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LECTURE NO. 6 Signs and Symptoms of Psychiatric Disorders Learning Objectives Describe the symptoms of common psychiatric disorders Elicit and discuss various signs of psychiatric disorders Introduction Symptoms are the complaints with which a patient presents to the clinician. Signs are the ones which the clinician obtains on examination of the patient. In psychiatry, the boundary between symptoms and signs is not that distinct because when explored further, a symptom can become a sign. Common Psychiatric Disorders Anxiety Depression Mania Schizophrenia Anxiety One of the most commonly experienced emotions and disorders Often experienced as excessive worrying about almost everything, tension and fear of the unknown Anxiety (cont.) Various disorders categorized under anxiety disorders include: – Generalized anxiety disorder – Panic disorder – Obsessive–compulsive disorder – Phobias – Post-traumatic stress disorder Common Symptoms of Anxiety Feelings of fear or dread Increased heart rate Palpitations Sweating Cold and clammy hands and feet Dryness of mouth and throat Common Symptoms of Anxiety (cont.) Difficulty in talking and breathing Light headedness or giddiness Tremors of hands Restlessness Depression Major depressive disorder is most closely associated with persistent sadness. The most prominent symptom is depressed mood which is clearly different from sadness due to day-to-day events. Common Symptoms of Depression Persistent sadness Poor concentration Feelings of worthlessness Easy crying Feelings of hopelessness and helplessness Suicidal ideas Common Symptoms of Depression (cont.) Poor appetite and sleep Lack of energy Decreased socialization Easy irritability Inability to experience pleasure Decreased interest in work and surroundings Mania Characterized by the sustained elevation of mood, i.e. marked happiness or at times irritability Common Symptoms of Mania Persistent and undue happiness (at times marked irritability) Increased self-esteem Over-activity Increased and rapid speech Making big plans Common Symptoms of Mania (cont.) Spending money unnecessarily Poor self-control Increased socialization Decreased need for sleep Schizophrenia Considered as one of the major psychiatric disorders Characterized by the presence of psychotic symptoms, which include: – Disturbances of thought process (delusions, derailment, illogicality) – Disturbances of perception (sensory hallucinations) Common Symptoms of Schizophrenia Inappropriate affect Talking to self Neglect of personal hygiene and work Hearing voices Suspiciousness Decreased socialization Common Symptoms of Schizophrenia (cont.) Unusual and illogical thoughts Aggressive behaviour Lack of interest in surroundings and activities Common Signs of Psychiatric Disorders Categorized into four types: 1. Disorders of motor activity (conation) 2. Disorders of emotion 3. Disorders of thought process 4. Disorders of perception 1. Disorders of Motor Activity (Conation) Commonly seen motor disorders include: Hyperactivity Mannerisms Stereotypies Tics Psychomotor agitation 1. Disorders of Motor Activity (Conation) (cont.) Psychomotor retardation Catatonic symptoms, i.e. stupor, muteness, posturing, waxy flexibility, echopraxia, echolalia, ambitendency and negativism 2. Disorders of Emotion Two types: – Disorders of mood: euthymic, dysphoric, irritable, euphoric, expansive, elated, exaltation, ecstasy, depression, anxiety and apathy – Disorders of affect: inappropriate, labile, emotional incontinence, blunted and flat 3. Disorders of Thought Process Various disorders of thought process can be categorized under: – Disorders of form – Disorders of stream – Disorders of content – Disorders of possession 4. Disorders of Perception Include illusions and hallucinations Illusions: false sensory distortion of a real sensory stimulus. Hallucinations: false sensory perception without adequate stimulus. Depending upon the sensory organ involved, hallucinations can be auditory, visual, tactile, gustatory or olfactory.