Signs and Symptoms of Psychiatric Disorders LECTURE NO. 6

Learning Objectives Describe the symptoms of common psychiatric disorders Elicit and discuss various signs of psychiatric disorders

Introduction Symptoms are the complaints with which a patient presents to the clinician. Signs are the ones which the clinician obtains on examination of the patient. In psychiatry, the boundary between symptoms and signs is not that distinct because when explored further, a symptom can become a sign.

Common Psychiatric Disorders AnxietyDepressionManiaSchizophrenia

Anxiety One of the most commonly experienced emotions and disorders Often experienced as excessive worrying about almost everything, tension and fear of the unknown

Anxiety (cont.) Various disorders categorized under anxiety disorders include: –Generalized anxiety disorder –Panic disorder –Obsessive – compulsive disorder –Phobias –Post-traumatic stress disorder

Common Symptoms of Anxiety Feelings of fear or dread Increased heart rate Palpitations Sweating Cold and clammy hands and feet Dryness of mouth and throat

Difficulty in talking and breathing Light headedness or giddiness Tremors of hands Restlessness Common Symptoms of Anxiety (cont.)

Depression Major depressive disorder is most closely associated with persistent sadness. The most prominent symptom is depressed mood which is clearly different from sadness due to day-to-day events.

Common Symptoms of Depression Persistent sadness Poor concentration Feelings of worthlessness Easy crying Feelings of hopelessness and helplessness Suicidal ideas

Poor appetite and sleep Lack of energy Decreased socialization Easy irritability Inability to experience pleasure Decreased interest in work and surroundings Common Symptoms of Depression (cont.)

Mania Characterized by the sustained elevation of mood, i.e. marked happiness or at times irritability

Common Symptoms of Mania Persistent and undue happiness (at times marked irritability) Increased self-esteem Over-activity Increased and rapid speech Making big plans

Spending money unnecessarily Poor self-control Increased socialization Decreased need for sleep Common Symptoms of Mania (cont.)

Schizophrenia Considered as one of the major psychiatric disorders Characterized by the presence of psychotic symptoms, which include: – –Disturbances of thought process (delusions, derailment, illogicality) – –Disturbances of perception (sensory hallucinations)

Common Symptoms of Schizophrenia Inappropriate affect Talking to self Neglect of personal hygiene and work Hearing voices Suspiciousness Decreased socialization

Unusual and illogical thoughts Aggressive behaviour Lack of interest in surroundings and activities Common Symptoms of Schizophrenia (cont.)

Common Signs of Psychiatric Disorders Categorized into four types: 1.Disorders of motor activity (conation) 2.Disorders of emotion 3.Disorders of thought process 4.Disorders of perception

1. Disorders of Motor Activity (Conation) Commonly seen motor disorders include:  Hyperactivity  Mannerisms  Stereotypies  Tics  Psychomotor agitation

 Psychomotor retardation  Catatonic symptoms, i.e. stupor, muteness, posturing, waxy flexibility, echopraxia, echolalia, ambitendency and negativism 1. Disorders of Motor Activity (Conation) (cont.)

2. Disorders of Emotion Two types: –Disorders of mood: euthymic, dysphoric, irritable, euphoric, expansive, elated, exaltation, ecstasy, depression, anxiety and apathy –Disorders of affect: inappropriate, labile, emotional incontinence, blunted and flat

3. Disorders of Thought Process Various disorders of thought process can be categorized under: –Disorders of form –Disorders of stream –Disorders of content –Disorders of possession

4. Disorders of Perception Include illusions and hallucinations Illusions: false sensory distortion of a real sensory stimulus. Hallucinations: false sensory perception without adequate stimulus. Depending upon the sensory organ involved, hallucinations can be auditory, visual, tactile, gustatory or olfactory.