PSYCHOPATHOLOGY

It is the study of the abnormal states of mind An attempt to understand the disease process in terms of symptoms &sings

Schools of Psychopathology
FREUDIAN Psycho analytic dynamics (the unconscious process- )scientifically un valid Clinical descriptive Psychopathology (study of phenomenology)

DESCRIPTIVE PSYCHOPATHOLOGY
It is the objective description of abnormal states of mind conscious experience &observable behavior defines essential qualities of morbid mental experiences

Disturbance of attention Disturbance of consciousness Disturbance of emotions motor behavior thought perception cognition speech Obsession Phobia Abnormal &psychopathic personalities

Disturbance of Attention
Ability to direct ones activity focus on certain experience active or inactive

Distractibility Selective inattention Trance (Twilight states) hyper vigilance

DISTURBANCE OF CONSCIOUSNESS
Consciousness is state of awareness of self & the environment. Discrepancy between the grasp of the environment &social situation ,personal appearance & occupation. Disturbance of consciousness is usually associated with:
Brain pathology
a) tumors b) infections c) trauma d) other systemic diseases affecting the brain presents with disorders of perception, attention, attitude ,thinking ,registration &orientation Altered states of consciousness range from slight noticeable confusion to deep un arousable coma GLASGO COMA SCALE

Altered states of consciousness

Include : Clouding of consciousness (associated with disorders
of perception ,attention, registration ,orientation &attitudes)

Delirium (dream like ,anxious ,confused, disoriented may hallucinate,

illusions, delusions)

Stupor (slow or lack of response ,un awareness) Coma Depersonalization Derealization

DISTURBANCE OF EMOTIONS
It is the feeling or response to sensory input from the environment or mental image. MOOD is the subjective inward experience of emotions influenced by experience, expectations, disease &drugs AFFECT is the out ward behavioral expression of emotion

MOOD

variations

Depression Dysphoria Anhedonia Apathy Euthymia Irritability Elation (elevated ,high) Euphoria Ecstasy incongruent

Motor Behavior
observable behavior that depicts aspects of psyche eg impulses ,motivations ,drive , instincts & wishes

DISORDERS OF POSTURE
a) MANNERISM & STEROTYPY b) ECHOPRAXIA c) CATATONIA

d) CATALEPSY AKISTHISIA CATATONIC EXCITEMENT AKINESIA (stupor) CATAPLEXY NEGATIVISM MUTISM COMPULSION

DISORDERS OF THOUGHT
logic sequence of goal directed flow of ideas .symbols & associations leading to reality oriented conclusion

1)Disorders in the form of thought (flow ,stream & structure) a) abstract or concrete thinking b) incoherent c) autistic d) flight of ideas e) word salad f) derailment g) thought block h) neologism i) echolalia

DISORDERS OF THOUGHT
logic sequence of goal directed flow of ideas .symbols & associations leading to reality oriented conclusion
2- Disorders in the content of thought a) Delusions these are false unshakable beliefs not consistent with intelligence & culture types of delusions: 1-guilt or worthlessness 2-nihlistic (extreme pessimism) 3-poverty 4-persecutory 5-refrence 6-infidelety (jealousy) 7-hypocondriac 8-grandiose 9-religious 10-sexual or amorus (clerambaults syndrome) (eratomania) 11-delusions of alienation 12-delusion of control b) over valued ideas these are less firmly held ideas & are successptible to reason & logic eg religious ideas

DISORDERS OF THOUGHT
logic sequence of goal directed flow of ideas .symbols & associations leading to reality oriented conclusion

3- disorders of the control , possession of thought or alienation a) thought withdrawal b thought insertion c) thought broadcasting d) obsession ( irresistible recognized own thought ) e) compulsion

Disorders of Speech
communication through the use of words & language

1. Functional Disorders Stammering & stuttering Mutism ( poverty of speech ,a phonia ) Talking past the point ( pseudo dementia, Ganser syndrome) Neologism Word salad (speech confusion) 2. Aphasia (motor or sensory) 3. Pressure of speech 4. Poverty of speech

DISORDERS OF PERCEPTION
1- Disorders of sensory distortion (a distorted perception of a
real stimulus)

a) change in intensity (hyperaesthesia) (perceive a cow as a lion) b) changes in quality (qualitative change of perception not hallucination) (see green as blue ) c) changes in spatial forms (Lilliputian hallucinations = micropsia) (dysmegalopsia = megalopsia, or macropsia )

Disorders of perception
2- Sensory deceptions a) Hallucinations (false sensory perception without an external stimulus ) auditory 1st ,2nd,3rd, persons either commentary, command or argumentative visual olfactory gustatory tactile (habtic) deep sensations (formications) hypnagogic & hypnapompic (NORMAL) b) Illusions (abnormal perception in presence of an external stimulus )

Disorders of Cognitive Functions

1. Memory (immediate, recent, long term)
Amnesias confabulations dj vu ,jamma vu

2. Thinking
1.

Abstract or concrete with previous experience)

3. Intelligence (constructive integration& utilization of new information 4. Orientations (time , date , place & person) 5. Judgement 6. Insight