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MINISTRY OF HEALTH OF UKRAINE
BUKOVYNIAN STATE MEDICAL UNIVERSITY
“Approved”
on the methodical meeting
of the Department of neurology, psychiatry
and medical psychology nm. S.M.Savenko
“____” ___________ 2009 (Report № __).
Chief of the Department
_______________________
Professor V.M. Pashkovsky
METHODICAL INSTRUCTION
for 4-th year students of medical faculty №2
(the speciality “medical affair”)
for independent work during preparing to practical class
Theme 10: PSYCHOPATHOLOGICAL SYNDROMES
MODULE 1. GENERAL QUESTIONS OF PSYCHIATRY AND NARCOLOGY.
GENERAL PSYCHOPATHOLOGY
TOPICAL MODULE 2. GENERAL PSYCHOPATHOLOGY
Сhernivtsi,2009
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1. Actuality Aim
It is known that at psychical diseases the functions of higher departments of brain are
violated: disorder of intercommunications comes between basic nervous processes, between a bark
and below placed parts of brain. These changes predetermine forming of certain symptoms of
abnormal psychologies and syndromes. But not only psychical diseases are accompanied violation
of nervous processes and consciousness but also any diseases of organism can cause similar
disorders.
That is why it is very important for the doctor of every profession to know physiological
bases of psychical activity and able to estimate correctly the state of consciousness of sick and
psychopathological syndromes.
2. EDUCATIONAL PURPOSE
2.1.A student must know:
 psychopathological syndromes of perception disorders;
 psychopathological syndromes of memory disorders;
 psychopathological syndromes of thoughts disorders;
 psychopathological syndromes of intellect disorders;
 psychopathological syndromes of emotions disorders;
 psychopathological syndromes of will disorders;
 criteria of clear consciousness;
 criteria of consciousness on K.Jaspers;
 classification of syndromes of consciousness disorder;
 disorders of self-consciousness.
2.2. A student must be able:
 to determine the criteria of clear consciousness;
 to determine the criteria of consciousness disorders;
 to use the clinical method of research of consciousness and self-consciousness.
2.3. A student must capture practical skills:
 determination of psychopathological syndromes;
 determination of criteria of clear and broken consciousness;
 determination of the state of consciousness.
3. EDUCATE PURPOSE.
Importance of knowledge of scientific developments of physiologists І.М.Sechenov and
І.P.Pavlov students is underlined about reflex nature of psychical activity and value of correct
estimation of the state of consciousness of man for giving her necessary medical assistance.
4. INTERSUBJECT INTEGRATION (base level of preparation).
Names of previous disciplines
1. Anatomy.
2. Physiology.
3. General psychology.
Skills are got
1. To know an anatomy and topographical anatomy of
cerebrum.
2. To know the basic cork functions of cerebrum. Able
to define the type of higher nervous activity.
3. To know psychology of psychical processes,
consciousness and self- consciousness.
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5. CONTENTS OF THEME.
Illusions – perceptions of really existent objects and phenomena, which understanding of
appearances of того, which is perceived, does not answer reality and has other maintenance, is at,
are disfigured.
Hallucinations are imaginary perception, without a really existent object. After the
mechanism of origin they are the painfully changed and involuntary presentations which become
dominant in consciousness.
The real hallucinations are all characteristics of perception – extra projection, feeling of
reality and absence of arbitrary change of appearance.
Hallucinosis – the plural proof verbal hallucinations of antagonism character (one protect a
patient, and other threaten him) speak with a patient in the third person.
Psychical automatism unites symptoms which are characterized patients, as stranger in
relation to their consciousness, independent of their will, violent.
 In anterograde amnesia, new events contained in the immediate memory are not transferred
to the permanent as long-term memory, so the sufferer will not be able to remember
anything that occurs after the onset of this type of amnesia for more than a brief period
following the event. The complement of this is retrograde amnesia, where someone will
have impaired recall of events that occurred prior to the onset of the amnesia. The terms are
used to categorise patterns of symptoms, rather than to indicate a particular cause or
etiology. Both categories of amnesia can occur together in the same patient, and commonly
result from drug effects or damage to the brain regions most closely associated with
episodic/declarative memory: the medial temporal lobes and especially the hippocampus.
