SYMPTOMATOLOGY

https://www.youtube.com/watch?v=g9GSh7163Jk

By: Shamayinda
Chainama College of Health Sciences
Dept: Mental Health & Clinical Psychiatry
Cell: 0978495511
 Intro’
Def: The study of the relationships between
symptoms and condition
• A set of symptoms that are associated with a
disease or that affect a patient
 Psychopathology
• Study of the abnormal state of the mind
a. Disorders of Perception- These are disorders the affect
sensory organs
– Sensory Deceptions
i. Illusion -A misperception or misinterpretation of
a real external stimulus, such as hearing the
rustling of leaves as the sound of voices. There is
owz a misinterpretation of a real external stimuli
ii. Hallucination- apparent misperception of the
external stimuli in the absence of a real existing
stimuli
 Types of Hallucinations
i. Auditory- pt hears a sound or voice without any
stimulus. Common in medical & psychotic
conditions. Types of Auditory hallucinations -
Types of Auditory hallucinations
i. Second person-talking directly to the pt. May be found in
depression or Schizophrenia
ii. Third person-Voices talk among themselves abt the pt.
Common in Schizophrenia
iii. Commentary voices- A voice or voices talking or
describing what is pt is doing or thinking
ii. Olfactory- misperception of the sense of smell.
Common in medical conditions i.e. epilepsy &
CNS
 Types of Hallucinations
iii. Visual Hallucination- misperception of the
sense of sight.
• It involves sight of both formed images e.g. pipo
or unformed images such as light
• Common in medical disorders of the CNS bt may
oso be present in psychotic condition
iv. Tactile- false perception of the sense of touch
• There is surface sensation as in amputated limb,
crawling sensation on or under skin
• Common in substance abuse & psychotic
condition
 Types of Hallucinations
v. Gustatory- false perception of the sense of
taste without a stimulus
• Common in medical conditions that affect the
CNS such as focal epilepsy, espl temporal lobe
epilepsy
 Sensory Distortions
i. Macropsia- It’s a false perception that
objects are lager than they really are
ii. Micropsia- It’s a false perception that objects
are smaller than they really are
 Disorders of Emotion
i. Anxiety- Feeling of apprehension (fear)
caused by anticipation of danger or
misfortune accompanied by a feeling of
dysphoria or somatic symptoms such as
headache, perspiration, palpitation
ii. Phobias- persistent & irrational fear of &
wish to avoid specific objects & situations.
• Fear is irrational in the sense that it is out of
proportional of the real danger & is only
recognized by the person experiencing it
 Disorders of Emotion
iii. Depressed Mood- Psychopathological &
exaggerated feeling of sadness
iv. Elated Mood- An exaggerated feeling of joy or
abnormal happiness associated with motor
activity
v. Euphoria- intense exaggerated feeling of well-
being dt z inappropriate 2real events-substance
abuse(opiates, amphetamine, alcohol)
Heightened feeling of psychological well-being
in inappropriate to events
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 Disorders of Emotion
vi. Lability of Affect- Rapid shift in outward
emotional expression or emotional change in an
excessive & rapid way e.g. sharp change of
emotion frm sadness 2happiness
vii. Blunting of Affect- represents significant
reduction in the intensity of emotional expression
e.g. a person who doesn’t show significant
facial/emotional change
 Disorders of Emotion
viii. Incongruity of Affect- inappropriate
response to a situation or reacting in a way that
is different from what is expected
 Disorders of Thought
• Disorders of Stream of Thought
• Flight of Ideas- Content of speech moves quickly
from one idea to another so that one train of speech
is not completed b4 another is introduced
• The normal logical sequence of idea is generally
preserved
• When severe speech may be disorganized and
incoherent.

b. Retarded Thinking- Slow, laborous flow of thot

process ass with continous delay in expressing
thots wth omost no progress. Common in
depression
 Disorders of Thought Cont'
• c. Circumstantiality- disorder in which too
many associated ideas come into
consciousness because of too little selective
suppression
• Or over inclusion of trivial or irrelevant details
dt disturbs/hinders the sense of getting 2the
point
• Pt digresses into unnecessary & inappropriate
thots b4 communicating the central idea
Disorders of Continuity of Thought
i. Perseveration- Persistant & inappropriate
repetion of the same thots. e.g. In reply to a
question a person may give the correct answer
to the 1st bt continue 2giv the same answer to
subsequent questions
ii.Thought Blocking- refers to the sudden arrest
in the flow of thots
• The prevoius idea may then be taken up again
or replaced by another thot
 Disorders of the Portion of Thought
i. Obsessions- recurrent/persistent thot, impulses
or images that enter the mind despite the
person's effort to exclude them e.g. observing
the death of a loved one, pornographic
sceneries

