Psychiatry

Basic symptoms part 1

Basic levels of psychiatric disorders
• Psychotic
• Neurotic
• Personality
• Organic
Psychotic symptoms
Positive (‘’+’’) Negative (‘’-’’)

Hallucinations Loss of interests

Delusion Difficulty of organizing
Disorganized speech Difficulty concentrating
Disorganized behavior Social isolation
Agitation Lack of emotions
Depression Lack of energy
Hallucinations – are perception without an object that is experienced by
the sense organs to the same degree as the impact of an actually existing
object
• Simple / Complex
• True / Pseudo
• Auditory / Visual / Olfactory / Gustatory / Visceral
Auditory Hallucinations
• I have a headache
• Why?
• Can not sleep at night
• The cause of insomnia?
• The neighbor plays loud music all night till morning
• What do others ( members of youre family, other neighbors ) say about this?
• The are probably bothered too, but how could they say something about it?!
• Do youre family members sleep well at night?
• The daughter is sleeping next to me
Auditory Hallucinations
• They mock me at work (the laugh at me at work)
• How do you know?
• Heard that they were talking about his appearance
• Where did you hear the conversation?
• When he was working near the table, he heard voices behind him
• How often and how does it happen?
• It is getting more frequent, they talk about me when I’m sitting at my table. I can hear
it from every direction...In the corridor as well...
• Does it happen only at work?
• Also in transport; I saw a relative of my co-worker in the bus and he was talking about
me too
Auditory Hallucinations
• My head bothers me
• How?
• There is something inside my head
• What is it?
• Chip
• How come you have a chip inside youre head?
• The foreign intelligence service put it there
• What does it do?
• They talk inside my head through it
Auditory Hallucinations
• The origin of voice( Familiar / Unknown ) ( male / female )
• Second person/ Third person/ Dialog / Supernatural
• Imperative
Visual hallucinations
• Rare in complex forms
• More frequent during organic pathologies
• During intoxications
• In severe forms of schizophrenia
• During epileptic psychosis
Olfactory hallucinations
• I can not go to the places where people are
• why?
• My body emitts gases and they smell bad
• How do you know (that youre body emitts gases)?
• I do not, it happens on it’s own; I just smell terrible odor
• How often and where does it happen?
• When I am near people, not at home…when I am in the transport I
notice that people turn their heads away and cover their nose with
their hands
Gustatory hallucinations
• Are rear
• During epilepsy (aura)
• During organic pathology
• Side effects of the drug
• Mostly poisonous or metallic
Tactile hallucinations
• I have itching
• When has it started?
• My son took out an old sofa, I lay on it once, and I got infested with insects from there
• Have you seen these insects?
• No, but I can feel them crawling under my skin
• Have you been to a dermatologist?
• The doctor only says that I have excoriations; They can not find them; How could
the?! The insects are under the skin. The medications they prescribe do not help
• Has the same thing happened to a family member other than you?
• No
Somatic (visceral) hallucinations
• My throat feels weird, I can sense something is stuck there
• How has it started?
• I ate cherrie and I have seed stuck in my throat
• When did it happen?
• Three days ago
• Does it affect youre swallowing, breathing, or do you have coughing
• I feel that it is stuck in there and is not moving, it bothers me
• Have you consulted a doctor?
• Yes, they say there is nothing in my throat
Delusion
•Systematized (paranoia)/ Unsystematized
•Primary / Secondary
• Persecution
• Reference
• Grandiose
• Guilt or sin
• Nihilistic
•  Hypochondrical
• Religiouse
• Jealousy
• Erotomania or delusion of love
• Control
• Thought insertion
• Induced delusion or folie a`duex
Delusions
• Bizarre delusion
• Non-bizarre delusion
• Mood-congruent delusions
• Mood-neutral delusions
Delusion
• Paranoia -> Paranoid -> Paraphrenia
• The constructor thinks that his invention will save the world - > He is
trying to prove his discovery - > His thoughts can not pass the reality
check - > He gets the thought that people are envious and they are
making enemy out of him, they interfere, contribute to intrigue- >
persecute him -> Various systems are involved in the persecution- >
He defeats all thee enemies and sees that he is glorified, everything
proves his greatness, he is rich and has special power
Delusion
• I have insomnia
• What do you think is a reason of youre insomnia? / what bothers you?
• I am worried about the condition of my skin, I think about it and I can not sleep
• What happened to youre skin?
• I have sensitive skin, I was very beautiful, if something gets on my skin it gets hard and swells; my whole face is swollen
(shows us some recent pictures and claims that compared to them her face is swollen)
• Have you been to a dermatologist?
• Doctors can not find anything, some prescribe medications but I am dissatisfied; the process does not stop
• Do those around you notice these changes?
• They do, but they do not tell me
• How do these things affect youre life?
• I do not go out of the house, I do not do daily housework; I am mostly in front of a mirror or looking at my computer for a
treatment of my skin
• What are youre plans for the future?
• I want to find a doctor who can restore my skin to its old state
Delusion
• I get the ideas about killing myself
• Why are you killing youreself?
• 1) My father was mentally ill and committed suicide; I think I am
going to kill myself too
• 2) these ideas come from outside my brain