 Retrograde Amnesia is the inability to recall some memory or memories of the past, beyond
ordinary forgetfulness. An example of mixed retrograde and anterograde amnesia may be a
motorcyclist unable to recall driving his motorbike prior to his head injury (retrograde
amnesia), nor can he recall the hospital ward where he is told he had conversations with
family over the next two days (anterograde amnesia).
 Traumatic amnesia is generally due to a head injury (fall, knock on the head). Traumatic
amnesia is often transient, but may be permanent of either anterograde, retrograde or mixed
type. The extent of the period covered by the amnesia is related to the degree of injury and
may give an indication of the prognosis for recovery of other functions. Mild trauma, such
as a car accident that could result in no more than mild whiplash, might cause the occupant
of a car to have no memory of the moments just before the accident due to a brief
interruption in the short/long-term memory transfer mechanism.
 Long-term alcoholism or malnutrition can cause a type of memory loss known as Korsakoff's
syndrome. This is caused by brain damage due to a Vitamin B1 deficiency and will be
progressive if alcohol intake and nutrition pattern are not modified. Other neurological
problems are likely to be present in combination with this type of Amnesia. Korsakoff's
syndrome is also known to be connected with confabulation.
 Short-term memory loss is a common symptom of Alzheimer's disease and other forms of
dementia.
 Psychogenic amnesia results from a psychological cause as opposed to direct damage to the
brain caused by head injury, physical trauma or disease, which is known as organic amnesia.
This can include:
 Dissociative amnesia is used to refer to inability to recall information, usually about stressful
or traumatic events in persons' lives, such as a violent attack or rape. The memory is stored
in long term memory, but access to it is impaired because of psychological defense
mechanisms. Persons retain the capacity to learn new information and there may be some
later partial or complete recovery of memory. This contrasts with e.g. anterograde amnesia
caused by amnestics such as benzodiazepines or alcohol, where an experience was
prevented from being transferred from temporary to permanent memory storage: it will
never be recovered, because it was never stored in the first instance.
 Lacunar amnesia is the loss of memory about one specific event.
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
Childhood amnesia (also known as Infantile amnesia) is the common inability to remember
events from one's own childhood. Whilst Sigmund Freud attributed this to sexual repression,
others have theorised that this may be due to language development or immature parts of the
brain. This is often exploited by the use of false memories in child abuse cases.
 Global Amnesia is total memory loss. This may be a defence mechanism which occurs after a
traumatic event. Post-traumatic stress disorder can also involve the spontaneous, vivid
retrieval of unwanted traumatic memories. (flash-backs)
Disturbances in speech.
1. Pressure of speech: rapid speech that is increased in amount and difficult to interrupt.
2. Volubility (logorrhea): copious, coherent, logical speech.
3. Poverty of speech: restriction in the amount of speech used; replies may be monosyllabic.
4. Nonspontaneous speech: verbal responses given only when asked or spoken to directly;
no self-initiation of speech.
5. Poverty of content of speech: speech that is adequate in amount but conveys little
information because of vagueness, emptiness, or stereotyped phrases.
6. Dysprosody: loss of normal speech melody (called prosody).
7. Dysarthria: difficulty in articulation, not in word finding or in grammar.
8. Excessively loud or soft speech: loss of modulation of normal speech volume; may reflect
a variety of pathological conditions ranging from psychosis to depression to deafness.
9. Stuttering: frequent repetition or prolongation of a sound or syllable, leading to markedly
impaired speech fluency.
10. Cluttering: erratic and dysrhythmic speech, consisting of rapid and jerky spurts.
B. Aphasic disturbances: disturbances in language output.
1. Motor aphasia: disturbance of speech caused by a cognitive disorder in which
understanding remains but ability to speak is grossly impaired; halting, laborious, and inaccurate
speech (also known as Broca's, nonfluent, and expressive aphasia).
2. Sensory aphasia: organic loss of ability to comprehend the meaning of words; fluid and
spontaneous but incoherent and nonsensical speech (also known as Wernicke's, fluent, and
receptive aphasia).
3. Nominal aphasia: difficulty in finding correct name for an object (also termed anomia and
amnestic aphasia).
4. Syntactical aphasia: inability to arrange words in proper sequence.
5. Jargon aphasia: words produced are totally neologistic; nonsense words repeated with
various intonations and inflections.
