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m4 psych > 1. Psychopathology > Flashcards

1. Psychopathology Flashcards

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1
Q

What is an illusion?

A

Involuntary false perception in which a transformation of real objects takes place (sensory stimulus)

(eg. curtain in the ward perceived by a patient to be a female witch)

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2
Q

What is a hallucination?

A

Perception of an external object when NO such object is present
(no sensory stimulus)

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3
Q

Complex auditory hallucination

A
  • occurs in schizophrenia

Mood congruent: stating depressive/manic themes in second person (“you are useless”) or command hallucinations (“you are useless and you should hurt yourself”)
- occurs in depressive disorder or bipolar disorder

Mood incongruent: voices discussing in 3rd person, giving a running commentary on the patient’s behaviour or thoughts spoken out loud

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4
Q

Simple auditory hallucination

A

Sounds or music
- alcohol misuse, deafness, right temporal lobe lesion

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5
Q

Simple visual hallucination

A

eg. flashing lights

common in acute organic disease, lesions are found in the occipital cortex

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6
Q

What is positive scotoma? (Simple visual hallucination)

A

Simple visual hallucinations seen following head injury

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7
Q

What is migrainous visual aura? (Simple visual hallucination)

A

often zigzag lines

due to transient disturbance of occipital cortex

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8
Q

Complex visual hallucination

A

eg. involving people/animals

occurs in organic diseases; lesions are found in the temporal lobe

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9
Q

Lilliputian visual hallucination

A

hallucinated objects (usually people) appear greatly reduced in size

occurs in psychiatric states associated with febrile or intoxicating conditions

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10
Q

Alcoholic hallucinations

A

Acute hallucinosis seen in people with alcohol dependence following excess alcohol intake; can also be part of withdrawal symptoms

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11
Q

Hypnogogic/Hypnopompic

A

Hallucinations occur as conscious levels fluctuates between dreaming and waking.

HypnoGogic: Going to sleep
HypnoPompic: waking uP

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12
Q

Autoscopy

A

Seeing one’s self or double;

the double imitates movements and facial expressions of the original, as if a reflection in a mirror

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13
Q

Extracampine

A

Experiences outside the limits of sensory fields including visual field and range of audibility

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14
Q

Kinesthetic hallucinations

A

Sense of bodily movement

eg. a person believes that his elbow is rotating involuntarily but there is no such sign on PE

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15
Q

Cenesthetic hallucinations

A

False perception/ Sensation of an altered state in a body organ without corresponding receptors which can explain the sensation in normal human physiology

eg. feeling a lump in the throat even when it is not there, of animals crawling through the body

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16
Q

Circumstantiality

A

Speech takes a long time to reach the point because of a great deal of unnecessary details but still reaches the point
(“beating around the bush”)

  • occurs in schizophrenia, dementia, temporal lobe epilepsy and normal people
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17
Q

Tangentiality

A

Stream of thought that diverges from the topic and speech appears to be unrelated and irrelevant at the end so it never reaches the point

  • occurs in schizophrenia, mania
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18
Q

Flight of ideas

A

Continuous speech where topics jump RAPIDLY from one to another and there may be a logical link between topics

  • occurs in mania (accompanied by pressure of speech)
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19
Q

Loosening of associations

A

Diffuse and unfocused speech where there is a lack of logical connections between topic; difficult for listener to establish any link

  • occurs in schizophrenia
  • aka thought derailment aka Knight’s move thinking
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20
Q

Thought insertion

A

Feels that external thoughts which do not belong to them are being inserted into their mind

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21
Q

Thought withdrawal

A

Feels that their own thoughts are being taken away by others

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22
Q

Thought broadcasting

A

Feels that their own thoughts are being made known to others through broadcasting like a radio or tv station

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23
Q

Thought blocking

A

Feels that their own thoughts are being blocked as it will just disappear, no amount of jogging of memory can bring it back

  • occurs in schizophrenia, brain trauma/injuries, drugs
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24
Q

Logoclonia

A

Spastic repetition on syllabus

  • occurs in autism, schizophrenia, Alzheimer’s and Parkinson’s
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25
Q

Logorrhoea

A

Excessive verbal production

26
Q

Neologism

A

Invention of own words which hold special meaning for the one who created them; not a real word

  • occurs in schizophrenia
27
Q

Metonym

A

Approximate but related term used in an idiomatic way; real words

eg. sky sheep to describe clouds because it looks like sheep in the sky
- occurs in schizophrenia

28
Q

Word salad

A

Jumble of words and phrases with little obvious connection

  • occurs in schizophrenia
29
Q

Mutism

A

State of being silent and voiceless

Organic causes: catatonia, herpes simplex viral encephalitis, locked-in syndrome, myasthenia gravis, polio infection

Psychological causes: conversion disorder, malingering

30
Q

Akinetic mutism

A

Cannot move nor talk; able to open and close eyes under voluntary control

31
Q

Overvalued idea

A

Possible idea pursued beyond normal boundaries which causes distress and functional impairment to the patient

  • idea can be challenged
  • deeply held personal convictions that are understandable when the patient’s background is known
  • other members in the family may share the same belief
32
Q

Obsession

A

Repetitive and irrational thoughts (egodystonic) recognised to be the patient’s own;
often leads to anxiety and compulsions

