PSYCHIATRIC TERMINOLOGIES

Presented by- Jasleen Kaur Brar

Types of personality• Cyclothymic personality: person with cyclothymic

personality has alternating periods of elation and depression. These people are predisposed to manic depressive or affective psychosis.

• Hypomanic personality: these people are outgoing ,cheerful, confident, aggressive, full of energy. They do not like failure. They are pleasure loving people. They are predisposing to manic episodes.

• Melancholic personality: these kind of people are kind, quite, submissive, sympathetic and gloomy. They feel helpless and pessimistic. They are predispose to depression.

• Paranoid personality: People with paranoid personality suspects other people will harm them. These people are predispose to paranoid schizophrenia.

• Schizoid personality: The persons having this type of personality are quite, withdrawn and remain aloof. These people are shy, timid and self conscious. They may develop schizophrenia.

• Obsessive compulsive personality: people with this type of personality are rigid to their behavior, stick to what they say to want. They do their work with perfection. They feel uncomfortable if anything is changed or moved against their wish.

• Hysterical personality: People show the cluster of traits emotional, exhibitionism, sexual provocativeness, dependence, suggestibility and aggressiveness.

Deviation from normal behaviorDisturbance of consciousness

Disorders of motor activity

Disorders of perception

Disorders of thought

Disorders of affect

Disorders of memory & intelligence

Disorders of orientation

Disturbances of consciousness• Confusion- it is characterized by disturbance of

orientation to time, place and person and also disturbance of associative functioning.

• Clouding of consciousness- the patient has disturbance of clear mindedness. The capacity to think, perceive, respond and remember is impaired.

• Stupor- individual’s activity is reduced to minimum. The patient remains motionless and mute but movement of eyes and respiration occur.

• Delirium- A state of mental confusion and excitement characterized by disorientation for time and place, often with hallucinations, incoherent speech, and a continual state of aimless physical activity.

• Dream state- it is an altered state of consciousness like a dream state. It is accompanied by visual, auditory and olfactory hallucinations and is believed to be associated with temporal lobe lesions.

Disorders of motor activity• Increased activity-the person impulsively ruses

about for an activity. The activity is not well organized and it is purposeless. As in case of manic patient, he first starts with an activity, then with another and leaves it. Any activity taken up by him is never completed.

• Decreased activity-(psychomotor retardation) the patient takes too long to start the activity. After starting the patient takes too much time to complete it.

• Dysactivity- it include-

• Repititious activity- repetitious especially needless or purposeless activity. When there is continuous repetition of any action, it is called stereotype activity. It can be in position, movement and speech.

• Stereotype position- continous maintained position without any movement. Also called cateplexy or waxy flexibility.

• Stereotype movement- also known as mannerism e.g. repeated touching the neck while talking, lifting the shoulder and swallowing the saliva while talking.

• Stereotype speech– repetition of words, phrases or sentences.

• Negativism- the individual is aware of the stimuli but he is trying to oppose these actively or passively. The patient does the opposite of what he is asked to do.

• Automatism- the condition in which activity is carried out without conscious knowledge on the part of the patient.

• Compulsion- repeatedly performing an act which may look unreasonable to the viewers and individual himself.

• Violence-it is an aggressive behavior in which physical force is exerted.

• Suicide- violence towards self may lead to suicide or an act of killing oneself.

Disorders of perception• Illusions: These are misinterpretation of sense

impressions or stimuli. is a subjective perversion of an objective content.

• E.g. A patient sees a rope and misinterpret it as a snake.

• Hallucinations: It is a sensory experience or perception of stimulus in the absence of a stimulus or an object. Common types of hallucinations are as follow:

• Auditory hallucination: It involves the sense of hearing. The patient hears the voices of people talking, buzzing sounds or ill defined sounds. The patient may hear voices telling him what to do, communication on his actions, criticising his actions or giving suggestions.

• Visual hallucinations: It involves the sense of sight. The patient sees version, usually of clearly defined people or objects.

• Olfactory hallucinations: It involves the sense of smell. The smell is commonly horrible and unpleasant.

• Gustatory hallucinations: It involves the sense of taste and smell.

• Tactile hallucination: It involve the sense of touch.

• Kinesthetic hallucination: It is false perception of movement or sensation as from phantom limb.

• Macropsia: It is state in which the objects appears larger than they are.

• Micropsia: It is state in which objects appears smaller than they are.

Disorders of thought

There are three aspect of disorder.• Form of thought• Content of thought• Rate of speech/progression of thought.

FORM OF THOUGHT-• Circumstantiality- Patient includes in his

conversation many un necessary details and explanation before the goal is finally reached.

• Incoherence-There is disordered and disconnected thinking in which no sense can be extracted from patient speech.

• Irrelevant- When the patient does not answer appropriately to the question.

• Tangentiality- In this disorder, patient includes in the conversation many unnecessary details and explanations but goal is never reached.

• Neologism- Patient may invent his own language and use new words. It is the coinage of new words usually by condensing several other words each of which has special meaning for the patient.

• Word Salad- Isolated, disconnected words mixed up in a hopeless jumble.

• Perseveration- It is the involuntary and morbid repetition of a specific word or ideas which persists inspite of patient efforts to move on to a new idea.