6. Global aphasia: combination of a grossly non-fluent aphasia and a severe fluent aphasia.
7. Alogia: inability to speak because of a mental deficiency or an episode of dementia.
8. Copropregia: involuntary use of vulgar or obscene language; seen in Tourette's disorder and
some cases of schizophrenia.
Disorders of intellect
An intellect is a capacity of man for using the operations of thought, ability to apply the
purchased knowledge and experience in practical activity, to get to essence of things and
phenomena of environment, select a main link in the difficult chain of connections and accumulate
new knowledge and experience.
Violations of intellectual activity at psychical diseases are various enough. The states which
insufficiency of intellect is named dementia (if purchased ) and mental retardation (if born).
Dementia is characterized the proof decline of cognitive activity of man.
Partial dementia is characterized the partial defects of intellect as a result of decline of
memory. A man have difficulties at the operations of thought. At vascular diseases, cranial-cerebral
traumas, syphilitic defeats of cerebrum.
Total dementia appears the decline of all forms of cognitive activity. A patient loses ability to
use the operations of thought, critically to estimate the state, acts, and also outward things. There is
a global decline of intellection with disintegration of kernel of personality. A patient needs
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examination and supervision. Total dementia develops at a dotage, progressive paralysis, illnesses
of Al'tsgeymera, Lance and other.
Concentric (epileptic) dementia is characterized
gradual psychical degradation of
personality with the loss of flexibility of thought due to the decline of capacity for using the
operations of thought. Thought becomes viscid, gone into detail. Attention of patients is
concentrated on own necessities, mainly biological. Observed at epilepsy.
Schizophrenic dementia is characterized the weakness of cognitive processes, by propensity
to progress. Patient not able to use the operations of thought not due to violation of memory or loss
of knowledges and abilities, but as a result of dissociation of psychical processes. At schizophrenia.
Oligophrenia (born mental retardation)
A general sign there is a presence of born retardation with predominance of intellectual
insufficiency.
General signs:
1. An abnormal psychology structure with totality of psychical retardation and predominance
of weakness of abstract thought.
2. Stable state of intellectual insufficiency.
3. The rate of psychical development of individual is slow.
After the degree of psychical retardation and clinical picture select such forms:
easy mental backwardness (JQ in a range 50-69);
moderate mental backwardness (JQ – 35-49);
heavy mental backwardness (JQ – 20-34);
deep mental backwardness (JQ below 20).
Syndromes of Mood Disorders
Depression. In psychiatry the classical (typical) depression is a clinical syndrome consisting
of lowering of mood-tone (feelings of painful dejection), difficulty in thinking (slowing down of
thinkin), and psychomotor retardation (the so called depressive triad). Depressive patients
experience conscious psychic suffering, anguish, and sometimes feelings of boredom, despair, guilt
or other negative emotions. Some patients with depression complain of painful mental insensibility
(anesthesia psychica dolorosa) — lack of emotions, especially this concerns feelings of love
towards relations and other positive feelings. These experiences are associated with ideas of selfhumiliation, loss, or sinfulness. Patients with depression think that they are failures, that there was
nothing good in the lives in the past, nothing good occurs at present, and the future will bring them
only misfortune.
Depression of mood is associated with a characteristic expression in which the corners of the
mouth are turned down and the centre of the brow has vertical furrows. The head is inclined
forward with the gaze directed downwards, and the shoulders are bent. The patient's gestures are
reduced. If the psychomotor retardation is pronounced
Depressive stupor can occur, in which patients do not move at all. In some cases after a long
period of motor retardation a sudden episode of wild agitation and frenzy can occur. It is called
"raptus melancholicus." Patients in this state beat their heads against a wall, scratch their faces, they
can injure themselves seriously, or commit a suicidal attempt or suicide.
Depressive patients often have several physical complaints, although no organic changes in
their inner organs are found. Mood disorders, though, are in the majority of cases associated with
the autonomous nervous system dysfunction, such as tachicardia, dilation of pupils, and
constipation (Protopopov's triad); there are also dryness in the mouth and other symptoms. In
depression appetite is usually low, and decrease of weight is observed in the patients.
Non-typical depressions differ from the classical depressive syndrome in a number of ways.
