TYPICAL SIGNS and SYMPTOMS of MENTAL
ILLNESS experience
OBJECTIVES in IDENTIFYING SIGNS and
SYMPTOMS of MENTAL ILLNESS
To make accurate diagnoses
To carry out effective treatments
To offer reliable prognoses
To analyze psychiatric issues as fully as
possible
To communicate fruitfully with other clinicians
DEFINITION of TERMS
SIGN: Observation and objective finding
SYMPTOM: Subjective experience described by
patient
SYNDROME: Group of signs and symptoms
that make up a recognizable condition
SOME SIGNS and SYMPTOMS of MENTAL
ILLNESS
CONSCIOUSNESS
State of awareness
Disturbances of consciousness
Disturbances of attention
Disturbances in suggestibility
DISTURBANCES of CONSCIOUSNESS
Impairment in perception and sensorium
Most often associated with brain pathology
SOME DISTURBANCES of CONSCIOUSNESS
Disorientation - disturbance of orientation in
time, place, or person
Clouding of consciousness incomplete
clear-mindedness with disturbances in perception and
attitudes
Stupor lack of reaction to an unawareness of
surroundings
Coma profound degree of unconsciousness
Somnolence abnormal drowsiness
DISTURBANCES of ATTENTION
Inability to focus on certain portions of an
external feeling tone
Inability to focus on one activity
Inability to concentrate
SOME DISTURBANCES of ATTENTION
Distractibility attention is drawn to
unimportant external stimuli
Hypervigilance excessive inattention and
focus on all internal and external stimuli
Trance focused attention and altered
consciousness
DISTURBANCES in SUGGESTIBILITY
Compliant and uncritical response to an idea or
influence
Folie a deux/a trois communicated
emotional illness between two/three persons
Hypnosis artificially induced modification of
consciousness characterized by a heightened
suggestibility
EMOTION
Complex feeling state with psychic, somatic and
behavioral components
Affect
Mood
Other emotions
Physiological disturbances associated with
mood
AFFECT
Observed expression of emotion
Possibly inconsistent with description of
emotion
DESCRIPTIONS of AFFECT
Appropriate emotional tone in harmony with
accompanying idea, thought or speech
Inappropriate disharmony between
emotional tone and idea, thought or speech
Blunted severe reduction in intensity of
Restricted or constricted reduction in
intensity of feeling tone less severe than blunted affect
Labile rapid and abrupt changes in emotional
feeling tone, unrelated to external stimuli
MOOD
Pervasive and sustained emotion
Subjectively experienced and reported
DESCRIPTIONS of MOOD
Dysphoric unpleasant mood
Euthymic normal range of mood
Expansive expression of feelings without
restraint
Irritable easily annoyed and provoked to
anger
Elevated air of confidence and enjoyment;
mood more cheerful than usual
Elation feelings of joy, triumph, intense self-
satisfaction or optimism
Euphoria intense elation with feelings of
grandeur
Ectasy feeling of intense rapture
Depression psychopathological feeling of
sadness
Labile (mood swings) oscillations between
euphoria and depression or anxiety
Anhedonia loss of interest in and withdrawal
from all regular and pleasurable activities
Alixethymia inability or difficulty in describing
or being aware of emotions or mood
OTHER EMOTIONS
Anxiety feeling of apprehension caused by
anticipation of internal or external danger
Free-floating anxiety pervasive, unfocused
fear not attached to any idea
Fear anxiety caused by consciously
recognized and realistic danger
Agitation severe anxiety associated with
motor restlessness
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 Apathy dulled emotional tone associated with
detachment or indifference
Ambivalence two opposing impulses toward
same thing in same person at same time
Shame failure to live up to self-expectations
Guilt emotion secondary to doing what is
perceived as wrong
PHYSIOLOGICAL DISTURBANCES ASSOCIATED
with MOOD
Signs of somatic (usually autonomic)
dysfunction
Most often associated with depression
Also called vegetative signs
SOME PHYSIOLOGICAL DISTURBANCES
ASSOCIATED with MOOD
Anorexia loss of or decrease in appetite
Bulimia insatiable hunger and voracious
eating
Hyperphagia increase in appetite and intake
of food
Insomnia lack or diminished ability to sleep
Hypersomnia excessive sleeping
Constipation inability to defecate or difficulty
in defecating
MOTOR BEHAVIOR (CONATION)
Aspect of psyche that includes impulses,
motivations, wishes, drives, instincts and cravings
Expressed by behavior or motor activity
SOME DISTURBANCES in MOTOR BEHAVIOR
Echopraxia pathological imitation of
movements of one person by another
Catalepsy immobile position that is
constantly maintained
Cataplexy temporary loss of muscle tone and
weakness precipitated by a variety of emotional states
Negativism motiveless resistance to all
attempts to be moved or to all instructions
THINKING