ii. Compulsions- these are repetitive &

seemingly purposeful behaviors performed in a
stereo-typed way
• A recurrent, unwanted & distressing urge to
perform an act
 Portion of Thought contd'
• They are accompanied by a subjective sense
that they must be carried out
• Failure 2perform the compulsive act gives
raise 2anxiety & tension
• Example include
– Hand-washing
– touching
– counting
– checking
 Thought Alienation
• Thought Insertion- Persons belief that some
of his/her thought are not his/hers own but
have been implanted by an outside agency
• Thought Broad Casting- Persons belief that
unspoken thoughts are known to other pipo
thru radio, telepathy or in some other way
• Thought Withdrawal- Belief that thoughts
have been taken out of the mind
 Disorders of the Content of
Thinking
• Delusion: false , firmly held belief on
inadequate grounds wch is not affected by
rational argument or evidence
• Primary Delusions- One that appears
suddenly & with full conviction but without
any mental event leading to it
• Secondary Delusions-Can be understood as
derived from some preceding mental illness or
morbid experience
 Types of delusions
• Bizarre delusion- strange false fixed belief that is
implausible (hardly likely to be true) & not understandable &
is not derive from ordinary life experiences.eg. a
person believing aliens have removed part of their
brain
• Non-Bizarre- false fixed belief that may potentially
occur in daily life, e.g. a belief that a partner is
unfaithful.

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 Types of delusions
• Persecutory delusion-It’s a false fixed belief dt a
client is being followed, spied upon, obstructed,
poisoned, conspired against or harassed by other
individuals or an organization.
• As a result, the sufferer may retaliate violently
against the persecution and/or turn to the law &
other government agencies for support.
• Most common form of delusional disorder

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 Types of delusions
• Paranoid delusions- involving suspiciousness or
the belief that one is being harassed, persecuted,
or unfairly treated.
• Grandiose delusion- A belief of exaggerated self
importance or that a client is much greater or more
influential than he/she really are.
• The patient may think of himself as wealthy, endowed
with unusual abilities or special person
• Nihilistic delusions- Delusion of non- existence
of some pipo or things e.g. body part missing
 Types of delusions
• Delusions of jealous – Jealous preoccupations
with some obsessional thoughts concerning
doubts abt the spouse’s fidelity
• When the beliefs are strong they may lead to
dangerously aggressive behavior towards the
person thought to be unfaithful
• common among men
 Types of delusions
• Delusions of poverty- belief that one is
impoverished or destitution

• Delusions of jealous- belief that one’s

spouse/lover is unfaithful, based on erroneous
inference drawn from innocent events
imagined to be evidence
 Types of delusions
• Delusion of control-false belief that another
person, group of people, or external force controls
one's thoughts, feelings, impulses, or behaviour.
• A person may describe, for instance, the
experience that aliens actually make him or her
move in certain ways and that the person affected
has no control over the bodily movements.

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 Types of delusions
• Delusion of reference-The person falsely
believes that insignificant remarks, events, or
objects in one's environment have personal
meaning or significance. E.g. a person may believe
they are receiving special messages from newspaper
headlines; they are being talked about on the radio/tv.
• Delusion of guilt- false feeling of remorse or
guilt dt 1 has committed some horrible crime &
should be punished severely. E.g. a person who is
convinced he is responsible for some disaster
(such as fire, flood, or earthquake) with which
there can be no possible connection.
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 Types of delusions
• Religious delusion: Any delusion with a
religious or spiritual content. Client believes that
that they have received special powers,
communicate with God or can perform miracles.
• NB: Beliefs are considered normal for an
individual's religious or cultural background
• Erotomania- is a delusion in which one believes
that another person of is in love with him or her.
• They believe that this other person was the first to
declare his or her affection, often by special
glances, signals, telepathy, or messages through
the media.
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 Types of delusions
• Somatic delusion: A delusion whose content
pertains to bodily functioning, bodily sensations,
or physical appearance.
• Usually the false belief is that the body is
somehow diseased, abnormal, or changed—for
example, infested with parasites.
• Somatic delusion: A delusion whose content
pertains to bodily functioning, bodily sensations,
or physical appearance. Usually the false belief is
that the body is somehow diseased, abnormal, or
changed—for example, infested with parasites.
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 Disorders of form of Thinking
• Loosening of Association- A disturbance of
thinking shown by speech in which ideas shift
from one subject to another that is unrelated or
minimally related to the first
• Loose of normal structure of thnkn in wch speech
z muddled, illogical & cnt b clarified by further
inquiry (lack of clarity in speech)
Disorders of form of Thinking
• Derailment- A pattern of speech in which a
person's ideas slip off from one track onto
another that is completely unrelated or only
obliquely related
• Or abnormality in speech that z extreme &
disrupts not only the connections btn
sentences but also fine grammar of speech
i.e. disorganized schizophrenia, profound
mental retardation

