General Symptomatology by Prof. Dr. Elham Fayad Objectives : At the end of the session the student will be able to :- Explain General symptomatology of psychiatric disorder.

Contents : General symptomatology of psychiatric disorders. a- Composition of mind 1- Disorders of Intellect. 2- Disorders of Affect. 3- Disorders of Behaviour.

I- Disorder of Thought a- Formal thought disorder Clinical manifestations of formal thought disorder 1- Concrete thinking :- Concreteness versus abstractness 2- Autistic thinking Autistic versus realistic Autistic versus realistic

Disorders of the stream of thinking 1- Tangentiality 2- Circumstantially 3- Looseness of association 4- Flight of ideas 5- Clang association 6- Incoherence or word salad 7- Pressure of speech 8- Poverty of speech

CONT. STREAM OF THOUGHT 9- Retardation 10- Blocking 11- Preservation 12- Palilalia 13-Echolalia 14- Irrelevant answer 15- Neologisms

C- Disorder of the content of thoughts : It includes : 1- Delusion 2- Obsession 3- Preoccupation 4- Suicidal ideation

1- Delusion Definition : It is false fixed believe, not consistent with patient’s educational and cultural background, that cannot be corrected by logic or reasons

Categorization of delusions: 1- Paranoid delusions.. 2- Delusion of influence 3- Depressive delusion. 4- Hypochondria cal delusion

1- Paranoid delusion : a- Delusion of grandeur b- Delusion of persecution c- Delusion of reference d- Erotic delusion e- Delusion of jealousy f- Delusion of infidelity g- Litigious delusion

2- Delusion of influence (delusion of control) false belief that one is being controlled by others or agencies.

3- Depressive delusion a- Delusion of self-blame, guilt or sin b- Delusion of poverty c- Nihilistic delusion c- Nihilistic delusion

4- Hypochondria cal delusion Patient has false belief that he has physical disease e.g. cancer stomach,that is not based on real organic pathology.

2- Obsessive thoughts Obsessive thoughts are intrusive thoughts invading the conscious awareness against the resistance of the person in an involuntary way that is fully aware that they are unnecessary and absurd

II- Disturbance in perception 1- Hallucinations. 2- Illusion. 2- Illusion. TYPES: TYPES: Visual: Seeing things that are not there. Auditory : Hearing voices when none are present. Olfactory : Smelling smells that do not exist. Tactile : Feeling touch sensations in the absence of stimuli. Gustatory: Experiencing taste in the absence of stimuli.

III- Unreality states 1- Depersonalisation : A phenomenon whereby a person experiences a sense of unreality or self -estrangement. or self -estrangement. 2- Derealization : The false perception by a person that his or her environment has changed. Also they can be categorized under affect and perception. Also they can be categorized under affect and perception.

IV- Disorder of memory 1- Amnesia types of amnesia : types of amnesia : a- Anterograde amnesia : Loss of memory for recent events. b- Retrograde amnesia : Loss of memory for remote events. c- Total amnesia : Loss of memory for recent and remote events. d- 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. 3- Hyperamnesia : It’s excessive memory, the patient mentions 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.

V- Orientation,disorientation 1- Orientation : the ability to relate the self correctly to time,place and person. 2- Disorientation : confusion and impaired ability to identify time, place and person. VI- Judgement: is the ability to assess a situation correctly and act appropriately within that situation.

VII - Insight VII - Insight It is the ability to understand the objective condition of his illness. VIII- Attention and concentration VIII- 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.

X- Disorder of affect a- Inappropriate affect : (incongruity),it is a disharmony of affect and ideation. b- Pleasurable affect : 1- Euphoria 2- Elation 3- Exaltation 4- Ecstasy

c- Depressive affect : d- Inadequate affect 1- Apathy 1- Apathy 2- Indifference 2- Indifference e- Ambivalence g- Anxiety.Apprehension, Fear and Phobia 1- Anxiety :A state of feeling, uneasiness, uncertainty 1- Anxiety :A state of feeling, uneasiness, uncertainty 2- Apprehension :- Intense fear of any non- fearful stimulus 2- Apprehension :- Intense fear of any non- fearful stimulus 3- Fear : A reaction to a specific danger. 3- Fear : A reaction to a specific danger. 4 Phobias :- An intense irrational fear of an object, situation or place 4 Phobias :- An intense irrational fear of an object, situation or place

XI- Disorder of behaviour a- Hyperactivity :- It includes 1- Agitation 1- Agitation 2- Excitement 2- Excitement b- Psychomotor retardation c- Repetitive activities 1- Stereotypy 2- mannerism 1- Stereotypy 2- mannerism 3- Preparation 4- Way flexibility 3- Preparation 4- Way flexibility 5- Catalepsy ( posturing ) 5- Catalepsy ( posturing )

d- Echopraxia e- Negativism f- Automatic Obedience g- Impulsiveness h- Compulsion