sign & symptom dr seddigh signs and symptoms consciousness emotion motor behavior thinking...

Sign & symptom

DR SEDDIGH

Signs and Symptoms

Consciousness

Emotion Motor

behavior Thinking Speech

Perception Memory Intelligence Insight Judgment

Ⅰ. Consciousness

A. Disturbance of consciousness

1. Disorientation ; impairment of awareness of time, place, and person Characteristic of cognitive disorders.. 2. Clouding of consciousness not fully awake, alert, and oriented. Occurs in delirium, dementia, and cognitive disorder.3. Delirium Acute reversible mental disorder characterized by confusion and

some impairment of consciousness;

4. Alert – drowsy-stupor-semicoma-coma 5. Confusion

B. Disturbances of attention

1. Distractibility Inability to focus one's attention; 2. Selective inattention 3. Hypervigilance, excessive attention , and focus on, all internal

and external stimuli; usually seen in delusional or paranoid states.4. Trance Sleep-like state of reduced consciousness and

activity.

II. Emotion mood Pervasive and sustained feeling influence virtually all

aspects of a person's behavior and perception of the world.

affect Affect has outward manifestations that can be classified

as restricted, blunted, flattened, broad, labile, appropriate, or inappropriate.

II. Emotion 1. Euthymic mood Normal range of mood, implying absence of

depressed or elevated mood.

2. Appropriate affect 3- inappropriate affect

II. Emotion

1. Broad affect 2. Blunted affect 3. Restricted or constricted affect 4. Flat affect

II. Emotion

1. Mood swing,

Oscillation of a person's emotional feeling tone between periods of elation and periods of depression.

2.Labile affect

Affective expression characterized by rapid and abrupt changes, unrelated to external stimuli.

3.Irritable mood

State in which one is easily annoyed and provoked to anger. See also irritability.

II. Emotion

1. Elevated mood Air of confidence and enjoyment; not pathological.2. Euphoria Exaggerated feeling of well-being that is inappropriate to real events. Can occur with drugs such as opiates, amphetamines, and alcohol.3. Exaltation Feeling of intense elation and grandeur.4. Ecstasy 5. Hypomania 6. Mania 7.Elation Mood feelings of joy, euphoria, intense self-satisfaction or optimism. Occurs in mania when not grounded in reality.

II. Emotion 1. Dysphoric mood 2. Grief or mourning 3. Depression 4. Anhedonia Loss of interest in Often associated with depression.5. Melancholica Severe depressive state. 6. Alexithymia Inability or difficulty in describing one's emotions or moods with depression, substance abuse, and posttraumatic stress

disorder (PTSD).

II. Emotion G. Other emotions1. Anxiety anticipation of danger, 2. Free-floating anxiety:Severe, pervasive, generalized anxiety that is not

attached to any particular object, Observed particularly in anxiety disorders, in some

cases of schizophrenia. 4. Agitation Severe anxiety associated with motor restlessness. 5. Tension Physiological or psychic arousal,

II. Emotion 6. Panic Acute, intense attack of anxiety 7. Ambivalence Coexistence of two opposing impulses toward the same

thing in the same person at the same time. Seen in schizophrenia, borderline states, and obsessive-

compulsive disorders (OCDs).8. Shame 9. Guilt 10.Impulse control Ability to resist an impulse, drive, or temptation to

perform some action.

Ⅲ. Motor behavior

1.Hyperactivity Increased muscular activity. Seen in attention-deficit/hyperactivity disorder (ADHD).2. Psychomotor agitation Physical and mental overactivity seen in agitated depression.3. Akathisia Subjective feeling of motor restlessness manifested by a

compelling need to be in constant movement; seen as an extrapyramidal adverse effect of antipsychotic

medication 4. Hypoactivity Decreased motor and cognitive activity Also called hypokinesis.

Ⅲ. Motor behavior1. Stereotypy Continuous mechanical repetition of speech or physical activities; observed in catatonic schizophrenia.2. Mannerism Ingrained, habitual involuntary movement.3.Tic involuntary, spasmodic, stereotyped movement of small groups of

muscles; 4. Command automatism Condition associated with catalepsy in which suggestions are followed

automatically.5. Echopraxia 6. Echolalia repeating of words or phrases of one person by another; Seen in schizophrenia, particularly the catatonic types.