In the cases of anxiety-depression, besides feelings of sadness or dejection, patients feel
intensive anxiety and agitation, associated with the expectation of some specific misfortune (death
of relations, loss of property, etc.). Such patients, instead of being retarded are restless and cannot
stay still even for a few minutes, they become fussy and often complain, ask other people for help,
tell them that something fatal has happened, or express their wish to die. If such state of excitement
grows very severe, long-termed, and patients go into a frenzy, the depression is called agitated.
Apathetic depression makes patients indifferent to their environment, to their own state and to their
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relations, apathetic, inert, and listless. They do not want to communicate with other people, do not
complain, and their only wish is to be left alone.
Masked or somatized depression is manifested mainly in various physical complaints, such
as pains and aches in the chest, stomach, or other parts of the body, decrease of appetite,
disturbances of sleep, heart palpitations, headaches, etc. Patients do not feel anguish or despair, they
experience only boredom or sadness, but attribute these feelings to their physical problems. They
consult different physicians, but no somatic diseases are found in them. It usually takes a
considerable time to diagnose the masked depression.
Depressive states occur in different psychoses (maniac-depressive, or bipolar affective
disorder, involution melancholy, reactive states, neuroses and some others). Depression is one of
the most frequent syndromes in psychiatry.
The manic syndrome is characterised by: a) an elated or euphoric mood (hyperthymia); b)
increased psychomotor activity, restlessness; c) increased number of ideas, speed of thinking and
speech (manic triad). The intensity if these symptoms can be different. Elation of mood is
associated with a lively cheerful expression. Posture is normal. The patients speak very much and
fast, in a loud voice. Often they don't finish sentences. Their movements are quick and active.
The attention in the manic syndrome is unstable, patients are easily distracted and usually
don't finish the work they begin doing. Thus, they are extremely active, but not productive. Their
memory, on the contrary, increases (hypermnesia). These patien do not express any complaints,
they experience "moral elation” and increased physical powers. They tend to overestimate their
capacities and opportunities. For example, women find themselves extremely attractive, they think
that the male personnel of the hospital and the students are in love with them. They decorate their
hair and clothes with flowers or bright-coloured ribbons, and use cosmetics too much. Patients may
believe, that they are capable of attaining great social changes, or make an important scientific
discovery.
Physical symptoms. Manic patients usually have increased appetite, but they do not gain
weigh, owing to their excessive activity. They sleep for only 3 or 4 hours at night (although this fact
does not disturb them). Their sexual activity grows.
Disturbances of Volitional Actions can develop at any stage of the volitional action: at the
level of motivation (wish, drive), at the level of intellectual component of the action ("struggle of
motives", goal-setting, planning) and at the level of realization (action). The general classification
of volitional processes pathology is shown in Table 3.
Abulia is absence of willpower or wish-power, pathological absense of wishes or motivation
to activity. Abulia usually causes adinamia — decrease of movements in a patient. It occurs in
different mental disorders, especially schizophrenia, depression. Total abulia is rare, the more
frequent disorder is hypobulia that manifests usually in weak motivation, inertia, listlessness and
motor retardation - slowing down and decrease of the number of movements.
Absence of movements is sometimes called stupor in psychiatry. Stupor refers to a state in
which the person is mute, immobile, and unresponsive, but appears to be conscious because the
eyes are open and follow external objects. (This is the usage in psychiatry; in neurology the same
term often implies a degree of impairment of consciousness.)
Hyperbulia — the pathologically increased activity can be manifested in three forms:
I) Increase of volitional activity (purposeful activity) — in manic and some other states. The
patients' behaviour is overactive and anreasonable, they manifest increased energy and lack of
critical attitude towards their actions.
Example: a patient with the manic syndrome decided that his flat needed a new coat of paint.
When his wife was away, he spent all the money they had saved for their summer vacation on
expensive paints, brushes, etc., and painted each wall and ceiling in the flat a different bright colour
(red, bright, yellow, green). He had done all the work in one day and night, so the quality was
extremely poor. In addition he splashed the paint all over the carpets and furniture.