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 Disorders of form of Thinking
• Substitution- A defense mechanism, operating
unconsciously, by which an unattainable or
unacceptable goal, emotion, or object is
replaced by one that is more attainable or
acceptable
• Omission-pipo fail to recollect a prior event
when they try to retrieve it
 Functional Speech Disorders
• Mutism-absence of speech which can be partial
or completely motoric inhibited
• Neologisms- entirely newly invented words or
phases only understood by pt e.g. sarrible to
mean sad & terrible
• Stammering- disturbance in the rhythm &
fluency of speech
• Characterized by spasmodic, halting or hesitating
speech
• May be repetition of syllables, words or blocks in
production of speech
 Organic Speech Disorders
• Aphasias (Receptive, Expressive)-An impairment
in the understanding or transmission of ideas by
language in any of its forms:
• reading,
• writing, or
• Speaking
• Or a disturbance in comprehension or expression
of language due 2brain lesion
 Disorders of Memory
• Psychological Amnesia-Loss of functional
memory in the absence of structural brain
damage or known neurological cause

Types of amnesia
i. Anterograde- Loss of memory of events that occur
after the onset of the etiological condition or agent.
ii. Retrograde-Loss of memory of events that occurred
before the onset of the etiological condition or
agent.
 Disorders of Memory
• Distortions of Memories- remembering events
quite different from the way they happened or
recalling an event that never happened

• Confabulations- spontaneous & unconscious

production of false memories of events which never
occurred or of actual events but which are displaced in
space & time
 Disorders of Memory
• Dejavu- Strong sensation that an event
or experience currently been experienced
has already been experienced in the past
• Feeling of familiarity
• Jamais vu- failure 2recall / recognize
events dt have been encountered
or experienced
• Misidentification-Belief that the identity
of a person, object or place has changed
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or been altered
 Motor Disorder
• Akathisia-subjective feeln of restlessness
manifested by a compelling need to be in
constant movement-seen as a SE of
antipsychotics
• Parkinsonism- syndrome characterized by
muscle rigidity & tremors at rest
• Acute dyskinesia- A state of abnormal muscle
tone, posture, or involuntary movements
• Tardive dyskinesia- syndrome characterized by
involuntary movement of muscles of the tongue,
lips, face & the extremities
 Disorders of Experience of Self
• Ego Boundaries-A sense or awareness that
there is a distinction btn the real & the
unreal
• Depersonalization-sensation of unreality
concerning oneself, part of self or
environment that occurs under extreme
stress or fatigue
• A feeling that your body is unreal, changing or
dissolving
• It includes out-of-body experiences such as
seeing yourself as if watching a movie
 Disorders of Consciousness
• Disorientation- impairment in awareness
regarding time, place & pipo
• Clouding of consciousness- state of drowsiness
in which a pt reacts incompletely to stimuli
-Attention, concentration & memory are impaired &
orientation is disturbed
• Coma-profound degree of unconsciousness frm
wch a pt cnt respond 2stimuli
• Common in brain injury, alcohol intoxication,
catatonic state or conversion disorder
 Disorders of Consciousness
• Twilight state-state in which pt, otho not
asleep describes experiences of vivid imagery
2that of a dream.
• A disturbance of consciousness characterized
by hallucinations

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 Disorders of Consciousness
• Stupor- A state of reduced reaction to
stimuli & reduced awareness of one’s
environment (partial coma/ semi-coma)
• Patient is immobile, mute & unresponsive but
seems to be fully awake
• Delirium- syndrome characterised by
disturbed consciousness, cognitive function
or perception
 NDATOKODZA

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