Saturday, 10 March 2018

SYMPTOMS RELATED TO MOOD


1.      Alexithymia- inability or difficulty in describing or being aware of one’s emotions or moods. The elaboration of fantasies associated with depression, substance abuse and post traumatic stress disorder (PTSD).
2.      Anaclitic- depending on others (relating to or characterized by a strong emotional dependence on another or others). Especially seen as the infant on the mother. Anaclitic depression in children results from an absence of mothering.
3.      Anhedonia- loss of interest in, and withdrawal from all regular and pleasurable activities. Often associated with depression.
4.      Apathy- dulled emotional tone associated with detachment or in-difference. It is observed in certain types of schizophrenia and depression.
5.      Bereavement- feeling of grief or desolation, especially at the death or loss of a loved one.
6.      Blunted effect- disturbance of affect manifested by a severe reduction in the intensity of externalized feeling tone. As outlined by Eugen Bleuler, it is one of the fundamental symptoms of schizophrenia.
7.      Constricted affect- reduction in the intensity of feeling tone that is less severe than that of blunted affect.
8.      Dysphoria- feeling of unpleasantness or discomfort, a mood of general dissatisfaction and restlessness (occurs in depression and anxiety).
9.      Emotional lability- excessive emotional responsiveness characterized by unstable and rapidly changing emotions.
10.   Euphoria- exaggerated feeling of well being that is inappropriate to real events. Can occur with drugs such as opiates, amphetamines and alcohol.
11.   Euthymia- normal range of mood, implying absence of depressed or elevated mood.
12.   Exaltation- feeling of intense elation and grandeur.
13.   Excited- agitated, purposeless motor activity uninfluenced by external stimuli.
14.   Expansive mood- expression of feelings without restraint, frequently with an overestimation of their significance or importance. It is seen in mania and grandiose delusional disorder.
15.   Flat effect- absence or near absence of any signs of affective expression.
16.   Free floating anxiety- severe, pervasive, generalised anxiety that is not attached to any particular idea, object or event.
17.   Hyperpragia- excessive thinking and mental activity. Generally associated with manic episodes of bipolar 1 disorder.
18.   Hypomania- mood abnormality with the qualitative characteristics of mania, but somewhat less intense (seen in cyclothymic disorder).

