General Psychopathology Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague



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General Psychopathology

  • Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague

  • Head: Prof. MUDr. Jiří Raboch, DrSc.


Basic Terms in Psychiatry

  • Psychiatry studies the causes of mental disorders, gives their description, predicts their future course and outcome, looks for prevention of their appearance and presents the best ways of their treatment

  • Psychopathology describes symptoms of mental disorders

  • Special psychiatry is devoted to individual mental diseases

  • General psychiatry studies psychopathological phenomena, symptoms of abnormal states of mind:



Disorders of Consciousness

  • Consciousness is awareness of the self and the environment

  • Disorders of consciousness:

    • qualitative
    • quantitative
      • short-term
      • long-term
  • Hypnosis – artificially incited change of consciousness

  • Syncope – short-term unconsciousness



Disorders of Consciousness

  • Quantitative changes of consciousness mean reduced vigility (alertness):

    • somnolence
    • sopor
    • coma
  • Qualitative changes of consciousness mean disturbed perception, thinking, affectivity, memory and consequent motor disorders:

    • delirium (confusional state) – characterized by disorientation, distorted perception, enhanced suggestibility, misinterpretations and mood disorders
    • obnubilation (twilight state) – starts and ends abruptly, amnesia is complete; the patient is disordered, his acting is aimless, sometimes aggressive, hard to understood
      • stuporous
      • vigilambulant
      • delirious
      • Ganser sy


Disturbances of Perception

  • Perception is a process of becoming aware of what is presented through the sense organs

  • Imagery means an experience within the mind, usually without the sense of reality that is part of reality

  • Pseudoillusions – distorted perception of objects which may occur when the general level of sensory stimulation is reduced

  • Illusions are psychopathological phenomena; they appear mainly in conditions of qualitative disturbances of consciousness (missing insight)

  • Hallucination are percepts without any obvious stimulus to the sense organs; the patient is unable to distinguish it from reality



Disturbances of Perception

  • Hallucinations:

  • auditory (acousma)

  • visual

  • olfactory

  • gustatory

  • tactile (or deep somatic)

  • extracampine, inadequate

  • intrapsychic (belong rather to disturbances of thinking)

  • hypnagogic and hypnopompic (hypnexagogic)

  • Pseudohallucinations - patient can distinguish them from reality



Disorders of Thinking

  • Thinking

  • Cognitive functions

  • Disorders of thinking:

    • quantitative
    • qualitative


Quantitative Disorders of Thinking

  • Quantitative (formal) disorders of thinking:

  • pressure of thought

  • poverty of thought

  • thought blocking

  • flight of ideas

  • perseveration

  • loosening of associations

  • word salad - incoherent thinking

  • neologisms

  • verbigeration



Qualitative Disorders of Thinking

  • Quantitative disorders of thought (content thought disorders):

  • Delusions:

    • belief firmly held on inadequate grounds,
    • not affected by rational arguments
    • not a conventional belief
  • Obsessions (obsessive thought) are recurrent persistent thoughts, impulses or images entering the mind despite the person's effort to exclude them. Obsessive phenomena in acting (usual as senseless rituals – cleaning, counting, dressing) are called compulsions.



Qualitative Disorders of Thinking

  • Division of delusions:

  • according to onset

    • primary (delusion mood, perception)
    • secondary (systematized)
    • shared (folie a deux)
  • according to theme

    • paranoid (persecutory) - d. of reference, d. of jealousy, d. of control, d. concerning possession of thought
    • megalomanic (grandiose, expansive) – d. of power, worth, noble origin, supernatural skills and strength, amorous d.
    • depressive (micromanic, melancholic) – d. of guilt and worthlessness, nihilistic d., hypochondriacal d.
    • concerning the possession of thoughts
      • thought insertion
      • thought withdrawal
      • thought broadcasting


Disorders of Memory

  • Sensory stores - retains sensory information for 0.5 sec.

  • Short - term memory (working memory) - for verbal and visual information, retained for 15-20 sec., low capacity

  • Long-term memory – wide capacity and more permanent storage

    • declarative (explicit) memory – episodic (for events) or semantic (for language and knowledge)
    • procedural memory – for motor arts
    • priming – unconscious memory
    • conditioning – classic or emotional


Disorders of Memory

  • Disorders of memory:

  • Amnesia – inability to recall past events

  • Jamais vu, déja vu

  • Confabulation, amnesic disorientation, Korsakov’s syndrome

  • Pseudologia phantastica

  • Hypomnesia

  • Hypermnesia



Disorders of Attention

  • Concentration

  • Capacity

  • Tenacity

  • Irritability

  • Vigility

  • Hypoprosexia (global, selective)

  • Hyperprosexia

  • Paraprosexia



Disorders of Mood (Emotions)

  • Normal affect – brief and strong emotional response

  • Normal mood – subjective and for a longer time lasting disposition to appear affects adequate to a surrounding situation and matters discussed

  • Higher emotions:

    • intellectual
    • aesthetic
    • ethic
    • social


Disorders of Mood (Emotions)

  • Pathological affect – very strong, abrupt affect with a short change of consciousness on its peak

  • Pathological mood – two poles:

    • manic
    • depressive
  • Phobia – persistent irrational fear and wish to avoid a specific situation, object, activity:

    • agoraphobia
    • claustrophobia
    • social phobias
    • hipsophobia
    • aichmophobia
    • keraunophobia
  • Depersonalization – change of self-awareness, the person feels unreal, unable to feel emotion



Disorders of Mood (Emotions)

  • Pathological mood:

    • origin – based on pathological grounds, no psychological cause
    • duration – unusually long-lasting
    • intensity – unusually strong, large changes in intensity
    • impossibility to be changed by psychological means
  • Pathological features of mood:

    • euphoria
    • expansive
    • exaltation
    • explosive
    • mania
    • hypomania
    • depression
    • apathy (anhedonia)
    • blunted, flattened affect
    • emotional lability
    • helpless


Intelligence Disorders

  • Intelligence:

    • abstract
    • practical
    • social
  • Intelligence quotient (IQ):

  • IQ = (mental age : calendar age) x 100

  • Disorders of intellect:

    • mental retardation
    • dementia


Motor Disorders

  • quantitative:

    • hypoagility
    • hyperagility
    • agitated behaviour


Disorders of Volition

  • Disorders of volition:

    • hypobulia
    • abulia
    • hyperbulia


Disorders of Personality

  • Personality means a complex of persistent mental and physical traits of a person

  • Disturbances of personality:

    • transformation of personality
    • appersonalization
    • multiple personality (alteration of personality)
    • specific personality disorder
    • deprived personality
































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