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Hyperbulia
a)Increase of volitional
activity (purposeful activity)
b)Redundancy of volitional
activity motor excitement)
c)Hyperactivity
Table 3. Pathology of Volitional Processes
Hypobulia
Parabulia
a) Motor retardation (slowness a) Catatonic syndrome
of movements)
b) Hebephrenic syndrome
b) Absence of movements
(stupor)
2) Redundancy of volitional activity, motor excitement — agitation, general perturbation,
when a patient makes quick, usually senseless movements (catatonic state, agitated depression,
etc.). This state is different from the previous, because there is no conscious purpose in the patients'
behaviour and actions.
3) Hyperactivity — manifestation of disturbed child behaviour, when a child is constantly
restless and in motion. It is usually combined with attention deficiency.
Parabulia — perversion of volition or will. Usually occurs in schizophrenia as a
manifestation of ambivalence. There are two kinds of parabulia manifestations — catatonic and
hebephrenic syndromes.
The symptoms of the catatonic syndrome are presented in Table 4. As you can see, there are
two variants of this syndrome, manifested in excitement or retardation. There are also some
symptoms common for both variants. Some terms used in the table need explanation.
We shall begin with common symptoms. Stereotypy means multiple repetition (of words, phrases,
gestures) or preservation (of posture or place). For example, a catatonic patient for whole days long
stands in a corner with a slipper in his hands and plucks at it with the same characteristic movement
of his fingers. He returns to this place and action every morning and after every meal for several
months. Ambitendency means two opposite impulses (wishes) appearing in a person simultaneously
(ex. to go and have lunch, and not to do it). Paramimia consists in strange, inadequate facial
expressions. Echopraxia and echolalia are repetitions of somebody else's actions or words.
Table 4. Structure of the Catatonic Syndrome
Catatonic excitement
Catatonic motor retaidation
Speech and motor excitement
Impulsiveness
Affectation Verbigeration
Catatonic stupor (receptor and effector)
Automatic submission
Negativism (active and passive)
Waxy flexibility of muscles
Mutism
Stereotypy (posture, pose, place)
Ambitendency
Paramimia
Echopraxia
Echolalia
Catatonic excitement, besides these symptoms, includes purposeless impulsive actions (a
patient suddenly tares his/her clothes, runs down the hospital corridor, or hits somebody without
any provokation). Verbigeration is meaningless repetition of words and phrases (synonymous to
verbal stereotypy).
Catatonic motor retardation can be of different levels. In the state of stupor patients lie in
bed in an embryonic postuxe and don't move. If they lie on the back, you can often notice that they
hold their head raised above the pillow. This, as well as waxy flexibility of muscles, is caused by
increased plastic muscle tonus. If someone shapes a patient's limbs into some posture (raises his/her
arm, bends his/her leg), this posture will be preserved for several minutes even if it is
uncomfortable. If the retardation doesn't reach the level of total stupor, patients are able to move
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slowly and, besides common symptoms, can manifest either automatic submission (obedience), or
negativism (in passive negativism they simply do not follow instructions, and in active negativism
they do the opposite to what is expected from them). Mutism means absence of speech.
Hebephrenic manifestations consist in incongruous., ridiculous, and frolicsome behaviour
(pulling faces, grimacing, affectation, mimicking others, unmotivated laughter, etc.). Patients can
jump about, ask other people ridiculous questions. The mood is changeable. The speech is fast, the
patients use neologisms, sometimes speak in rimes. Both these syndromes occur in schizophrenia.
Classification of frustration of consciousness:
1. Set of symptoms of the switched off consciousness. Allocate the following stages:
- an obnubilation,
- a sopor,
- a coma - the consciousness is absent.
2. Sets of symptoms of the changed consciousness - the consciousness is kept, but in new
quality - patients behave unusually. Then do not remember or badly remember, happened
with them at the moment of obscuring event. Experiences bright, externally not clear.
Criteria of the changed consciousness (on K.Jaspers):
а) detachment from the real world
б) infringement of orientation
в) an amnesia - specific to each variant.
Jaspers has described stages of development of delirium.
There are 4 basic such as stupefaction:
a delirious stupefaction - more often;
an oneiric stupefaction;
an amental stupefaction;
a twilight stupefaction.
The delirium is one of many alcoholic psychosis’s. Develops only on 2 or 3 stages of an
alcoholism. It is a lot of signs.