Friday, 9 March 2018

MOTOR OR MOVEMENT RELATED SYMPTOMS

1.      Abulia- reduced impulse to act and to think which is associated with indifference about consequences of action. Occurs as a result of neurological deficit, depression and schizophrenia.
2.      Adiadochokinesia- inability to perform rapid alternating movements. Occurs with neurological deficit and cerebellar lesions.
3.      Adynamia- weakness and fatigability, characteristic of neurasthenia and depression.
4.      Agitation- severe anxiety associated with motor restlessness.
5.      Akathisia- subjective feeling of motor restlessness manifested by a compelling need to be in constant movement. May be seen as an extrapyramidal adverse effect of antipsychotic medication. May be mistaken for psychotic agitation.
6.      Akinesia- lack of physical movement, as in extreme immobility of catatonic schizophrenia. It can also occur as an extrapyramidal effect of antipsychotic medication.
7.      Akinetic Mutism or Coma Vigil- absence of voluntary motor movement or speech in a patient who is apparently alert (as evidenced by eye movement). It is seen in psychotic depression and catatonic states.
8.      Apraxia- inability to perform a voluntary purposeful motor activity. It cannot be explained by paralysis or other motor or sensory impairment.
9.      Constructional Apraxia- patient cannot draw a 2 or 3 dimensional form (inability to copy a drawing).
10.   Astasia Abasia- inability to stand or walk in a normal manner, even though normal leg movements can be performed in a sitting or lying down position. It is seen in conversion disorder.
11.   Ataxia- lack of coordination, physical or mental. In neurology, refers to loss of muscular co-ordination. In psychiatry, the term intra-psychic ataxia refers to lack of co-ordination between feelings and thoughts. It is seen in schizophrenia and in severe OCD.
12.   Atonia- lack of muscle tone.
13.   Bradykinesia- slowness of motor activity, with a decrease in normal spontaneous movement.
14.   Catalepsy or Waxy flexibility or Cerea Flexibilitas- condition in which person maintains the body position into which they are placed. It is observed in severe cases of catatonic schizophrenia.
15.   Cataplexy- temporary sudden loss of muscle tone, causing weakness and immobilization. It can be precipitated by a variety of emotional states and is often followed by sleep. It is commonly seen in narcolepsy.
16.   Catatonic excitement- excited, uncontrolled motor activity seen in catatonic schizophrenia. Patients in catatonic state may suddenly erupt into an excited state and may be violent.
17.   Catatonic Posturing- voluntary assumption of an inappropriate or bizarre posture, generally maintained for long periods of time (may switch unexpectedly with catatonic excitement).
18.   Catatonic rigidity- fixed and sustained motoric position that is resistant to change.
19.   Catatonic stupor- stupor in which patients ordinarily are well aware of their surroundings.
20.   Chorea- movement disorder characterized by random and involuntary quick, jerky, purposeless movements. It is seen in Huntington’s disease.
21.   Command Automatism- condition associated with catalepsy in which suggestions are followed automatically.
22.   Cycloplegia- paralysis of the muscles of accommodation in the eye. It is observed at times, as an automatic adverse effect (anti-cholinergic effect) of antipsychotic or antidepressant medication.
23.   Dyskinesia- difficulty in performing movements. It is seen in extrapyramidal disorders.
24.   Dystonia- extrapyramidal motor disturbance consisting of slow, sustained contractions of the axial or appendicular musculature. One movement often predominates, leading to relatively sustained postural deviations. Acute dystonic reactions (facial grimacing and torticollis) are occasionally seen with the invitation of antipsychotic drug therapy.
25.   Hypoactivity or hypokinesis- decreased motor and cognitive activity, as in psychomotor retardation. Visible slowing of thought, speech and movement.
26.   Mannerism- ingrained, habitual involuntary movement.
27.   Muscle rigidity- state in which the muscles remain immovable. It is seen in schizophrenia.
28.   Mydriasis- dilation of the pupil. Sometimes occurs as an autonomic (anticholinergic) or atropine like adverse effect of some antipsychotic and antidepressant drugs.
29.   Overactivity- abnormality in motor behaviour that can manifest itself as psychomotor agitation, hyperactivity (hyperkinesis), tics, sleepwalking or compulsions.
30.   Paresis- weakness or partial paralysis of organic origin.
31.   Posturing or Catatonia- strange, fixed and bizarre bodily positions held by a patient for an extended time.
32.   Psychomotor Agitation- physical and mental over activity that is usually non-productive and is associated with a feeling of inner turmoil, as seen in agitated depression.
33.   Stupor- state of decreased reactivity to stimuli and less than full awareness of one’s surroundings; as a disturbance of consciousness, it indicates a condition of partial coma or semi-coma. In psychiatry, used synonymously with mutism and does not necessarily imply a disturbance of consciousness. In catatonic stupor, patients are ordinarily aware of their surroundings.
34.   Tic disorders- predominantly psychogenic disorders characterized by involuntary, spasmodic, stereotyped movement of small groups of muscles. It is seen most predominantly in moments of stress or anxiety, rarely as a result of organic disease.
35.   Tremor- rhythmical alteration in movement, which is usually faster than one beat a second. It typically decreases during periods of relaxation and sleep and increase during periods of anger and increased tension.
36.   Ideomotor Apraxia- often called IMA, is a neurological disorder characterized by the inability to correctly imitate hand gestures and voluntarily mime tool use, e.g.- pretend to brush one’s hair.
37.   Lesh- Nyhan Syndrome- impaired kidney function, acute gouty arthritis and self mutilating behaviours such as lip and finger biting and/or head banging. Additional symptoms include involuntary muscle movements, and neurological impairment.
38.   Stereotypy- repetitive, abnormal frequent, non-goal directed movements.
39.   Grimacing- an ugly, twisted expression on a person’s face, typically expressing disgust, pain or wry amusement.

