BASIC PSYCHOPATHOLOGY
PRESENTE
R:
JANNAH
AZMYZA
Mental State
Examination
BY:
COMPONENTS
General appearance & behavior
Speech
Mood & affect
Thought disturbances
Perceptual disturbances
Test of cognitive function
Appearance &
behavior
Speech
Spontaneity
Rate
Quantity
Volume
Tone
Relevant
Coherence
Mood & affect
Mood
Affect (types, range, lability &
congruity)
Thought disturbances
Content of thought
Form of thought
Flow of thought
Thought possession
Content of thought
Suicidal idea
Phobia
Delusion
Form of thought
Looseness of association
Incoherence
Flight of ideas
Tangentiality
Pressure of speech
Poverty of speech
Circumstantial
Clang of associations
Flow of thought
Thought block
Slow thought
Pressure speech
Possession of thought
Thought insertion
Thought withdrawal
Thought broadcasting
Perceptual disturbances
Hallucination
Illusion
Test of cognitive function
Orientation
Memory
Attention & Concentration
Intelligence
Abstraction
Judgment
Insight
Psychopathology of
Schizophrenia
MUHAMMAD SYAFIEQ
Introduction
In psychiatry there is no confirmatory
laboratory finding to confirm the
psychiatric illness
The diagnosis is made based on
psychopathology which is by eliciting
symptoms and signs of abnormal
behavior, thought, affect, perception
and cognition
Schizophrenia
Appearance
and behavior
Bizarre appearance
Poor oral hygiene
and dirty nails
Food stained cloth
No eye contact and
poor rapport
Smelly
Ambivalence
Catatonia
Lack of volition
Agitation
Stereotyping
Inappropriate
behavior
Speech
Lack of spontaneity
Psychomotor retardation
Incoherence
Mood and Affect
Affect- emotions observable by others
Mood- subject feelings described by patient
Flat/blunted no noticeable expression of feeling at
all
Restricted noticeable expression feeling is reduced
Inappropriate affect is discordant with
accompanying thought
Labile affect changes rapidly from
sadness/anger/laughing
Thought disorder
1) Contents
) Delusion of reference- pt believes some external
events have personal reference to him
) Delusion being controlled- thought/
feeling/action are being controlled by some
external forces
) Bizarre delusion- odd, strange or implausible
beliefs
) Hypochondriacal delusion- morbid preoccupation
that one is having serious physical illness
) Autistic thinking- thought originated from
fantasy, withdrawn from external reality
2) Form
Looseness of association- no connection between
one sentence to following sentences
Circumstantiality- speech and thought are going
round and out of the course before the central idea
is finally presented
Derailment- speech or thought is off the track (while
conversation is taking place)
Tangentiality- person whilst speaking on a topic
deviates from the topic
Poverty of thought- global reduction in the quantity
of thought, person keeps returning to the same
limited set of ideas
Thought block- person stops speaking suddenly and
without explanation in the middle of a sentence
3) Flow
Retardation
Rapid/fast
4) Possession
Thought withdrawal
Thought insertion
Thought broadcasting
Perceptual disorder
Hallucination
Auditory- 3rd person is common in
schizophrenia
Visual
Gustatory- perception of taste without a
stimulus
Olfactory- smelling an odour that is not
actually there
Tactile- sensory input simulating various
types of pressure to the skin or other organs
Somatic-individual feels that his body is
being mutilated
Cognition
Poor concentration/ attention
Disorientation
Poor judgment
Poor insight
MAJOR
DEPRESSION
1. Behavior :
. Poor rapport
. Dejected posture
. Stupor/agitation
. Self-neglect
. Self-isolation
. Anhedonia (inability to experience pleasure)
. Speech :
- Lack of spontaneity
- Psychomotor retardation
- Mutism
2. Mood/affect :
Low mood
Depressed
Affect congruent with mood
3. Thought :
Content
Flow
Suicidal idea
Pessimistic, lack of
motivation/confidence
Delusion of guilt
Hypochondriacal idea/delusion
Nihilistic delusion (patient believes
that a part of his/her body is dead/rotten)
Slow
Retardation
4. Perceptual disorder :
2nd person auditory hallucination
5. Cognition :
Poor concentration/attention
Forgetful
BIPOLAR
(MANIC)
1. Appeareance/Behavior :
. Wearing colorful clothes/dress, excessive use of
makeup, jewelry like earrings etc.
. Very good rapport/overfriendly
. Bright color attire
. Over confidence
. Irritable
. Disinhibited
. Hyperactive, agitated, restless
. Highly energetic
. Hypersexuality
. Hyperreligiosity
2. Speech :
Talk spontaneously
Pressured speech/talkative
Voice is loud and rapid
3. Mood :
Elated mood
Affect congruent with mood
Irritability
4. Thought :
Optimistic
Delusion of grandeur (also commonly found in
schizophrenia)
Flight of ideas
5. Perceptual disorder :
Hallucination, mood related (2nd person AH is
common in affective disorder)
6. Cognition :
Distractible
Inattentive
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