Phenomenology Flashcards
Mannerism
Odd purposeful movements that are goal-directed. Seen in chronic schizophrenia.
Stereotypy
Non-goal-directed involuntary movements that are carried out repetitively and uniformly. Seen in autism and schizophrenia.
Automatic obedience
Patient does whatever is asked despite being told not to.
Ambitendency
Alternating cooperation and opposition
Echopraxia
Imitates movements of interviewer
Echolalia
Imitates words
Perseveration
Senseless repetition of previously requested movement.
Palilalia
Perseverated word repeated with increasing frequency
Logoclonia
Perseveration of last syllable. Also seen in organic disorders.
Forced grasping
Offered hand grasped despite being told not to. Seen in frontal lobe lesions.
Mitmachen
Body can be put into any posture despite instruction to resist
Mitgehen
Extreme form of mitmachen. Slight passive pressure leads to movement. Associated with forced grasping.
Posturing
Strange postures adopted habitually
Catalepsy
Perseveration of posture. If placed in an awkward position, this position is held.
Waxy flexibility
Smooth resistant muscle tone felt to initial movement
Negativism
Patient does reverse of what is asked. Disorder of volition.
Gegenhelten
Form of negativism. Resistance to passive movement.
Positivism
Echopraxia, mitgehen and automatic obedience.
Apraxia
Disorder of skilled movement, reflects motor system dysfunction at the cortical level.
Ideomotor apraxia
Unable to perform a task to command, even though they are capable of performing the action without prompting.
Limb apraxia
Involves movements of arms/legs
Non-verbal-oral/buccofacial apraxia
Unable to carry out facial movements on command
Ideational apraxia
Difficulty completing a relatively complex motor task, for example, putting toothpaste on a toothbrush.
Limb kinetic apraxia
Unable to make fine precise movements with limbs
Verbal apraxia
Unable to plan movements for speech
Constructional apraxia
Unable to construct pentagons
Oculomotor apraxia
Difficulty with eye movements
Dressing apraxia
Unable to dress self.
Involves non-dominant parietal lobe.
Gerstmann’s syndrome
= dysgraphia/agraphia, dyscalculia/acalculia, finger agnosia, left-right disorientation.
Due to lesion of dominant parietal lobe.
First rank symptoms
- Delusional perception/autochthonous delusion
- Auditory hallucinations - 3rd person AH, running commentary on actions/thoughts, gedankenlautwerden
- Delusions of thought interference - insertion, withdrawal, broadcasting
- Passivity phenomenon
Oneiroid state
Dreamlike state with vivid visual hallucinations.
Can occur in catatonic state in schizophrenia.
Extracampine hallucination
Experienced outside of normal sensory field.
Occur in schizophrenia, epilepsy, organic disease, hypnagogic states.
Lilliputian hallucinations
Small animals/people/fantasy figures.
Can occur in delirium, schizophrenia, seizures, organic disorders, visual disturbance.
Functional hallucination
Generated by an unrelated stimulus in same modality
Reflex hallucination
Generated by unrelated stimulus in a different modality
Palinopsia
Abnormal persistence or recurrence of an image in time.
Seen in organic disease (Parkinson’s).
Autoscopic/heautoscopic hallucinations
Phantom mirror image, can see double of oneself projected into space.
Can occur in depression, schizophrenia, temporal lobe epilepsy, parietal lobe lesions.
Associated with decreased LOC, delirium, narcissism, depersonalisation.
Negative autoscopy
See nothing when looking at oneself in mirror
Double phenomenon/Doppelganger
Subjective phenomenon of doubling
Charles Bonnet syndrome
Complex visual hallucinations which are formed, persisting and repetitive.
No demonstratable psychopathology.
More common in elderly, central/peripheral visual loss.
Insight retained, no delusions.
Illusion
Distortion of real objects. Involuntary false perception. Often occurs at extremes of emotion and tiredness.
Completion illusion
Occur during inattention. Banished by attention.
Affective illusion
Based on mood
Pareidolic illusion
Vivid mental images occurring without conscious effort when perceiving ill-defined stimuli, eg, shapes in clouds.
More common in children.
Pseudohallucinations
A form of imagery, experienced as emanating from the mind. Although vivid, they are less substantial than normal perception. Unwilled. Insight retained.
Occur in depression, obsessional states, hysteria, personality disorders, crisis states.
Logorrhoea
Excessive speech but not pressured.
Pathologically excessive and often incoherent talkativeness or wordiness that is characteristic especially of the manic phase of bipolar disorder.
Paraphasia
Unintended utterances, a failure of selection at the phonemic level, producing a phonemic (literal) paraphasia (e.g., “I drove home in my lar”) or at a word (lexical) level (e.g., “I drove home in my wagon”), producing a verbal paraphasia.
Verbigeration
Repetition of words/syllables while searching for correct word. Meaningless and stereotyped repetition of words/phrases.
Clang associations
Initial syllable in schizophrenia.
Last syllable in mania.
Cryptolalia/Cryptographia
Private language/script
Approximate answers
Wrong answer but question has been understood.
Occurs in hebephrenic schizophrenia, organic disease, Ganser syndrome, dissociation.
Pseudologia fantastica
Frequent plausible lying. Occurs in histrionic and antisocial PD.
Ganser syndrome
= approximate answers, clouding of consciousness, echolalia/echopraxia, auditory/visual hallucinations, somatic conversion symptoms.
Rare dissociative disorder. High rate in prisoners.
