Assessment Notes:

TYPICAL SIGNS AND SYMPTOMS OF PSYCHIATRIC ILLNESSES

I. CONSCIOUSNESS
• Consciousness: state of awareness
• Apperception: perception modified by one's own emotions and thoughts
• Sensorium: state of functioning of the special senses

A. Disturbances of consciousness:
1. Confusion: disturbance of orientation as to time, place or person
2. Clouding of consciousness: incomplete clearmindedness
3. Stupor: lack of reaction to and unawareness of perception and attitudes
4. Delirium: Bewildered, restless, confused, disoriented reaction associated with fear and
hallucinations
5. Coma: profound degree of unconsciousness
6. Coma Vigil: coma in which eyes remain open
7. Dreamy state: (twilight: disturbed consciousness with hallucinations

B. Disturbances of Attention: the amount of effort exerted in focusing on certain portions of an

experiences
1. Distractibility: inability to concentrate attention
2. Selective inattention: blocking out of things that generate anxiety

C. Disturbances in suggestibility: complaint and uncritical response to an idea

1. Folie a deux (or folie a trois): communicated emotional illness between two or three persons
2. Hypnosis; artificially induced modification of consciousness

II. AFFECT

• Affect: emotional feeling tone

A. Disturbances in affect
1. Inappropriate affect: disharmony of affect and ideation
2. Pleasurable affects:
o Euphoria: heightened feeling of psychological wellbeing inappropriated to apparent
events
o Elation; air of confidence and enjoyment associated with increased motor activity
o Exaltation; intense elation with feelings of gradeur
o Ecstacy: feeling of intense rapture
3. Unpleasurable affects:
o Depression: psychopathological feeling of sadness
o Grief mourning: sadness appropriate to a real loss
4. Other affects:
o Anxiety: feeling of apprehension due to unconscious
o Fear: anxiety due to consciously recognized and realistic danger
o Agitation; anxiety associated with severe motor restlessness
o Tension: with increased motor and psychological activity that is unpleasant
 o Panic: acute intense attack of anxiety associated with personality disorganization
o Free-floating anxiety: pervasive fear not attached to any idea
o Apathy: dulled emotional tone associated with detachment or indifference
o Ambivalence: existence of two opposing impulses toward the same thing in the same
o person at the same time
o Depersonalization: feeling of unreality concerning oneself or one's environment
o Derealization: distortion of spatial relationships so that the environment becomes
unfamiliar
o Aggression: forceful goal-directed action that may be verbal or physical and that is the
o motor counterpart of the counterpart of the affect rage anger or hostility
o Mood swings: oscillations between periods of euphoria and depression or anxiety

III. MOTOR BEHAVIOR

• Motor behavior (connation): the capacity to initiate action or motor discharge that concerns the
basic strivings of a person as expressed through his behavior.

A. Disturbances of connation:
1. Echolalia: psychopathology repeating of words of one person by another
2. Echopraxia: pathological limitation of movements of one person by another
3. Cerea flexibilities (waxy flexibility): state in which patient maintains body position into which he
is placed
4. Catelepsy: state of unconsciousness in which immobile position is constantly
5. maintained
6. Command automatism: automatic following suggestions
7. Automatism: automatic performance of acts representative of unconscious symbolic
activity
8. Cataplexy: temporary loss of muscle tone and weakness precipitated by a variety of
emotional
9. Stereotype: continuous repetition of speech or physical activities
10. Negativisms: frequent opposition to suggestions
11. Mannerisms: stereotyped involuntary movements
12. Verbigeration: meaningless repetitions of speech
13. Overactivity:
• Hyperactivity (hyperkenesis): restless, aggressive, destructive activity
• Tic: spasmodic, repetitive motor movements
• Sleepwalking (somnambulism): motor activity during sleep
• Dipsomania: compulsion to drink alcohol
• Egomania: pathological self-preoccupation
• Erotomania: pathological preoccupation with sex
• Kleptomania: compulsion to steal
• Megalomania: pathological sense of power
• Monomania: preoccupation with a single subject
• Nymphomania: excessive need for coitus in male
• Satiriasis; excessive need for coitus in male
• Trichotilomania: compulsion to pull one's hair
• Ritual: automatic activity compulsive in nature emotional in origin
 14. Hypoactivity: decrease activity or retardation, as in psychomotor retardation, allowing of
psychological and physical in origin
15. Mimicry: goal directed flow of ideas, symbols and associations initiated by a problem or task and
leading toward sequence occurs thinking is normal

IV. THINKING

• goal directed flow of ideas, symbols and associations initiated by a problem or task and leading
toward a reality-oriented conclusion; when a logical sequence occurs, thinking is normal.