"Delirium tremens" is preceded with an alcoholic abstinent set of symptoms. On the CART
the alcoholic abstinent set of symptoms is a set of somatic, vegetative neurological and
psychopathological sets of symptoms which arise at sudden deprivation of alcohol, and all these
displays reduce the expressiveness and intensity at addition of new doses of alcohol. The abstinence
is preceded with a drinking-bout, as a rule, a true drinking-bout (5-7 days) after which reception of
alcoholic drinks suddenly stops that results in occurrence of a symptomatology.
For 2-3 day after deprivation of alcohol, is closer by the night the delirium develops.
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Clinical displays of a delirium:
The patient lays in bed fixed, but the patient unshaven, dirty, "vegetative" tries to rise, tongue
is impose with a brown raid, frustration of perception, frustration of thinking are observed. The
behaviour of the patient is defined by potent hallucinate experiences. The patient in own person, a
place, time is focused. Frustration of perception are shown by true hallucinations, all the images
long with a negative shade (draw, mice, rats, cockroaches). Huge value for statement of the correct
diagnosis is played with emotional reaction of the patient. The patient defends actively, protected
from hallucinate images.
In treatment of patients by a delirium it is important to achieve dream which will be an output
from a delirium. During 2-3 months after an output from a delirium - an asthenic condition.
Deeper than delirium form - oneiric stupefaction of consciousness, - dreamlike panoramic
hallucinations, which unite with the conduct after the type of “charmed”, prevail in the clinical
picture of which. It is observed at psychical disorders, more frequent at schizophrenia.
Complete disorientation is the basic clinical displays of amental stupefaction of
consciousness in circumferential and own personality, fragmentaryness of perception of
circumferential, inconsistence of thought, confusion, fearfulness. Patients are uneasy, restless within
the limits of the limited space. Amention is finished by deep amnesia. Develops mainly on a
background the heavy exhausting somatopathies and is the sign of heavy decompensation of bodily
condition and worsens the prognosis of basic disease.
At twilight stupefaction of consciousness, which is characteristic for the state of heavy
intoxication (at the infectious diseases febril schizophrenia) a patient is fully confused, contact with
him impossible, he can be excited within the limits of bed, original appearance is characteristic is
face of Hippocrates, is accompanied by the grave common condition of patient.
For the twilight state of consciousness is characteristic outbreak, briefness and rapid (critical)
exit from him, shows up disorientation or Riga narrowing of the field of consciousness, often with
ability to execute enough difficult, but inadequate actions. Delusions and hallucinations under act of
which a patient can have the flashes of aggressively-destructive excitation is possible. Takes place
complete amnesia of period of stupefaction of consciousness. This state is observed at epilepsy,
organic diseases of cerebrum.
Ambulatory automatism is characterized by mobile excitation noninfringement other any in
the spheres of perception, thought and emotional. Can show up in the series of successive,
stereotyping motions or in more difficult purposeful motive acts on motion. If irresponsible motions
are chaotic, nonsense, brief (a patient rolls up a sheet, rummages by hands the body, head, twirls on
a city, suddenly begins to hurry and other) name such type of ambulatory automatism fugue. More
protracted states (a few days, weeks, months) and с more well-organized conduct is named trances.
Disorder of consciousness is depersonalization - the pathologically changed perception of
surrounding reality and (or) own “Я”. Depersonalisation is divided into the derealization.
The derealization is violation of reflection of circumferential. The all circumferential
acquires unusual internalss: “allegedly artificial”, unreal, “people as dolls, lifeless”. The
imperception time is experienced as “stop of time”, “delay of time”, “acceleration of time”, “loss of
sense of time” and other Meets at epilepsy, affects violations.
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Students on the basic stage of tutorial independently under the direction of teacher inspect
mentally patients with mental disorders. Independently collect information of anamnesis, find out
quantitative of psychopathological syndromes.
With the purpose of mastering of new knowledges and abilities on this stage of employment
the tasks of situations are used and questions, which are executed in writing, checked up a teacher
during employments and results come into question, are standardized.