Wernicke’s aphasia
Sensory or fluent dysphasia but impaired comprehension.
Wernicke’s area is located in dominant temporal lobe.
Broca’s aphasia
Motor or non-fluent dysphasia, with comprehension intact.
Broca’s area is located in dominant inferior frontal cortex.
Can also be associated with mood as it is in frontal lobe.
Conduction aphasia
Repetition impaired only.
Also called syntactical/central aphasia.
Due to damage to the arcuate fasciculus.
Tested in MMSE with “ifs ands or buts”.
Transcortical sensory aphasia
Wernicke’s aphasia but repetition is intact.
Echolalia prominent.
Transcortical motor aphasia
Broca’s aphasia but repetition intact
Paralogia
Positive thought disorder.
Adamantly illogical or delusional thinking and oral expression, at times, seen in schizophrenia.
Alogia
Negative thought disorder.
Poverty of speech or thought content.
A complete lack of speech, as in profound mental retardation or advanced dementia.
Desultory thinking
Correct syntax/grammar but ideas are juxtaposed inappropriately
Made action
Passivity phenomena. Motor actions experiences as being caused by an external agent.
Delusion
Fixed firm false belief, held despite evidence to the contrary, and out of keeping with patient’s social or cultural norms.
Always self-involved or self-referential.
Often bizarre.
Primary delusion
Autochthonous idea, not understandable in terms of other psychopathology, not connected to previous experiences.
Types of primary delusion
- Delusional intuition - arise fully formed as sudden intuition, Wahreinfall
- Delusion perception - real perception which is interpreted in delusional way (1st rank symptom)
- Delusional atmosphere - delusional mood
- Delusional memory - retrospective delusion
Secondary delusion
Emerge understandably from other psychic experiences or preoccupations, eg, affect, fears, stress
Ekbom’s syndrome
Delusional parasitosis OR restless legs syndrome
de Clerambault’s syndrome
Erotomania
Capgras’ syndrome
Delusion that a familiar person has been replaced by a stranger
Fregoli sydnrome
Delusion that a stranger has been replaced by a familiar person
Reduplicative paramnesia
Misidentification delusion that surroundings exist in multiple locations
Intermetamorphosis
Misidentification delusion that people in the environment have swapped places or belief that others can change into one another at will.
Balint’s syndrome
= simultanagnosia (unable to recognise whole picture but can identify individual parts), optic ataxia, oculomotor ataxia.
Occurs due to lesion of bilateral parietal lobes.
Cotard syndrome
Psychotic depression with bizarre hypochrondriacal and nihilistic delusions, often tinged with grandiosity. Common in elderly.
Depersonalisation
Experiences of unreality, detachment or being an outside observer to one’s thoughts, feelings, sensations, body or actions.
Can occur due to lesion of right (non-dominant) dorsolateral prefrontal cortex and anterior cingulate.
Derealisation
Experience of unreality or detachment with respect to one’s surroundings.
Obession
Feeling of subjective compulsion, which person resists. Preserved insight.
Compulsion
Purposeful act, performed in accordance to a set of rules. Act is intended to bring about another state of affairs, but they are disconnected.
Echo de la pensee
French description of thoughts spoken aloud. Also known as Gedankenlautwerden in German.
Cataplexy
Abrupt temporary loss of voluntary muscle tone invoked by an emotional event, such as laughing or crying.
Flexibilitas cera
Waxy flexibility. A characteristic feature of catatonia.
Jamais vu
Illusion where the familiar is experienced as unfamiliar
La belle indifference
A relative lack of concern about the nature or implications of the symptom. Characteristic feature of conversion disorder.
Marche à petit pas
Shuffling gait with upper body having preserved function. Characteristic of diffuse cerebrovascular disease, but also present in Parkinson’s disease.
Boufée délirante
Brief psychotic disorder
Décalage
- Horizontal refers to that once the child learns a certain function, they don’t have the capability to apply it immediately to all problems.
- Vertical refers to a child using the same cognitive function in different stages across development.
According to Piaget, these occur during the concrete operations stage of development.
Délire de negation
Cotard syndrome, delusion of non-existence or body part missing.
Déjà entendu
Illusion that what one is hearing has been heard previously.
Déjà pensé
A thought never entertained before is incorrectly regarded as a repetition of a previous thought.
Déjà vécu
Unable to recognise that a situation is new, person believes they are reliving it.
Fausse reconnaissance
False recognition.
Folie circulaire
Circular insanity
Folie impose
Dominant person initially forms a delusional belief, then imposes it another person.
Folie simultanée
Two people suffering independently from psychosis influence the content of the others delusions.
Abulia
Absence of volition
Dysgraphaesthesia
Inability, without looking, to perceive, recognise and identify numbers of letters traced on the palm of the hand, or on the palmar surface of the fingertips, by tactile sensation.
Used as a test of parietal lobe.
Myerson sign
Patient continues to blink with repeated glabellar taps.
Often an early sign of Parkinson’s but occurs in dementia as well.
Indicates frontal release.
Passage hallucinations
Visual hallucinations, which occur in the peripheral visual field. They are usually shadows or cats or dogs passing by, but when the person looks at them, the images disappear.
Tend to be an early sign of Parkinson’s.
Couvade syndrome
Man develops extreme anxiety and various physical symptoms, as of pregnancy, when women is pregnant.
Anton’s Syndrome
Due to a lesion of occipital lobe(s).
Presents with denial of visual disability and confabulation of visual detail.