A. Disturbances in form of thinking

1. Dereism: mental activity not concordant with logic or experience
2. Autistic thinking: thinking that gratifies unfulfilled desires but has no regard for reality; term
used somewhat synonymously with dereism
B. Disturbances in structure of associations
1. Neologism: new words created by the patient for psychological reasons
2. Word salad: inherent mixture of words and phrases
3. Circumstantiality digression of inappropriate thoughts into ideational processes, but patient
eventually gets from starting point to desired goal
4. Tangentiality: inability to have goal-directed associations of thought; patient never
gets from starting point to desired goal
5. Incoherence running together of thoughts with no logical connection, resulting in
disorganization
6. Perservation: psychopathological repetition of the same word or idea in response to different
questions
7. Condensation: fusion of various concepts into one
8. Irrelevant answer: that is not in harmony with question asked
C. Disturbances in speed of associations
1. Flight of ideas: rapid verbalizations so that there is a shifting from one idea to another
2. Clang associations: words similar in sound but not in meaning all up new thoughts
3. Blocking: interruption in train of thinking, unconscious in origin
4. Pressure of Speech: Voluble speech difficult to interrupt
5. Volubility (logorrhea): copious, coherent, logical speech
D. Disturbances in type of associations:
1. Motor Aphasia: disturbance of speech due to organic brain disorder in which understanding
remains but ability to speak is lost
2. Sensory Aphasia: loss of ability to comprehend the meaning of words or use of objects
3. Nominal Aphasia: difficulty in finding right name for an object
4. Syntactical Aphasia: inability to arrange words in proper sequence
F. Disturbances in control of thought:
1. Delusion: false belief, not consistent with patient's intelligence and cultural background, that
cannot be corrected by reasoning
• Delusion of grandeur: exaggerated conception of one's importance Delusion
persecution: false belief that one is being persecuted: often found in
• litigious patients
• Delusion of reference: false belief that the behavior others refers to oneself; derived
from ideas of reference in which patient falsely feels his talked about by others
 • Delusion of self-accusation: false feeling of remorse
• Delusion of control: false feeling that one is being controlled by others
• Delusion of infidelity: false belief derived from pathological jealousy that one's lover is
unfaithful
• Paranoid delusions: over suspiciousness leading to persecutory delusions
2. Trend or preoccupation of thought: centering of thought content around a particular idea,
associated with a strong affective tone.
3. Hypochondria exaggerated concern over one's health that is not based on real organic
pathology.
4. Obsession: pathological persistence of an irresistible thought feeling or impulse that cannot be
elimination from consciousness by logical effort.
5. Phobia: exaggerated and invariably pathological dread of some specified type of stimulus or
situation. Some examples are listed:
• Acrophobia: dread of high places
• Agoraphobia: dread of open places
• Algophobia: dread of pain
• Xenophobia: dread of strangers
• Zoophobia: dread of animals

V. PERCEPTION

• Perception: awareness of objects and relations that follows a stimulation of peripheral sense
organs

A. Disturbances associated with organic brain disease, such as agnosia, that is an inability to recognize
and interpret the significance of sensory impressions
B. Disturbances associated with hysteria: illnesses characterized by emotional conflict, the use of the
defense mechanism of conversion, and the development of physical symptoms involving the voluntary
muscles or special sense organs
1. Hysterical anesthesia: loss of sensory modalities resulting from emotional conflicts
2. Macropsia: state in which objects appear larger than they are
3. Mycropsia: state in which objects appear smaller than they are
C. Hallucinations: false sensory perceptions not associated with the real external stimuli
1. Hypnagogic hallucinations: false sensory perception occurring midway between falling asleep
and being awake
2. Auditory hallucinations: false auditory perception
3. Visual hallucinations: false visual perception
4. Gustatory hallucination: false perception of taste, such as unpleasant taste
5. Olfactory hallucination; false perception of smell
6. Tactile haptic hallucination: false perception of touch, such, such as the feeling of worms under
the skin
7. Kinesthetic hallucination; false perception of movement or sensation as from an amputated limb
(Phantom Limb)
8. Lilliputain hallucination; perception of objects as reduced in size

D. Illusion: perception of real external sensory stimuli

 VI. MEMORY

• Memory is the function by w/c information stored in the brain is later recalled to consciousness

A. Amnesia: partial or total inability to recall past experiences

B. Paramnesia: falsification of memory by distortion of recall
1. Fause renaissance: false recognition
2. Retrospective falsification: recollection of a true memory to which the patient adds false
details
3. Confabulation: unconscious filling of gaps in memory by imagined or untrue experience that
patient believes but that have no basis in fact
4. De ja vu: illusion of visual recognition in which a new situation is incorrectly regarded as a
repetition of a previous memory
5. De ja ontend: illusion of auditory recognition
6. Jamais vu: false feeling of unfamiliarity with a real situation on has experienced
C. Hypermnesia: experienced exaggerated degree of retention and recall situation one has

VII. INTELLIGENCE

• Intelligence: the ability to understand, recall, mobilized, and integrated constructively previous
learning in meeting new situations

A. Mental retardation: organically caused lack of intelligence to such a degree that there is
interference with social and vocational performance:
• mild (I.Q. of 50 to 70)
• moderate (I.Q. of 35 to 49)
• severe (I.Q. of 20 to 34)
• profound (I.Q. below 20)
• obsolescent terms: (mental age less than 3 years), imbecile (mental age of 3 to 7 years),
and moron (mental age of 8 or more).
B. Dementia: organic loss of mental functions.