Ⅲ. Motor behavior

1. Catatonia postural abnormalities2. Catalepsy maintain the body position into which they are placed; observed in severe cases of catatonic schizophrenia. Also called waxy flexibility and cerea flexibilitas. 3. Negativism Verbal or nonverbal opposition or resistance to outside

suggestions and advice; commonly seen in catatonic schizophrenia 4. waxy flexibility Also called catalepsy

Ⅲ. Motor behavior1. Ritual (1) Formalized activity practiced by a person to reduce anxiety, as in OCD. (2) Ceremonial activity of cultural origin.2. Kleptomania Pathological compulsion to steal. 3. kleptomania 4. Trichotillomania 1. Acting out Behavioral response to an unconscious drive or impulse Common in borderline states. 2. Ataxia Lack of coordination (1) In neurology, refers to loss of muscular coordination. (2) In psychiatry, the term intrapsychic ataxia refers to lack of coordination

between feelings and thoughts; seen in schizophrenia and in severe OCD.

Ⅳ. Thinking

A. General disturbances in form of process of thinking

B. General disturbances in content of thinking


1. Reality testing the ability to differentiate between the external world and the internal

world 2. Autistic thinking Thinking in which the thoughts are largely narcissistic and egocentric,Seen in schizophrenia and autistic disorder.

3. Magical thinking in which thoughts, words, or actions assume power (e.g., to cause or to

prevent events). 4. Fantasy Daydream;


5. Incoherence

Communication that is disconnected, disorganized, or incomprehensible.

6. Illogical thinking

Thinking containing erroneous conclusions 7. Neologism New word or phrase whose derivation cannot be understood; often seen in schizophrenia. . 8. Word salad Incoherent, essentially incomprehensible, mixture of words and

phrases commonly seen in schizophrenia.


9. Circumstantiality unnecessary details Observed in schizophrenia, obsessional disturbances, and

certain cases of dementia. 10. Tangentiality Oblique, digressive, or even irrelevant manner of speech in which the

central idea is not communicated.

11. Perseveration (1) Pathological repetition of the same response to different

stimuli, Seen in cognitive disorders, schizophrenia, and other mental

illness. See also verbigeration.


12. Loosening of association unrelated and unconnected ideas shift from one subject to

another 13. Flight of idea Rapid succession of fragmentary thoughts Seen in mania.14. Blocking Abrupt interruption in train of thinking (also known as thought deprivation or increased thought latency). Common in schizophrenia and severe anxiety.15. Clang association Association or speech directed by the sound of a word

rather than by its meaning; Seen most frequently in schizophrenia or mania.


15. Irrelevance Answer that is not responsive to the question.16. Verbigeration Meaningless and stereotyped repetition of words

or phrases, as seen in schizophrenia. Also called cataphasia. 17. Echolaria


delusion . 1) Bizarre delusion False belief that is patently absurd or fantasticCommon in schizophrenia.

2) Nihilistic delusion Depressive delusion that the world and everything related

to it have ceased to exist. 3)Delusion of poverty

False belief that one is bereft or will be deprived of all material possessions.


delusion 4) somatic delusion Delusion pertaining to the functioning of one's body.5) Persecutary delusion Most common delusion. 6) grandious delusion Exaggerated conception of one's importance, power, or

identity.7) delusion of reference


delusion

8) delusion of self-accusation False feeling of remorse and guilt. Seen in depression with psychotic features. 9) delusion of controll False belief that a person's will, thoughts, or feelings are being controlled

by external forces. a. thought withdrawa lDelusion that one's thoughts are being removed from one's mind by other

people or forces b. thought insertion Delusion that thoughts are being implanted in one's mind by other people or

forces. c. thought broadcasting Feeling that one's thoughts are being broadcast or projected into the

environment


Delusion 10) delusion of infidelity (delusional jealousy 11) erotomania preoccupation of thought Centering of thought content on a particular

idea, associated with a strong affective tone, such as a paranoid trend or a suicidal or homicidal preoccupation.


4. Hypochondria unrealistic interpretations of physical signs or sensations

as abnormal. 5. Obsession & compulsionPersistent and recurrent idea, thought, or impuls

6. Phobia Persistent, pathological, unrealistic, intense fear

of an object or situation; 7.Suicide Thoughts or act of taking one's own life.

