S1L3_PART 4_Typical Signs & Symptoms of Psychiatric Illness

NOTE: Example of acting out

In kids: meron sha gustong laruan, di bibilhin sa kanya bc he has too much toys. Throws a tantrum

In adults: I want my parents to pay more attention to me; steals in the mall for parents to notice them

Reduced impulse to act and to think, associated with indifference about consequence of action; does not care; does what he wants

Abulia

Lack of energy

Anergia

Inability to stand or to walk in a normal manner, even though normal leg movements can be performed in sitting or lying down positions; common in conversion disorder

Astasia Abasia

Eating of feces or filth

Coprophagia

State in which muscles remain immovable, seen in schizophrenia

Muscle rigidity

Continuous rotation in which the head is turned; seen in autism

• Constant rotation: keeps turning. Pts with autism can just ikot nang ikot 50x

Twirling

Lack of ability to make gestures or to comprehend those made by others

Amimia

Lack of coordination

Ataxia

Difficulty performing movements; seen in extrapyramidal syndromes

Dyskinesia

Rhythmic alteration in movement

Tremor

Slow motor activity, with a decrease in spontaneous movement

Bradykinesia

Movement disorder characterized by random and involuntary, quick, jerky, purposeless movements; Huntington disease

Chorea

Involuntary, violent muscular contraction or spasm

Convulsion

Attack or sudden onset of certain symptoms such as convulsions, loss of consciousness and psychic or sensory disturbances

Seizure

Slow, sustained contractions of axial or appendicular muscles

Dystonia

Goal directed flow of ideas, symbols and association initiated by a problem or task, leading toward a reality-oriented conclusion

Thinking

Thinking: 3 aspects

Content

Process

Form

What thoughts are occurring to the patient

Content

How thoughts are formed, formulated and expressed

• Normal: linear, organized, goal directed

Process

False, fixed ideas that are not shared by others and can be divided into; cannot be corrected by reasoning

Delusion

Absurd, totally implausible, strange belief

Reporting Impossible situations Vs. Imagining possible situations

Bizzare vs. non-bizzare

Pertaining to functioning of one’s own body (brain is rotting)

Somatic

Someone is deeply in love with them

Erotomania

Pathological infidelity

i believe my husband is cheating on me but in reality is not

Infidelity

False feeling of remorse or guilt

Self-accusation

Uncontrollable lying in which patients elaborate that they freely communicate and act on; ex. Munchausen syndrome

Pseudologia phantastica

Paranoid delusions:

• Persecution

• Reference

• Grandiose

• Control

False belief that one is being harassed, cheated or persecuted

Persecution

Belief that behavior of others refers to oneself; persons feel falsely that

others are talking about them

Reference

Exaggerated concept of one’s importance and power of identity

Grandiose

False belief that a person’s thoughts, will, or feelings are being controlled by external forces

Control

Control: types of thoughts

• Thought withdrawal

• Thought insertion

• Thought broadcast

• Thought control

Thoughts removed by external forces

Thought withdrawal

Thoughts implanted by others

Thought insertion

Thoughts can be heard by them

Thought broadcast

Disturbances in thought content

• Poverty of Content

• Overvalued Idea

• Preoccupation of thought

• Egomania

• Monomania

• Hypochondria

• Obsessional thoughts

• Compulsions

• Coprolalia

• Phobia

• Noesis

• Unio Mystica

Thought that gives little information due to vagueness, empty repetitions or obscure phrases

Poverty of content

False or unreasonable belief or idea that is sustained beyond the bounds of reason

Overvalued idea

Centering of thought content on a particular idea associated with a strong affective tone

Preoccupation of thought

Morbid self preoccupation or self-centeredness; narcissism

• me me me personality

Egomania

Preoccupation with one subject

Monomania

Exaggerated concern about health that is based on real medical pathology but on unrealistic interpretations of physical signs or sensations as abnormal

Hypochondria

Pt thinks there is something wrong with them; requests to do a test. Test shows pt is normal but pt still insists to do more and check baka the disease is so small it wasn't seen.

Hypochondria

Unwelcome and repetitive thoughts that intrude on patient’s consciousness, resisted by patient; involuntary

Obsessional thoughts

Repetitive, ritualized behaviors that the patient feels compelled to perform to avoid an increase in anxiety or some dreaded outcome

Compulsions

Compulsive utterance of obscene words

Coprolalia

Persistent, pathological, unrealistic, intense fear of an object or situation; person may recognize that fear is irrational but cannot dispel it

Phobia

Revelation in which immense illumination occurs in association with a sense that one has been chosen to lead and command

• Messiah complex- thinks he is the messiah

Noesis

Feeling of mystic unity with an infinite power

• Thinks he is the holy spirit

Unio mystica

Disturbance in form of thought; thought process is disordered

Formal thought disorders

Formal thought disorders: Types

• Circumstantiality

• Clang associations

• Derailment/ Loose association

• Flight of ideas

• Neologism

• Perseveration

• Tangentiality

• Thought blocking

• Word salad

Overinclusion of trivial or irrelevant details that impede the sense of getting to the point

• Daldal ng daldal but pt can still answer the question

Circumstantiality

Thoughts that are associated with by the sound of words rather than their meaning

Clang associations

The word he wants to say can't be said but pt says a word similar to its sound

Clang associations

Breakdown in both the logical connection between ideas and the overall sense of goal directedness. The words make sentences but the sentences do not make sense

• Connected ung sound but pawala sa goal

Derailment/ Loose association

A succession of multiple associations so that thought seem to move abruptly from idea to idea; often but not invariably expressed with rapid, pressured speech

Flight of ideas

Invention of new words or phrases or the use of conventional words in idiosyncratic ways

Neologism

Repetition of out of context words, phrases or ideas

Perseveration

In response to a question, the patient gives a reply that is appropriate to the general topic without actually answering the question

• San ka natulog kagabi? Ah ung kama kasi magulo. General topic is near the question.

Tangentiality