Wednesday, 24 January 2018

SIGNS AND SYMPTOMS RELATED TO SPEECH AND LANGUAGE

1.    Acataphasia- Disordered speech in which statements are incorrectly formulated. Patients may express themselves with words that sound like the ones intended, but not appropriate to the thoughts or they may use totally inappropriate expression.
2.    Aculalia- nonsense speech associated with marked impairment of comprehension. Occurs in mania, schizophrenia and neurological deficit.
3.    Alogia- inability to speak because of a mental deficiency or an episode of dementia.
4.    Aphasia- any disturbance in the comprehension or expression of language caused by a brain lesion.
5.    Asyndesia- disorder of language in which the patient combines unconnected ideas and images. It is commonly seen in schizophrenia.
6.    Bradylalia- abnormally slow speech. Commonly seen in depression.
7.    Circumstantiality- disturbance in the associative thought and speech processes in which a patient digresses into unnecessary details and inappropriate thoughts before communicating the central idea. It is commonly observed in schizophrenia, obsessional disturbances and certain cases of dementia.
8.    Clang association- association or speech directed by the sound of a word rather than its meaning. The words have no logical connection. Punning and rhyming may dominate the verbal behaviour. It is seen most frequently in schizophrenia and mania.
9.    Cluttering- disturbance of fluency involving an abnormally rapid rate and erratic rhythm of speech that impedes unintelligibly. The affected individual is usually unaware of the communicative impairment.
10.  Copralalia- involuntary use of vulgar or obscene language. Observed in some cases of schizophrenia and Tourette’s syndrome.
11.  Cryptolalia- a private spoken language.
12.  Cryptographia- a private written language.
13.  Dysphasia- (Reception dysphasia) -difficulty in comprehending oral language. (Expressive Dysphasia)-difficulty in trying to express verbal language.
14.  Dysprosody- loss of normal speech prosody. It is commonly seen in depression.
15.  Echolalia- psychopathological repeating of words or phrases of one person by the other, tends to be repetitive and persistent. It is seen in certain kinds of schizophrenia, particularly the catatonic types.
16.  Expressive aphasia or Broca’s Aphasia or Motor Aphasia or non-fluent aphasia- disturbance of speech in which understanding remains but ability to speak is grossly impaired, halting, laborious, inaccurate speech. People with this condition may know exactly what they want to say and understand what they hear others say, but they cannot control the actual production of their own words. Speech is halting and words are often mispronounced such as saying “cot” instead of “clock” or “non” instead of “nine”.
17.  Expressive dysphasia- difficulty in expressing verbal language, the ability to understand language in intact.
18.  Fluent aphasia or Wernicke’s aphasia or sensory aphasia or receptive aphasia- aphasia characterized by inability to understand the spoken word. Fluent but incoherent speech is present. A person with Wernicke’s aphasia would be able to speak fluently and pronounce words correctly, but the words would be the wrong one entirely. For example, “now get me some milk out of the air conditioner, woman!”
19.  Global aphasia- combination of grossly non-fluent aphasia and severe fluent aphasia.
20.  Glossolalia, it is also called “speaking in tongue”- unintelligible jargon that has meaning to the speaker but not to the listener. Commonly seen in schizophrenia.
21.  Holophrastic- using a single word to express a combination of ideas. It is seen in schizophrenia.
22.  Jargon aphasia- aphasia in which words produced are neologistic; that is nonsense words created by the patient.
23.  Metonymy- speech disturbance common in schizophrenia in which the affected persons use a word or phrase that is related to the proper one but is not the one ordinarily used. For example, the patient speaks of consuming a menu rather than a meal, or refers to losing the piece of string of the conversation, rather than the thread of the conversation.
24.  Mutism- organic or functional absence of faculty of speech.
25.  Neologism- new word or phrase whose derivation cannot be understood, often seen in schizophrenia. It has also been used to mean a word that has been incorrectly constructed but whose origins are nonetheless understandable ( e.g., head-shoe to mean hat), but such constructions are more properly referred to as word approximations)
26.  Nominal aphasia or Anomia or Amnestic aphasia- aphasia characterized by difficulty in giving the correct name of an object.
27.  Poverty of speech or Laconia speech- condition characterized by a reduction in the quality of spontaneous speech. Replies to questions are brief and unelaborated, and little or no unprompted additional information is provided. It commonly occurs in schizophrenia, major depression and organic mental disorders.
28.  Lethologica- momentary forgetting of a name or proper noun.
29.  Poverty of speech content- speech that is adequate in amount, but conveys little information because of vagueness, emptiness or stereotyped phrases.
30.  Pressured speech- increase in the amount of spontaneous speech, rapid, loud, accelerated speech, as occurs in mania, schizophrenia and cognitive disorders.
31.  Receptive aphasia- organic loss of ability to comprehend the meaning of words, fluid and spontaneous but incoherent and nonsensical speech.
32.  Receptive dysphasia- difficulty in comprehending oral language, the impairment involves comprehension and production of language.
33.  Paraphasia- abnormal speech in which one word is substituted for another, the irrelevant word generally resembling the required one in form, meaning or phonetic composition. The inappropriate word may be a legitimate one used incorrectly, such as “clover” instead of hand, or a bizarre nonsense expression such as “treen” instead of “train”.
34.  Stereotypy- continuous mechanical repetition of speech or physical activities. It is observed in catatonic schizophrenia.
35.  Stuttering- frequent repetition or prolongation of a sound or syllable, leading to markedly impaired speech fluency.
36.  Syntactical aphasia- aphasia characterized by difficulty in understanding spoken speech. Associated with gross disorder of thought and expression.
37.  Tangentiality- oblique, digressive or even irrelevant manner of speech in which the central idea is not communicated.
38.  Verbigeration or Cataphasia- meaningless and stereotyped repetition of words or phrases as seen in schizophrenia.
39.  Word salad or incoherence- incoherent, essentially incomprehensible, mixture of words and phrases commonly seen in far advanced cases of schizophrenia.
40.  Dysarthria- difficulty in articulation, the motor activity of shaping phonated sounds into speech, not in word finding or in grammar.
41.  Dyslalia- faulty articulation caused by structural abnormalities of the organs required for articulation or impaired hearing.
42.  Logorrhoea or Tachylogia or Verbomania or Volubility- copious, pressured, coherent speech, uncontrollable, excessive talking. It is observed in manic episodes of bipolar disorder.

43.  Hypergraphia- writing style that are unusual, excessive and preoccupied with selected themes.