The manifestation of psychiatric symptoms Organic disorders Symptomatic disorders Functional disorders (psychiatric dis- ord. in the narrow sense) Mental disorders due to general medical condition

Basic classification of psychiatric disorders (in the narrow sense) PsychosesNeuroses Persona- lity disorders ICD-9 (old) Schizophrenia Affective dis. Disorders: Anxiety Stress Dissociative Somatoform Eating Sex.dysfunc ICD-10 (new) Developm. dis. Conduct dis. ADHD Substance- related dis.

Psychiatric history I. Identifying data, incl. data promoting involunt. admission Family history Personal history (anamnesis): 1.Past illnesses (psychiatric, medical, substance abuse) 2.Prenatal, perinatal history and early psychomotor development 3.Preschool and school history 4.Occupational history 5.Marital and relationship history, incl. sexual history 6.Social history and current living situation 7.Traumatic experiences

Psychiatric history II. Present illness 1.Onset, precipitating factors 2.Course, periodicity 3.Chief complaint and problem Mental status examination 1.General description (orientation, appearence, behavior, atttitude, speech ) 2.Mood and affectivity 3.Perception (e.g.,hallucinations) 4.Thought process and content (e.g.formal thought disturb., delusions) 5.Memory. 6.Judgment and insight, suicidal thoughts.

Psychiatric history III. Diagnosis Differential diagnosis Further diagnostic plan (interviews with family members; psychological, neurological, laboratory examination, imaging methods etc.) Treatment plan

Disturbances of perception illusion = misperception of real external sensory stimuli hallucination = false sensory perception not associated with real external stimuli auditory, visual, olfactory, gustatory, tactile, somatic (visceral) micropsia mood-congruent and –incongruent hallucinations command hallucination

Formal thought disturbances neologism = new word created by a patient word salat = incoherent mixture of words and phrases incoherence = no logical or grammatical connection perseveration = persisting response to a previous stimulus after a new stimulus has been presented verbigeration = meaningless repetition of words/phrases loosening of associations = shift without logical relation blocking = abrupt interruption in train of thinking

Delusion - definition disturbance in thought content not a solitary sign, but a part of a psychotic illness false belief with 3 characteristics: 1.false presumption 2.not consistent with patients intelligence and cultural background 3.cannot be corrected by reasoning

Delusions paranoid 1.of persecution = being harassed, cheated or persecuted 2.of grandeur = exaggerated conception of importance, power, or identity 3.of reference = behavior of others refers to the patient

Delusions nihilistic = self, others, or the world is nonexistent of poverty = to be bereft of all material possessions somatic = incvolving functioning of the body of self-accusation = feeling of remorse and guilt delusion of control = person´s will, thoughts, or feelings are beeing controlled by external forces (thought withdrawal, t. insertion, t.broadcasting, t. control) of infidelity erotomanic

Catatonic symptoms catatonic stupor = markedly slowed motor activity, often to a point of immobility catatonic excitement = agitated, purposeless motor activity catatonic posturing = voluntary assumption of an inappropriate or bizarre posture echopraxia = pathological imitation of movements stereotypy = repetitive fixed pattern of physical action mannerism = habitual involuntary movement command automatism = automatic following of suggestions