Clinical Psychiatric

Signs and Symptoms

Group 1 (Section L)
BABATUGON, JULI NICOLE A.
CAMPANERO, MARK JUSTIN B.
CARIAGA, DEEVON M.
CIPRIANO, ALEXANDREA MAE KATHERINE L.
COMETA, GENE LORENZE S.
CRUZ, ALBERT KEVIN M.
CRUZ, ALLYSA JUNE Q.
DE CASTRO, CAMILLE PATRICIA T.

SIGNS SYMPTOMS
Objective evidence of disease Subjective evidence of disease
Perceived by the physician/examiner change in condition perceived by the
Ex. Patient’s constricted patient
affect or psychomotor e.g. patient’s complaint of pain or feeling
retardation depressed

“Personal World”
The way a person thinks or feels, normal or
Otherwise.
• Abnormal if:
– It springs from a condition that is universally accepted as abnormal
– Separates the person from others emotionally
– Does not provide the person with a sense of “spiritual or material” security

NEUROSIS vs. PSYCHOSIS

Milder mental disorder; partially incapacitate the individual to meet the demands of life
property and effectively.
Reality contact practically remains intact
Speech and thought processes are coherent and logical
Capable of self-management, partial or completely self-supporting, are rarely suicidal
Insanity/madness; make the individual incapable of adequate self-management and
adjustment to society.
Contact with reality is totally lost or changed
Speech and thought processes are incoherent, disorganized, bizarre and irrational.
Often attempt to commit suicide and need hospitalization or equivalent home care
Note that most psychiatric signs and symptoms are rooted in normal behaviour and can
be understood as various points on a spectrum of behaviours ranging from normal to
Pathological.
CONSCIOUSNESS
(+ Attention)
State of awareness
Disturbances in consciousness are most often associated with brain pathology
Apperception: perception modified by person’s own emotions and thoughts
Sensorium: state of cognitive functioning of special senses
Note that disturbances in consciousness are most often associated with brain pathology
Attention
Amount of effort exerted in focusing on certain portions of an experience;
Ability to concentrate

Disturbances of Consciousness
􀂀 Disorientation
􀂀 clouding of consciousness
􀂀 Stupor
􀂀 Delirium
􀂀 Coma
􀂀 Coma vigil: cannot be aroused but with eyes open
􀂀 Twilight state: disturbed consciousness with hallucination
􀂀 Dreamlike state: complex partial seizure or psychomotor epilepsy
􀂀 Somnolence: state of near-sleep; strong desire for sleep; long sleep
􀂀 Confusion
􀂀 Drowsiness
􀂀 Sun downing/Sundowner’s syndrome: drowsiness, confusion, ataxia and falling as
result of excessive medication; usually in older persons; happen at night

Disturbances of Attention
1. Distractibility
-Inability to concentrate
2. Selective inattention
-State in which attention is drawn to irrelevant or unimportant external stimuli
3. Hypervigilance
-Excessive focus and attention on all external and internal stimuli; usually secondary to
delusional or paranoid states
4. Trance
-Focused attention and altered consciousness (hypnosis)
5. Disinhibition
-Removal of an inhibitory effect that permits persons to lose control of impulses (alcohol
intoxication)
EMOTION
(+ Affect, Mood)

Complex feeling state with psychic, somatic and behavioral components related to
affect and mood
Affect is the subjective and immediate experience of emotion attached to ideas or
mental representations of objects has outward manifestations

MOTOR BEHAVIOR
Aspect of psyche that includes motivations, wishes, drives, instincts and cravings, as
expressed by a person’s behavior or motor activity

THINKING
Goal-directed flow of ideas, symbols and associations initiated by a problem or task and
leading toward a reality-oriented conclusion
Poverty of content, Overvalued idea, Delusion

SPEECH
vocalized form of communication; The ability to have a conversation is actually a
complex process involving multiple exchanges where both the speaker and listener
need to use their verbal abilities as well as their social thinking skills.