5.1. QUESTIONS OF CONTROLS:
1. Psychopathological syndromes of perception disorders.
2. Psychopathological syndromes of memory disorders.
3. Psychopathological syndromes of thoughts disorders.
4. Psychopathological syndromes of intellect disorders.
5. Psychopathological syndromes of emotions disorders.
6. Psychopathological syndromes of will disorders.
7. Criteria of clear consciousness.
8. Criteria of consciousness on K.Jaspers.
9. Classification of syndromes of consciousness disorder.
10. Disorders of self-consciousness.
6. MATERIALS OF METHODICAL PROVIDING OF EMPLOYMENT (MATERIALS OF
CONTROL OF BASE (INITIAL LEVEL) PREPARATION OF STUDENTS):
6.1. Additions. Facilities for control:
Questions of controls:
1. Psychopathological syndromes of perception disorders.
2. Psychopathological syndromes of memory disorders.
3. Psychopathological syndromes of thoughts disorders.
4. Psychopathological syndromes of intellect disorders.
5. Psychopathological syndromes of emotions disorders.
6. Psychopathological syndromes of will disorders.
7. Criteria of clear consciousness.
8. Criteria of consciousness on K.Jaspers.
9. Classification of syndromes of consciousness disorder.
10. Disorders of self-consciousness.
7. The tests:
1. The high level of capabilities is named:
A. temperament.
B. character.
C. capability.
D. creation.
*E. talent.
2. A memory disorder in which someone can recall certain information, but they do not know
where or how they obtained the information, named:
*A. Retrograde amnesia
B. Gypomnezia.
C. Anterograde amnesia.
D. Traumatic amnesia
E. Lacunar amnesia.
3. A patient actively casts aside ideas about illness and her consequences are possible, estimates
the displays of illness as not "serious feelings", that is why renounces an inspection and
treatment or limited to "self-treatment". Which type of reacting on illness?
A. Egocentric.
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B. Harmonious.
C. Apathetical.
D. Euphoric.
*E. Anosognosia.
4. Purchased organic and global deterioration of intellectual functioning without clouding of
consciousness named:
A. Concrete thinking.
B. Abstract thinking.
C. Mental retardation.
*D. Dementia.
E. Pseudodementia.
5. A patient is sure of presence for him of serious illness, constantly concentrated on the sickly
feelings, experiencing and continuous talks about illness result in the exaggerated subjective
perception of those, that is present and search of pseudo maladies. Desires to treat oneself are
combined with disbelief in success. Which type of reacting on illness?
A. Anxiously-depressed.
*B. Hypochondria.
C. Apathetical.
D. Egocentric.
E. Dysphoric.
6. Ability to appreciate nuances of meaning, multidimensional thinking with ability use
metaphors and hypotheses appropriately named:
A. Concrete thinking.
*B. Abstract thinking.
C. Mental retardation.
D. Dementia.
E. Volubility.
7. Ability to understand, recall, mobilize, and constructively integrate previous learning in
meeting new situations named:
A. Feeling.
B. Perception.
C. Memory.
*D. Intellect.
E. Thought.
8. False belief, based on incorrect experience about external reality, cannot be corrected named:
*A. Delusion.
B. Neologism.
C. Verbigeration.
D. Derailment.
E. Blocking.
9. Literal thinking, limited use of metaphor without understanding of nuances of meaning
named:
*A. Concrete thinking.
B. Abstract thinking.
C. Mental retardation.
D. Dementia.
E. Volubility.
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10. The inability to recall some memory or memories of the past, beyond ordinary
forgetfulness named:
*A. Retrograde amnesia
B. Gypomnezia.
C. Anterograde amnesia.
D. Traumatic amnesia
E. Lacunar amnesia.
11. A psychical process, higher form of creative activity of man through which the most
substantial signs of objects and phenomena of the objective world are represented and their
intercommunications open up named:
A. Feeling.
B. Perception.
C. Memory.
D. Attention.
*E. Thought.
12. Inborn lack of intellect to a degree in which there is interference with social and vocational
performance named:
A. Concrete thinking.
B. Abstract thinking.
*C. Mental retardation.
D. Dementia.
E. Pseudodementia.
Clinical Tasks.
1. A male patient, 37 years old, became too cheerful for no particular rea-son, he has a subjective feeling of
high creative abilities, enthusiasm, elation and increased productivity, in spite of manifest disability to
concentrate (impaired attention); his speed of thinking processes is too high. He is uncritical to his state, and
finds it normal.
