10.17 “Language” Of Psychiatry Flashcards
Define mental disorder
Syndrome characterised by clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning
- usually associated with significant distress or disability in social, occupational, or other important activities
Psychosis
Group of symptoms
Group of symptoms
- Impaired sense of reality
- Incoherent speech; Incoherent thoughts ➡️ Thought disorder
- Perceptual abnormalities = Hallucinations
- Hearing voices = auditory hallucinations (most common)
- Seeing visions = visual hallucinations
- Also: gustatory, olfactory, tactile hallucinations -
Fixed, false beliefs = Delusions NB!!!!
- Persecutory – someone trying to harm/kill them, watching them or following them
- Grandiose – exaggerated sense of own ability, importance or power
- Somatic – belief involving the body
- Delusions of reference – events, people or objects specifically refer to individual and have unique significance
Thought form vs Thought content
THOUGHT FORM (also called thought process)
- The “how” of thinking
- The way in which ideas are structured together – normal thought form is logical, linear, coherent and has a normal rate
- Formal thought disorder = a disruption of the form of thought, e.g. loosening of association, tangentiality, circumstantiality, blocking, poverty, flight of ideas etc
THOUGHT CONTENT
- The “what” of thinking
- The actual ideas/concepts being talked & thought about
- Examples: ideas, beliefs, delusions, obsessions, schemas etc
Speech
- The “how” of talking
- Production of speech as well as its prosody (patterns of rhythm and sound)
- Elements: rate, rhythm, articulation, volume, amount, melody, tone etc
- Abnormalities: dysarthria (neurological), pressure, monotony, excessive softness/inaudibility etc (psychiatric)
- Confusingly, the term “incoherent speech” actually refers to incoherent thought form
speech gives you clues about what else is going on
Mood vs Affect NB!!
MOOD
- Sustained emotion over time (climate)
- Dysphoric vs euphoric
- Expansive, elevated
- Euthymic (within normal range)
AFFECT
- Subjective feeling/emotional experience as observed by others (weather)
- Reactive, restricted, blunted, flat or labile
Mood
Main symptom clusters
1. Elevated/euphoric
Mania/hypomania = symptom complex
- Elevated/agitated mood
- Rapid speech and thoughts
- Distractible
- Excessive energy, impulsive Grandiosity
- Reduced need for sleep
2. Euthymic = normal/stable
3. Depressed/dysphoric
- Sad/tearful,
- Loss of pleasure = anhedonia
- Hopelessness, worthlessness
- Fatigue/agitation
- Excessive/reduced sleep
- Loss of appetite
- Thoughts about death
Anxiety
Definition
Main symptom clusters
Definition - Emotional response to and anticipated threat
When is it pathological? ➡️ Excessive; interferes with functioning
Symptoms
- Associated physical symptoms eg, palpitations, sweating, chest
pain, shortness of breath, dizziness
- Excessive worry, restlessness, irritability, ‘keyed up”
- Obsessions – persistent, intrusive thoughts
- Compulsions – repetitive behaviours in response to obsessions
- Prominent symptom in many disorders
Sensorium
- Sensorium = consciousness
- Needs to be clear to allow effective concentration and communication
- If NOT clear – MUST rule out DELIRIUM
Cognition
- Cognition - the process of acquiring knowledge and understanding what is learnt
- Complex function requiring attention and concentration, ability to receive and interpret information, memory, executive function and language.
- Executive functions include planning and performance of complex tasks.
Insight
- Understanding of current condition
- Entails recognition of the symptom(s), attributions of these to a disorder and recognising need to treat the disorder
Judgement
- In terms of illness behaviour: Ability to act in a manner
consistent with good insight - In terms of more general application: Ability to act in a reasonable and socially acceptable manner
