention to it

preconscious

closely related to instinctual drives

can become conscious by passing through unconscious

unconscious

what we are fully aware of at any one time

conscious

serves to maintain repressive barrier and to censor unacceptable wishes and desires

preconscious

ego falls under what aspect?

preconscious

superego and id falls under what aspect?

unconscious

very mild form of altered mental status in which patient has inattention and reduced wakefulness; not fully awake, alert and oriented

Clouding of consciousness

impaired awareness of time, place and person

Disorientation

pathological sleepiness or drowsiness from which one can be aroused to a normal state of consciousness

Somnolence

severe drowsiness in which patient can be aroused by moderate stimuli and then drift back to sleep

Lethargy

state of impaired awareness with a desire or inclination to sleep

Drowsiness

only vigorous and repeated (painful) stimuli will arouse the patient and when undisturbed, will immediately lapse back to unresponsiveness

Stupor

similar to lethargy

patient has lessened interest in the environment, slowed response to stimulation and tends to sleep more than normal with drowsiness in between sleep states

physical but nonpainful stimuli

Obtundation

unarousable unresponsiveness

coma

acute reversible mental disorder characterized by some confusion and some impairment of consciousness

generally associated with emotional lability, hallucinations or illusions, and inappropriate, impulsive, irrational or violent behavior

Delirium

Concentration/Focus

Aspect of consciousness that relates to the amount of effort exerted in focusing on certain aspects of an experience, activity or task

Attention

"It is the taking possession by the mind, in clear and vivid form, of one out of what seem several simultaneously possible objects or trains of thought. Focalization, concentration of consciousness are of its essence. It implies withdrawal from some things in order to deal effectively with others." - William James

Element of attention

The lecture is mildly interesting, and you are able to pay attention for the full 20-minute presentation

sustained attention or vigilance

Element of attention

Suppose you arrive at a lecture hall, open your notebook, and rather than scanning the room indiscriminately, turn your attention to the instructor, who is just beginning to speak

selective attention

Element of attention

At the same time that you are listening to the instructor, you are taking handwritten notes incorporating headings, and subheadings. It appears that you are able to simultaneously listen, write, and organize rather effortlessly, although you are probably shifting your attention among these competing tasks

divded attention

Element of attention

A fire engine goes by the lecture hall and you look up ______ but are then able to ignore the dimming noise of the siren _______

distraction

inhibition

becomes sustained attention again

Element of attention

Suddenly, the fire alarm rings, and you smell smoke. These distracters capture your full attention (_______ from lecture), and their importance causes you to change your attention and behavior (_______) as you hurriedly head for the door.

disengagement

set shifting

inability to focus attention; patient does not respond to task at hand but attends to irrelevant unimportant external stimuli

distractability

sleeplike state of reduced consciousness and activity; usually seen in hypnosis, dissociative disorders, ecstatic religious experience

Trance

blocking out only those that generate anxiety

Selective attention

excessive attention to and focus on all internal and external stimuli; usually seen in delusional or paranoid states

Hypervigilance

removal of inhibitory effect as in reduction of the inhibitory function of the cerebral cortex (ex alcohol

Disinhibition

• Greater freedom to act in accordance with inner drives or feelings with less regard for restraints dictated by cultural norms or one's superego