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Psychiatry summary
- Course
- MBChB (GNK581)
- Institution
- University Of Pretoria (UP)
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GNK 581Psychiatry
Lecture Notes
Done by: Erin Holmes
Sadiyah Ismail
Elmé Nel
MBChB V 2023
,Lecture: Page: Lecture: Page:
Psychiatric Symptoms 1 Anxiety Disorders in Adults 59
Evaluation & Diagnostic Classification 3 Anxiety Disorders in Children 63
Psychiatric Disorders due to General Medical Conditions 6 Obsessive-Compulsive & Related Disorders 69
Schizophrenia Spectrum 11 Post-traumatic Stress Disorder 73
Schizophrenia 14 Somatic Symptom & Other Disorders 76
Pharms – Anti-psychotics 17 Somatic Symptom & Other Disorders – Case Studies 80
Substance Related & Addictive Disorders 21 Aggression 84
Neurocognitive Disorders 27 Personality Disorders 87
Depressive Disorders 31 Sleep-Wake Disturbances 91
Depressive Disorders in Children 34 Suicide & Murder 96
Pharms – Anti-depressants 38 Mental Health Care Act 98
Electro-convulsive Therapy 41 Intellectual Disability 100
Cognitive Behavioural Therapy 43 Autism Spectrum Disorders 102
Bipolar Disorder 45 ADHD 104
Pharms – Mood Stabilisers 51 Eating & Feeding Disorders 107
Dissociative Disorders 54
,Psychiatric Symptoms & Signs Speech: Anxiety & Related Normal Thought Form:
Behavioural Symptoms: Echolalia: Pathological imitation of another person’s speech. Symptoms:
Motor Behaviours, Conation, Psychomotor Activity: Logorrhoea: increase in quantity of speech. Anxiety: feeling of
Poverty of Speech: decrease in quantity of speech. apprehension caused by
- Motor behaviour/activity expressing a person’s
impulses, drives, wishes, instincts, cravings & Poverty of Speech content: adequate amount of speech, but lacks anticipation of danger.
motivation. information due to vagueness. Fear: anxiety caused by a
- Decreased (psychomotor retardation). Pressure of Speech: rapid speech of increased quantity that is real/ realistic danger.
- Increased (psychomotor agitation). difficult to interrupt. Phobia: Persistent, irrational
Circumstantiality:
Catatonia: Nonspontaneous Speech: speech only in response to questions. exaggerated, pathological
Dysprosody: loss of normal melody/ prosody/ rhythm of speech. dread of a specific
- Catatonic Rigidity
- Catatonic Posturing Stuttering: frequent repetition/ prolongation of a sound/ syllable stimulus/situation.
- Waxy flexibility (catalepsy) leading to impaired speech fluency. Panic Attack: acute,
- Catatonic Stupor Dysarthria: problems with articulation (pronunciation, NOT episodic, intense attack of
- Akinesia language). anxiety with autonomic
- Catatonic excitement Aphasia: difficulties with language output (language, NOT symptoms associated with
pronunciation). overwhelming feelings of
- Catatonic Mutism
dread. Tangentiality:
Negatism: motiveless resistance against instruction,
questioning or to be moved. Mood & Affect: Obsession: pathological
Stereotyped Behaviour: repetitive fixed pattern of motor Mood → pervasive & sustained emotion subjectively experienced. persistence of an irresistible
behaviour. ➢ Dysphoric/ Melancholic – Unpleasant, low mood. thought or feeling that can’t
➢ Euthymic mood – normal range of mood. be eliminated from
Mannerisms & Tics:
- Habitual, ingrained, unconscious movements. ➢ Ecstatic/ Elevated/ Euphoric/ Elated – abnormally increased consciousness by logical
- Unconscious, spasmodic motor movements. ‘high’ mood state. effort (associated with
Echopraxia: ➢ Depressed – psycho-pathologically sad, dysphoric, anxiety).
- Pathological imitation of another person’s melancholic mood state. Compulsion: pathological Derailment:
movement. ➢ Mania – mood characterised by elation, hyperactivity, need to act on an impulse/
hypersexuality, as well as pressured speech & thought. obsession that, if resisted,
Ataxia:
- Muscle incoordination. ➢ Irritable – easily angered. produces anxiety.
Tremor: ➢ Labile – oscillations between depression & elation.
- Involuntary, rapid, rhythmical, alternating ➢ Alexithymic – inability to be aware of/describe ones Psychosis:
movement. emotions. The Inability to distinguish
Chorea: ➢ Anhedonic – loss of interest in all pleasurable activities. reality from fantasy.
3 Groups of Psychotic
- Involuntary, rapid, random, jerky, purposeless
movements. Affect is the objectively observed expression of emotion: Symptoms:
- Restricted: severe reduction observable expression of ➢ Disordered thought Loosening of Associations:
Dyskinesia:
- Difficulty performing voluntary movements. emotion. form (how we think) →
Dystonia: - Blunted: even greater reduction in observable expression of manifests as
- Sustained contractions of opposing muscle groups of emotion. disorganized speech.
- Flat: absence/near absence of observable expression of ➢ Disordered though
the trunk or limbs.
Akathisia: emotion. content (what we think
- Subjective feeling of inner restlessness & muscle - Appropriate: observable expression of emotion is in harmony of) → delusions.
tension secondary to antipsychotic medication, with the mood described. ➢ Disordered perception:
presenting with pacing & other signs of - Inappropriate: observable expression of emotion isn’t in hallucinations,
harmony with the mood described. illusions.
psychomotor agitation.
1
, Inappropriate/ Irrelevant Thought Form Disorders: Perceptual Disturbances:
Answer: Overinclusiveness: speech containing unnecessarily excessive detail. Hallucination: false sensory perception not associated with real
Perseveration: persisting response to a previous stimulus, even following a external stimuli.
new stimulus. Types according to senses:
Verbigeration: meaningless repetition of specific words or phrases. - Auditory hallucination: perception of sound, usually voices.
Word salad: incoherent mixture of words/ phrases. - Visual hallucination: perception of seeing images.
Neologisms: made up words that don’t form part of any language. - Olfactory hallucination: perception of smell.
Echolalia: pathological repeating of words/ phrases of one person be - Gustatory hallucination: perception of taste.
another. - Tactile hallucination: perception of touch.
Other Hallucinations:
Delusions: - Cenesthetic Hallucination: perception of sensation in an organ
Fixed, false beliefs, based on incorrect inferences about external reality that unable to experience sensation.
Thought Blocking: cannot be corrected by reasoning. - Hypnagogic Hallucination: non-pathological perception
Types: occurring while falling asleep.
Delusions of Persecution: belief of being harassed, cheated or persecuted. - Hypnopompic Hallucination: non-pathological perception
Delusion of Grandeur: belief of exaggerated importance, power or identity. occurring while awake from sleep.
Delusion of Reference: belief of behaviour of others refers to him/herself. Illusion: Misperception/ misinterpretation of real external sensory
Delusion of Poverty: belief of being bereft of all material possessions. stimuli.
Nihilistic Delusion: Belief that one’s self, others or the world is non-existent
or is coming to an end.
Somatic Delusion: belief surrounding a part of the body.
Delusion of Control: belief of one’s will, thoughts or feelings are being
Flight of Ideas: controlled by external forces.
Bizarre Delusion: absurd, totally implausible, strange belief.
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