Name the syndrome:
A. Manic (non-psychotic) syndrome
B. Syndrome of dysphoria
C. Hypomanic (non-psychotic) syndrome
D. Obsessive syndrome
E. Depersonalization syndrome
2. A male patient 22 years old, complained of the decrease of physical and mental productivity, as well as
increased fatigue, weakness, increased need for rest after easy work. He became irritable, impatient and less
tolerate towards people, it is difficult for him to wait even for a short time; he often has headache, sweats
easily, feels prickling sensations in the heart re-gion when worries.
Name the syndrome:
A. Depressive syndrome
B. Hypochondriac syndrome
C. Asthenic syndrome
D. Paranoia syndrome
E. Obsessive syndrome
3. The patient's mother complains that at night he gets up from bed with open eyes and roams around the
room aimlessly with a vacant expression on his face. He walks around the room, opening wardrobes and
drawers of the writing table, goes through the things as though looking for something. One day being in this
state, he opened the window, got onto the roof and walked near its edge with no signs of fear. All efforts to
wake the patient up when he is in such a state are useless. The patient doesn't remember anything about his
night adventures.
Name the probable syndrome:
A. Fugue
B. Trance
C. Ambulatory automatism
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D. Somnambulism
E. Motor automatism
4. A patient, while making repairs at home, suddenly stood quite still with the painting brush in his hand,
then dropped it. This state lasted for a few seconds. After that the patent was rather confused, for some
moments he couldn't understand what was happening. He totally forgot the state he was in and the events
around him, occurring while he was in that state.
Name the syndrome:
A. Obnubilation
B. Trance
C. Fugue
D. Absence (petit mal)
E. Derealisation
5. A male patient 27 years old complained that suddenly and unintentionally he found himself in a different
city. He couldn't understand, how this could happen. During his travel, of which he was completely unaware,
he made an impression of a person who was slightly confused and absentminded, absorbed in his thoughts,
but his behaviour was more or less normal.
Name the probable syndrome:
A. Fugue
B. Trance
C. Clerambault-Kandinsky syndrome
D. Somnambulism
E. Absence (petit mal)
6. At the hospital department the patient suddenly and unconsciously begins to turn round and round, then
undresses quickly, throwing his clothes down. This state lasts for approximately one minute, then suddenly
ends. The patient does not remember anything he was doing and what was happening during this period.
Name the probable syndrome:
A. Fugue
B. Trance
C. Clerambault-Kandinsky syndrome
D. Somnambulism
E. Absence (petit mal)
7. The parents of a 5-year-old child noticed the strange nature of his games. The boy seemed to transform
persistently and for long periods of time into different characters, and this was associated with behavioral
disorders. For example, pretending to be a dog, the boy asked for a bone, barked and refused to speak with
his parents, explaining later, that "dogs don't speak The intelligence level is normal.
Name the probable syndrome
A. Overvalued ideas
B. Delusion-like fantasies
C. Delusions of imagination
D. Paranoia syndrome
E. Depersonalisation syndrome
8. Patient of 39 years old, doctor. Constantly something writes and the written hides with
application. In a linguistic contact enters reluctantly, suspicious. Told a treating doctor, that opened
the method of treatment of AIDS, but «all his developments were stolen by the agents of institute of
oncology». Convinces a doctor, that kidnappers «hired three killers, to put to death me».
1. What pathology of thoughtis it?
2. What syndrome?
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8. LITERATURE IS RECOMMENDED:
8.1. Basic:
1. Clinical Psychiatry from Synopsis of Psychiatry by H.I.Kaplan, B.J.Sadock. – New York:
Williams @ Wilkins. – 1997.
2. Psychiatry.Course of lectures. – Odessa:The Odessa State Medical University. – 2005. – 336 p.
3. Lectures.
4. Internet resource.
8.2. Additional:
1. Морозов Т.В., Шумский Н.Г. Введение в клиническую психиатрию. – Н.Новгород:
Изд-во НГМА, 1998.
2. Попов Ю.В., Вид В.Д. Современная клиническая психиатрия. – М., 1997.
3. Сонник Г.Т. Психіатрія: Підручник / Г.Т.Сонник, О.К.Напрєєнко, А.М.Скрипніков. –
К.: Здоров’я, 2006.
Prepared by assistant
S.D.Savka