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

The manifestation of psychiatric
symptoms
Organic
disorders
Mental disorders
due to general
medical condition
Functional
disorders
(psychiatric disord. in the
narrow sense)
Symptomatic
disorders
Basic classification of psychiatric
disorders (in the narrow sense)
ICD-9
(old)
Psychoses
Neuroses
Personality
disorders
ICD-10
(new)
Schizophrenia
Affective dis.
Disorders:
Anxiety
Stress
Dissociative
Somatoform
Eating
Sex.dysfunc
Developm.
dis.
Conduct
dis.
ADHD
Substancerelated dis.
Psychiatric history I.
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Identifying data, incl. data promoting involunt.
admission
Family history
Personal history (anamnesis):
1.
2.
3.
4.
5.
6.
7.
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
Psychiatric history II.
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Present illness
1.
2.
3.
Onset, precipitating factors
Course, periodicity
Chief complaint and problem
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Mental status examination
1.
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.
2.
3.
4.
5.
6.
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
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auditory, visual, olfactory, gustatory, tactile, somatic (visceral)
micropsia
mood-congruent and –incongruent hallucinations
command hallucination
Formal thought disturbances
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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
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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
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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