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The manifestation of psychiatric symptoms

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Mental disorders due to general medical condition ... Personal history (anamnesis): Past illnesses (psychiatric, medical, substance abuse) ... – PowerPoint PPT presentation

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Title: The manifestation of psychiatric symptoms


1
The manifestation of psychiatric symptoms
Mental disorders due to general medical condition
Organic disorders
Symptomatic disorders
Functional disorders (psychiatric dis- ord. in
the narrow sense)
2
Basic classification of psychiatric disorders (in
the narrow sense)
Psychoses
Neuroses
Persona-lity disorders
ICD-9 (old)
Disorders Anxiety Stress Dissociative Somatofor
m Eating Sex.dysfunc
Schizophrenia Affective dis.
ICD-10 (new)
Developm. dis. Conduct dis. ADHD
Substance- related dis.
3
Psychiatric history I.
  • Identifying data, incl. data promoting involunt.
    admission
  • Family history
  • Personal history (anamnesis)
  • Past illnesses (psychiatric, medical, substance
    abuse)
  • Prenatal, perinatal history and early psychomotor
    development
  • Preschool and school history
  • Occupational history
  • Marital and relationship history, incl. sexual
    history
  • Social history and current living situation
  • Traumatic experiences

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

5
Psychiatric history III.
  • Diagnosis
  • Differential diagnosis
  • Further diagnostic plan (interviews with family
    members psychological, neurological, laboratory
    examination, imaging methods etc.)
  • Treatment plan

6
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

7
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

8
Delusion - definition
  • disturbance in thought content
  • not a solitary sign, but a part of a psychotic
    illness
  • false belief with 3 characteristics
  • false presumption
  • not consistent with patients intelligence and
    cultural background
  • cannot be corrected by reasoning

9
Delusions
  • paranoid
  • of persecution being harassed, cheated or
    persecuted
  • of grandeur exaggerated conception of
    importance, power, or identity
  • of reference behavior of others refers to the
    patient

10
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 persons will, thoughts, or
    feelings are beeing controlled by external forces
    (thought withdrawal, t. insertion,
    t.broadcasting, t. control)
  • of infidelity
  • erotomanic

11
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
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