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m4 psych > 1. Psychopathology > Flashcards

1. Psychopathology Flashcards

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
Logorrhoea
Excessive verbal production
26
Neologism
Invention of own words which hold special meaning for the one who created them; not a real word - occurs in schizophrenia
27
Metonym
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
Word salad
Jumble of words and phrases with little obvious connection - occurs in schizophrenia
29
Mutism
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
Akinetic mutism
Cannot move nor talk; able to open and close eyes under voluntary control
31
Overvalued idea
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
Obsession
Repetitive and irrational thoughts (egodystonic) recognised to be the patient's own; often leads to anxiety and compulsions - can be challenged
33
Delusion
Firmly maintained false belief contradicted by reality; idiosyncratic, incorrigible (impossible to change) and pre-occupying (consumes the mind)
34
Types of delusion
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
Causes of delusion
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
Delusional mood
Change in mood that precedes emergence of delusion: a feeling that something sinister is about to happen
37
Delusional perception
A real perception with delusional interpretation eg. “When the traffic light turns green, God is asking me to go to heaven”
38
Delusional memory
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
Ambitendency
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
Mitgehen
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
Mitmachen
Limb movement in response to an applied force in any direction without resistance - occurs in schizophrenia
42
Wavy flexibility
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
Automatic obedience
Blind following of examiner’s instructions without judgement or resistance - usually occurs in catatonic schizophrenia a
44
Negativism
Active performance of the opposite action to the instruction from the examiner - usually occurs in catatonia
45
Stereotypy
Non goal-directed repetitive movements (eg. rocking back and forth) - occurs in schizophrenia
46
Mannerism
Goal-directed repetitive movements (eg. repetitive hand gestures by a speaker to convey messages)
47
Echolalia
Repetition of words/phrases spoken by another person - occurs in autism, schizophrenia and dementia
48
Echopraxia
Repetition of movement demonstrated by another person - occurs in catatonia and schizophrenia
49
Catalepsy
Abnormal maintenance of posture in catatonia (increased muscle tone)
50
Cataplexy
Temporary loss of muscle tone and paralysis without loss of consciousness - precipitated by emotional excitement and a/w narcolepsy
51
Compulsion
Repetitive and purposeful movements resisted by the person as the movements are senseless Used to neutralise anxiety generated by delusions
52
Charles de Bonnet syndrome aka Visual release hallucinations
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
Folie à deux
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
Capgras syndrome
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
Erotomania (de Clerambault syndrome)
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
Fregoli syndrome
Delusional misidentification of an unfamiliar person as a familiar person - occurs in schizophrenia or dementia
57
Ganser syndrome
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
Morbid jealousy aka Othello syndrome
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
Münchausen syndrome
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
Alexithymia
Difficulty recognising, expressing, describing emotions
61
Risk factors for delusional disorder
1. Increased age 2. Sensory impairment (Hearing loss) 3. Low socioeconomic status 4. Severe stress 5. Immigration 6. Social isolation
62
Diogenes’ syndrome is
squalor syndrome

m4 psych (18 decks)

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