V. Speech1. pressure of speech Increase in the amount of spontaneous speech; rapid, loud,

accelerated speech, as occurs in mania, schizophrenia, and cognitive disorders. 2. Poverty of content of speech Speech that is adequate

in amount but conveys little information because of vagueness, emptiness, or

stereotyped phrases. 3. Dysarthria Difficulty in articulation, 4.Stuttering Frequent repetition or prolongation of a sound or syllable,

leading to markedly impaired speech fluency.

Perception 1. Hallucination False sensory perception occurring in the absence stimulation 2. Illusion Perceptual misinterpretation of a real external stimulus 3. Depersonalization Sensation of unreality concerning oneself, Seen in schizophrenia, depersonalization disorder, and

schizotypal personality disorder. 4.Derealization Sensation of changed reality or that one's surroundings have

altered. Usually seen in schizophrenia, panic attacks, and dissociative

disorders.4. Agnosia Inability to understand the import or significance of

sensory stimuli;

Perception

1. hallucination 1) auditory hallucination 2) visual hallucination 3) olfactory hallucination 4) gustatory hallucination 5) tactile hallucination 6) somatic hallucination Hallucination involving

the perception of a physical experience localized within the body.

2. illusion

Perception 6. fugue Dissociative disorder characterized by a period of almost

complete amnesia, during which a person actually flees from an immediate life situation and begins a different life pattern;

Ⅶ. Memory

Levels of memory 1. Immediate Reproduction, recognition, or

recall of perceived material within seconds after presentation.

2. Recent Recall of events over the past few days.

3. Recent past Recall of events over the past few months.

4. Remote Recall of events in the distant past.

Ⅶ. Disturbances of Memory

1.Amnesia Partial or total inability to recall past experiences 1) Anterograde Loss of memory for events subsequent to the onset of the

amnesia; common after trauma 2) Retrograde Loss of memory for events preceding the onset of the

amnesia.

2. Blackout Amnesia experienced by alcoholics about behavior during

drinking bouts; usually indicates reversible brain damage.

Ⅶ. Disturbances of Memory 1) Confabulation Unconscious filling of gaps in memory by

imagining experiences or events that have no basis in fact, 2) Déjà vu Unconscious filling of gaps in memory by imagining experiences or

events that have no basis in fact 3) Jamais vu Paramnestic phenomenon characterized by a false feeling of

unfamiliarity with a real situation that one has previously experienced.

4) Deja pens Condition in which a thought never entertained before is incorrectly

regarded as a repetition of a previous thought. See also paramnesia.5) Deja entendo Illusion that what one is hearing one has heard previously. See also

paramnesia.

Ⅷ. intelligence

1. mental retardations ; sufficient lack of intelligence to interfere with

social and vocational performance: mild (IQ of 50 or 55 to approximately 70) moderate (IQ of 35 or 40 to 50 or 55) severe (IQ of 20 or 25 to 35 or 40) profound (IQ below 20 or 25)

Ⅷ. intelligence

2. concrete thinking Thinking characterized by actual things, events, and immediate experience rather than by abstractions; seen in young children, in those who have lost or never developed the ability to generalize (as in certain cognitive mental disorders), and in schizophrenic persons. Compare with abstract thinking.

3. Abstract thinking Thinking characterized by the ability to grasp the essentials of a whole, to break a whole into its parts, and to discern common properties. To think symbolically.

Ⅸ. Insight

A. Intellectual insight Knowledge of the reality of a situation without the ability to use that knowledge successfully to effect an adaptive change in behavior or to master the situation. Compare with true insight.

B. True emotional insight A level of understanding or awareness that one has emotional problems. It facilitates positive changes in personality and behavior when present.

C. Impaired insight Diminished ability to understand the objective reality of a situation.

Ⅹ. Judgment

1. critical judgment 2. Automatic judgment 3. Impaired judgment Diminished ability to

understand a situation correctly and to act appropriately.

DSM-Ⅳ Multiaxial system

Axis Ⅰ Clinical disorder

Axis Ⅱ personality disorder-iq-defense mechanism

Axis Ⅲ general medical condition

Axis Ⅳ Psychosocial stressor

Axis Ⅴ (global assessment of functioning, GAF)

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sign & symptom dr seddigh signs and symptoms consciousness emotion motor behavior thinking...

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consciousness slide

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emotion mood swing

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dysphoric mood

irritable mood state

blunted affect restricted