Goal-directed flow of ideas, symbols and
associations initiated by a problem or task and leading
toward a reality-oriented conclusion
Normal thinking is characterized by a logical
sequence
Parapraxis
Freudian slip
Unconsciously motivated lapse from logic
Considered normal
SOME GENERAL DISTURBANCES in FORM or
PROCESS of THINKING
Reality testing objective evaluation and
judgment of the world outside the self
Psychosis inability to distinguish reality from
fantasy; impaired reality testing
Autistic thinking preoccupation with inner,
private world
Magical thinking similar to preoperational
phase in children (Jean Piaget); thoughts, words or
actions assume power
SOME SPECIFIC DISTURBANCES in FORM of
THINKING
Circumstantiality indirect speech that is
delayed in reaching the point but eventually gets from
original point to desired goal
Tangentiality inability to have goal-directed
associations of thought
Loosening of associations flow of thought
in which ideas shift from one subject to another in a
completely unrelated way
Flight of ideas rapid, continuous
verbalizations or plays on words creating constant shifting
from one idea to another
SOME SPECIFIC DISTURBANCES in CONTENT of
THOUGHT
Delusion
False belief, based on incorrect inference about
external reality
Not consistent with ones intelligence and
culutural background
Cannot be corrected by reasoning
Overvalued idea unreasonable, sustained
false belief maintained less firmly than a delusion
Obsession pathological persistence of an
irresistible thought or feeling that cannot be eliminated
from consciousness by logical effort
Phobia persistent, irrational, exaggerated and
invariably pathological dread of a specific stimulus or
situation
SPEECH
Ideas, thoughts, feelings as expressed through
language
Communication through the use of words and
language
SOME DISTURBANCES in SPEECH
Pressure of speech rapid, increased in
amount and difficult to interrupt
Poverty of speech - restricted amount; replies
may be monosyllabic
Poverty of content of speech adequate in
amount but conveys littel information because of
vagueness, emptiness or stereotyped phrases
PERCEPTION
Process of transferring physical stimulation into
psychological information
Mental process by which sensory stimuli are
brought to awareness
SOME DISTURBANCES of PERCEPTION
Hallucination false sensory perception not
associated with real external stimuli
Illusion misperception or misinterpretation of
real external sensory sitmuli
Depersonalization subjective sense of being
unreal, strange or unfamiliar
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 Derealization subjective sense that
environment is strange or unreal
MEMORY
Function by which information stored in the
brain is later recalled to consciousness
SOME DISTURBANCES of MEMORY
Amnesia partial or total inability to recall past
experiences
Anterograde - occuring after a point in time
Retrograde occuring before a point in time
Paramnesia falsification of memory by
distortion of recall
Deja vu illusion of visual recognition in which
a new situation is incorrectly regarded as a repetition of a
previous memory
Jamais vu false feeling of unfamiliarity with a
real situation that a person has experienced
LEVELS of MEMORY
Immediate reproduction or recall of perceived
material within seconds to minutes
Recent recall of events over past few days
Recent past recall of events over past few
months
Remote recall of events in distant past
INTELLIGENCE
Ability to understand, recall, mobilize and
constructively integrate previous learning in meeting new
situations
SOME DISTURBANCES of INTELLIGENCE
Mental retardation lack of intelligence
resulting in interference with social and vocational
performance
Dementia organic and global deterioration of
intellectual functioning without clouding of
consciousness
Concrete thinking
Literal thinking
Limited use of metaphor without understanding
of nuances of meaning
One-dimensional thought
Abstract thinking
Ability to appreciate nuances of meaning
Multidimensional thinking with ability to use
metaphors and hypotheses appropriately
INSIGHT
Ability to understand the true cause and
meaning of a situation
LEVELS of INSIGHT
Intellectual understanding of objective reality
of set of circumstances without ability to apply
understanding in any useful way to master situation
True understanding of objective reality of a
situation coupled with motivation and emotional impetus
to master situation
Impaired diminished ability to understand
objective reality of situation
JUDGMENT
Ability to assess a situation correctly and to act
appropriately in the situation
LEVELS of JUDGMENT
Critical ability to assess, discern and choose
among various options in a situation
Automatic reflex performance of an action
Impaired diminished ability to understand a
situation correctly and to act appropriately