  • can be challenged
33
Q

Delusion

A

Firmly maintained false belief contradicted by reality; idiosyncratic, incorrigible (impossible to change) and pre-occupying (consumes the mind)

34
Q

Types of delusion

A
  1. Persecutory
    - believes that others are out to harm, cheat or poison them
  2. Nihilistic
    - patient ceases to exist, being dead, a body part has rot
  3. Reference
    - believes that news/radio/tv/media etc have a direct reference to them without supporting evidence
  4. Grandiose
    - exaggerated power and importance eg I am God/Superman
  5. Jealousy
    - believe that one’s partner is unfaithful through pathological reasoning
  6. Erotomania
    - believe that someone (of a higher status) is in love with them
35
Q

Causes of delusion

A
  1. Primary delusion: arises out of the blue with no explanation
    eg schizo patient suddenly believes he is from Mars
  2. Secondary delusion: secondary to other psychopathology such as auditory hallucination in schizophrenia or grandiosity in mania
36
Q

Delusional mood

A

Change in mood that precedes emergence of delusion: a feeling that something sinister is about to happen

37
Q

Delusional perception

A

A real perception with delusional interpretation eg. “When the traffic light turns green, God is asking me to go to heaven”

38
Q

Delusional memory

A

A real memory with delusional understanding eg. “I had an appendectomy 10 years ago during which aliens put an implant in my body to control the world.”

39
Q

Ambitendency

A

Repetitive behaviour of cooperation and opposition; a form of ambivalence
- eg. a person makes a movement but before completing it, they start an opposing movement

  • occurs in schizophrenia
40
Q

Mitgehen

A

Excessive cooperation and limb movement in response to slight pressure of an applied force even when the person is told to resist movement

  • occurs in catatonia
41
Q

Mitmachen

A

Limb movement in response to an applied force in any direction without resistance

  • occurs in schizophrenia
42
Q

Wavy flexibility

A

Abnormal maintenance of posture in catatonia

  • eg. a person maintains his lift arm in the air after it is passively raised by the examiner
43
Q

Automatic obedience

A

Blind following of examiner’s instructions without judgement or resistance

  • usually occurs in catatonic schizophrenia a
44
Q

Negativism

A

Active performance of the opposite action to the instruction from the examiner

  • usually occurs in catatonia
45
Q

Stereotypy

A

Non goal-directed repetitive movements (eg. rocking back and forth)

  • occurs in schizophrenia
46
Q

Mannerism

A

Goal-directed repetitive movements (eg. repetitive hand gestures by a speaker to convey messages)

47
Q

Echolalia

A

Repetition of words/phrases spoken by another person

  • occurs in autism, schizophrenia and dementia
48
Q

Echopraxia

A

Repetition of movement demonstrated by another person

  • occurs in catatonia and schizophrenia
49
Q

Catalepsy

A

Abnormal maintenance of posture in catatonia (increased muscle tone)

50
Q

Cataplexy

A

Temporary loss of muscle tone and paralysis without loss of consciousness
- precipitated by emotional excitement and a/w narcolepsy

51
Q

Compulsion

A

Repetitive and purposeful movements resisted by the person as the movements are senseless

Used to neutralise anxiety generated by delusions

52
Q

Charles de Bonnet syndrome aka Visual release hallucinations

A

Complex visual hallucinations lasting from days to years on a b/g of central or peripheral reduction in vision
- can occur in blind/partially blind patients

53
Q

Folie à deux

A

Transfer of delusion from one person with a psychotic disorder to another with whom he/she is in close association such that they share the same delusion

  • context is usually both parties are extremely close to each other, stay together, very isolated from the world
  • management would be to separate the pair and just treat the person with psychosis
54
Q

Capgras syndrome

A

Delusional misidentification of a familiar person; patient believes that a familiar person is replaced by an imposter or double

  • more common in woman
  • occurs in schizophrenia, affective disorder or dementia
55
Q

Erotomania (de Clerambault syndrome)

A

Patient believes that a person is in love with them although there is no evidence to support their relationship

  • does not need to be of a higher status
  • more common in women
56
Q

Fregoli syndrome

A

Delusional misidentification of an unfamiliar person as a familiar person

  • occurs in schizophrenia or dementia
57
Q

Ganser syndrome

A

Approximate answers interspersed with correct answers, apparent disorientation, clouding of consciousness, vorbeireden (answering of a question in such a way that one can tell the patient has understood the question, although the answer may be obviously wrong), pseudohallucination, fluctuation of somatic symptoms

  • may have amnesia for the duration of illness after recovery
58
Q

Morbid jealousy aka Othello syndrome

A

Firm but pathologically concluded belief that one’s partner is unfaithful
- a/w confrontation and violence
- management involves geographical separation and antipsychotic treatment

  • more common in men > woman
  • a/w erectile dysfunction and alcohol misuse
59
Q

Münchausen syndrome

A

Exaggeration of symptoms in order to be admitted

Münchausen syndrome by proxy: parent imposed their child to be admitted; a form of child abuse

60
Q

Alexithymia

A

Difficulty recognising, expressing, describing emotions

61
Q

Risk factors for delusional disorder

A
  1. Increased age
  2. Sensory impairment (Hearing loss)
  3. Low socioeconomic status
  4. Severe stress
  5. Immigration
  6. Social isolation
62
Q

Diogenes’ syndrome is

A

squalor syndrome

m4 psych (18 decks)

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