PERCEPTION
Mental process by which sensory stimuli are brought to awareness
Illusion, Hallucination

MEMORY
Function by which information stored in the brain is later recalled to consciousness
Levels of Memory
1.Immediate: Recall of perceived material within seconds to minutes.
2.Recent: Recall of events over the past few days
3.Recent past: Recall of events over the past few months
4. Remote: Recall of events in the distant past

INTELLIGENCE
(+ Insight, Judgment)

Ability to understand, recall, mobilize and constructively integrate previous learning in

meeting new situations
Signs and Symptoms
ANERGIA Lack of energy
ABSTRACT THINKING
Thinking characterized by the ability to grasp the essentials of a whole, to break whole
into parts and to discern common properties
To think SYMBOLICALLY

ANXIETY
Feeling apprehension caused by anticipation of danger which may be internal or
external

ANTEROGRADE AMNESIA
Loss of memory for events subsequent to the onset of the amnesia; common after
trauma

AGRAPHIA
Loss or impairment of a previously possessed ability to write

ADIADOCHOKINESIA
Inability to perform rapid alternating movements
Occurs with neurological deificit & cerebellar lesions

ABULIA
Reduced impulse to act and to think, associated with indifference about consequences
of action
Occurs as a result of neurological deficit, depression and schizophrenia

BRADYKINESIA
Slowness of motor activity with a decrease in normal spontaneous movement

BRADYLEXIA
Inability to read at normal speed

CEPHALAGIA
Headache

CHOREA
Movement disorder characterized by random and involuntary quick, jerky, purposeless
movements
Seen in Huntington’s disease

CORPROLALIA
Involuntary use of vulgar or obscene language.
Observed in some cases of schizophrenia and Tourette’s syndrome
DEMENTIA
Mental disorder characterized by general impairment in intellectual functioning
characterized by:
Failing memory
Difficulty with calculations
Distractability
A;terations in mood & affect
Impaired judgement & abstraction
Reduced facility with language
Disturbance of orientation

DENIAL
Defense mechanism in which the existence of unpleasant realities is disavowed
Refers to keeping out of conscious awareness any aspects of external reality that, if
acknowledged, would produce

EGOCENTRIC
Self-centered
Selfishly preoccupied with one’s own needs
Lacking interest in others

ECHOLALIA
Psychopathological repeating of words or phrases of one person by another
Tends to be repetitive and persistent
Seen in certain kinds of schizophrenia particularly the catatonic types

FANTASY
Fabricated mental picture of a situation or chain of events
A normal form of thinking dominated by unconsciousness material that seeks wish
fulfillment and solutions to conflicts
The content of the fantasy may indicate mental illness

FEAR
Unpleasurable emotional state consisting of psychophysiological changes in response
to realistic threat or danger

GUILT
Emotional state associated with self-reproach and the need for punishment.
A feeling of culpability that stems from a conflict between the ego and the superego
(conscience).
Has normal psychological and social functions, but special intensity or absence of guilt
characterizes many mental disorders, such as depression and antisocial personality
disorder, respectively.
HALLUCINOSIS
State in which a person experiences hallucinations without any impairment of
consciousness.
Haptic hallucination - Hallucination of touch.
Gustatory hallucination - Hallucination primarily involving taste.
Olfactory hallucination: Hallucination primarily involving smell or odors; most common in
medical disorders.
Hypnagogic hallucination - Hallucination occurring while falling asleep, usually not
pathological
Hypnopompic hallucination - Hallucination occurring while awakening from sleep,
nusually not pathological
Formication - Tactile hallucination involving the sensation that tiny insects are crawling
over the skin. Seen in cocaine addiction and delirium tremens.
lilliputian hallucination - Visual sensation that persons or objects are reduced in size;.

HYPESTHESIA
Diminished sensitivity to tactile stimulation.