• Ambivalence- When two contradictory ideas, emotions, attitude or wishes exist in the mind of the patient and they are allowed to exist without objection of either.

CONTENT OF THOUGHT: At the content level the disorders the disorders of thought are described as delusions, obsession, phobia, preoccupation and fantasy.

• DELUSIONS-These are the false beliefs , which are irrational and not shared by persons of same race , age and standard of education, which is held by conviction, which cannot be altered by logical arguments and which are persistent. Delusions include:

• Persecutory delusions: In this the person beliefs that he is being interfered with or threatened or mistreated or being poisoned or discriminated against by his family members, neighbours or friends.

• Delusions of reference: These refers to delusional beliefs that either people are talking about him or referring to him or action of people intended to have some special significance for him.

• Delusions of influence: Delusional belief of an individual that enemies are influencing him in many ways and that his bodies, his emotions and his feelings are controlled by others.

• Delusions of guilt: Delusional belief of an individual that he have committed some sins or committed some wickedness in his past life that have brought calamity to others or have ruined his family.

• Delusions of grandeur: Delusional belief of great power. Wealth and influence. These are commonly seen in manic states.

• Delusions of infadability: Delusional belief that his/her spouse is having relations with other man/woman. These are suspicious thoughts for spouse about his/her character.

• Nihilistic delusions: Delusional belief that nothing exists, that the whole world is destroyed, that some has fallen on one or more of his relatives patient may also state that he is dead or that certain part of his body is died ceased to function. It has two forms:

a) Derealization: Delusional belief that all the things in the environment have changed or destroyed.

b) Depersonalization: Delusional belief that patient himself has changed or dead.

• OBSESSION- This refers to fixed and reoccurring ideas, thoughts in the patients mind and that cannot be eliminated from consciousness by logical efforts.

• PHOBIA- It is irrational or morbid fear with morbid anxiety or it is an exaggerated and pathological dread of some specific type of stimulus or situation.

• PREOCCUPATION-When thought content centres around a particular idea and is associated with a strong effective tone.

• FANATSY-It is a product of imagination. It is a mental representation of a scene or occurrence that is recognized as unreal but is either expected or hoped for. Fantasy can be of two type:

• CREATIVE: Which prepares the person for some later action.

• DAY DREAMING: Which is the refuse for wishes that cannot be fulfilled in reality.

• PROGRESSION OF THOUGHT/RATE OF SPEECH- It is referred to as association of each idea with the one that has proceeded. It is also known as stream of thought or stream of talk.

• Pressure of speech: The speech or flow of thought is too rapid that it is difficult for the listener to interrupt. It is seen in the state of excitement and over-activity.

• Flight of ideas: When pressure of talk is more severe, there is tendency of the patient to start talking on one subject and then switch to another subject and then another with little connection between them.

• Thought retardation: In thought retardation, the initiation and movement of thought is slow.

• Mutism: The patient may not talk at all.

• Aphonia: Patient is able to speak only in whisper.

• Thought block: The patient thought and speech are proceeding at an average rate but are very suddenly and completely. Interrupted in the middle, the gap may last for several seconds, even upto a minute after which patient resumes speaking either where he left off or on a completely new topic.

• Clang Association: It is an associated disturbance in which the patient may follow one word with another and where the mere of word rather than its meaning touches a new thought. The patient uses these word in rhythmic way like ” Bat Cat Rat Mat”.

Disorders of affectPleasurable effect-• Euphoria- First moderate level in the scale of

pleasurable effect. It is the feeling of emotional and physical well being.

• Elation- It is the second level of pleasurable effect. It is characterised by definite effect of gladness in which there is air of enjoyment, self-confidence and increased motor activity.

• Exaltation- It is the intense elation with the feeling of grandeur.

• Ecstasy- It is the feeling of extreme joy and happiness. The patient feels detached from the world.

Un pleasurable effect-• Depression: It is the psychopathological

feeling of the sadness. It is characterised by the feeling of inadequacy, hopelessness, helplessness and worthlessness.

• Grief and Mourning: It is the sadness appropriate to a real loss .It is self –limiting.

• Apathy: lack of emotional feeling.

Disorders of memory• Hypermnesia: Hypermnesia or excessive retention

of memories as seen in paranoid psychosis and manic state is limited to a specific period or specific events which have an emotional factor.

• Amnesia: Amnesia or absence of memory may be complete, partial, continuous or circumscribed.

• Anterograde amnesia: Amnesia of events occurring prior to the episode which precipitated the disorder.

• Retrograde amnesia: Amnesia of events occurring after the episode which precipitated the disorder

• Paramnesia: It is a false re-collection where the patient talks about those events which never took place of gives a false coloring to those that did happen. For example confabulation ( patient fills the gap in his memory by making up his own ideas).

• Deja vu: It is an illusion of recognition in which a new situation is incorrectly regarded as a repetition of a previous memory.

• James vu: vice versa of deja vu (unfamiliarity with familiar event.

Disorders of orientation

• When a person is aware of his position in reference to time, place, person and circumstances, it is considered to be oriented. In organic conditions orientation is most frequently lost, wholly or partly.

Disorders of attention

• Distractibility: It is a common type of disorder of attention in which the patient gives attention to everything which is happening, with the result his attention passes very rapidly from one object to another.

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