3.3 - Delirium and hallucinations Flashcards
Cite 2 types of classification of mental disorders.
- Syndromic classification (classical approach)
- Ethiopathogenic approach
What’s the principe of the syndromic classification ?
- To describe what is observed, the signs and their frequency.
- A single sign can be found in many disorders, but the association of several orients the diagnosis (eg halllucinations with disorganised speech, altered emotions, social dysfunction → schizophrenia)
What’s the principles of the ethiopathogenic approaches ?
They classify pathologies on
• the basis of defense mechanisms
• the nature of the conflict at the origin of the pathology (eg castration conflict)
• relation to elements (Oedipe conflict or other people).
Based on theoretical currents and their interpretations of phenomena.
Those theoris can contradict each other (eg Klein’s and Lacan’s : different conceptions of the subject and of distress).
What are the agreed diagnosis criteria for psychosis ?
- Loss of contact with reality
- Problems of identity
- Ignorance of the morbid state
What’s the definition of delirium ?
set of ideas out of sync with reality, that the subject still firmly believes.
What dimension help describe delirium ?
- Themes (such a persecution)
- Organisation (network or are)
- mechanisms (illusion, imagination, hallucinations)
How have hallucinations been clinically distinguised in France ?
Hallucinations can be clinically distinguished in terms of the perceptions involved. In France, psychosensorial H opposed to psychic H (internal or external to the subject). This distinction does not appear in the DSM.
What meaning do different authors give to hallucinations ?
- According to Kraeppelin, mean nothing (dysfunction in perception)
- Bleuler, have significance, due to a dissociation of consciousness
- Freud, signs that some unbearable representation and its return are being rejected
In teh theoretical framework of psychosis, what is the first stage leading to the disorder ?
The Freudian theory of rejection is included in the theoretical framework of psychosis, considered as a primary disturbance of the libidinal relation to reality.
Representation & its affect never reach the Ego, denial (unbearable fragment of reality rejected)
In psychosis, what appears in the second stage of the disprder ?
Delirium and hallucinations are secondary attempts to restore the object relationship.
Second stage : construction of a delirious/hallucinatory reality (return of the rejected fragment). Denial of exterior reality and projection of the subject’s internal world ont exterior reality at the same time.
What mechanism is seen as the basis for neurosis ?
Repression (refoulement)
Representation of a conscious sent the unconscious without the related affect
What does the neuro-scientific approach say about delirium and hallucinations ?
They are linked to a specific cerebral function, resulting in a dysfunctional psychological process