INSOMNIA
Difficulty in falling asleep or difficulty in staying asleep.
It can be related to a mental disorder, a physical disorder, or an adverse effect of
medication; or it can be primary.

JUDGEMENT
Mental act of comparing or evaluating choices within the framework of a given set of
values for the purpose of electing a course of action.
If the course of action chosen is consonant with reality or with mature adult standards of
behavior, judgment is said to be intact or normal
If the chosen course of action is frankly maladaptive, results from impulsive decisions
based on the need for immediate gratification, or is otherwise not consistent with reality
as measured by mature adult standards, judgment is said to be impaired.

MOOD
Pervasive and sustained feeling tone that is experienced internally and that, in the
extreme, can markedly influence virtually all aspects of a person's behavior and
perception.
Distinguished from affect, the external expression of the internal feeling tone

MOOD SWINGS
Oscillation of a person's emotional feeling tone between periods of elation and periods
of depression.
MEMORY
Process whereby what is experienced or learned is established as a record in the CNS
(registration), where it persists with a variable degree of permanence (retention) and
can be recollected or retrieved from storage at will (recall).

Types of memory:
Immediate memory: Reproduction, recognition, or recall of perceived material within
seconds after presentation.
Short-term memory: Reproduction, recognition, or recall of perceived material within
minutes after the initial presentation
Long-term memory: Reproduction, recognition, or recall of experiences or information
that was experienced in the distant past. Also called remote memory.

NARCISSISM
Primary narcissism
The early infantile phase of object relationship development, when the child has not
differentiated the self from the outside world, and all sources of pleasure are
unrealistically recognized
as coming from within the
self, giving the child a false
sense of omnipotence

Secondary narcissism
When the libido, once attached to external love objects, is redirected back to the self

NIHILISM
Delusion of the nonexistence of the self or part of the self. Philosophical view that the
world is without meaning.

PSYCHOSIS
The thoughts, affective response, ability to recognize reality, and ability to communicate
and relate to others are sufficiently impaired to interfere grossly with the capacity to deal
with reality
The classic characteristics of psychosis are impaired reality testing, hallucinations,
delusions, and illusions.

PARANOIA
Marked by the gradual development of a highly elaborate and complex delusional
system, generally involving persecutory or grandiose delusions, with few other signs of
personality disorganization or thought disorder.
Paranoid delusions: Includes persecutory delusions and delusions of reference, control,
and grandeur.
Paranoid ideation: Thinking dominated by suspicious, persecutory, or grandiose content
of less than delusional proportions.

PHOBIA
Persistent, pathological, unrealistic, intense fear of an object or situation
The phobic person may realize that the fear is irrational but, nonetheless, cannot dispel
it.

REGRESSION
Unconscious defense mechanism that involves taking the position of a child in some
problematic situation, rather than acting in a more adult way.

REPRESSION
-Placing uncomfortable or unwanted thoughts in relatively inaccessible areas of the
subconscious mind.
-This is important in normal psychological development and in neurotic and psychotic
symptom formation

SATYRIASIS/NYMPHOMANIA
Uncontrollable, morbid, insatiable sexual need or desire in a man/woman. This is a
symptom of a compulsion to have sexual intercourse with as many men/women as
possible and an inability to have lasting relationships with them

SIMULTANAGNOSIA
Impairment in the perception or integration of visual stimuli appearing simultaneously

TRANCE
Sleep-like state of reduced consciousness and activity.

UNDOING
-Unconscious primitive defense mechanism, repetitive in nature, by which a person
symbolically acts out in reverse something unacceptable that has already been done or
against which the ego must defend itself;
-a form of magical expiatory action, commonly observed in OCD.

VERBIGERATION
-Meaningless and stereotyped repetition of words or phrases, as seen in schizophrenia.
-Also called cataphasia

WORLD SALAD
Incoherent, essentially incomprehensible, mixture of words and phrases commonly
seen in far-advanced cases of schizophrenia.