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JINTO PHILIP
ASST. PROFESSOR
MSc in Psychiatric Nursing
DEFINITION: MENTAL HEALTH, MENTAL
ILLNESS, MENTAL HEALTH NURSING
TERMINOLOGY OF PSYCHIATRY
MENTAL HEALTH
“Mental health is a state of well-being in
which each individual is able to
recognize his or her own potential, cope
with the normal stresses of life, work
productively and fruitfully, and make a
contribution to the society”
[WHO]
DEFINITION: MENTAL HEALTH, MENTAL
ILLNESS, MENTAL HEALTH NURSING
TERMINOLOGY OF PSYCHIATRY
MENTAL ILLNESS
“Mental illness is considered to be a
clinically significant behavioral or
psychological syndrome marked by the
patient’s distress, disability or the risk of
suffering disability or loss of freedom”
[APA, 2000]
MENTAL HEALTH NURSING
“ A specialized area of nursing practice,
employing a wide range of explanatory
theories of human behavior as its science and
purposeful use of self as its art”
[ANA,2000]
 Psychiatric nursing is an interpersonal
process that promotes and maintains patient
behavior that contribute to integrated
functioning. The patient may be an individual,
family, group, organization or community.
PSYCHOPATHOLOGY OF MENTAL
DISORDERS
“Psychopathology is a term which refer
to either a study of mental illness or
mental distress, or the manifestations of
behaviors and experiences which may be
indicative of mental illness or
psychological impairment, such as
abnormal, maladaptive behavior or
mental activity”
Psyche- mind /social
Pathos- traces disease
Logos- study
It refers to the study of the causes
and nature of disease or abnormal
behavior
Signs and symptoms of mental
illness
Signs are observations and objective
findings elicited by the clinician
Symptoms are the subjective experience
described by the patient, often expressed
as chief complaints such as depressed
mood or lack of energy.
Syndrome is a group of signs and
symptoms that together make up a
recognizable condition.
• A neurosis is a chronic or recurrent nonpsychotic
disorder characterized mainly by anxiety, which
is experienced or expressed directly or is altered
through defense mechanisms; it appears to be a
symptom such as an obsession, a compulsion, a
phobia or a sexual dysfunction.
• Symptoms are distressing to the individual and
is recognized as unacceptable and alien, reality
testing is grossly intact.
• Behavior does not actively violate gross social
norms.
• no demonstrable organic etiology.
NEUROSIS
• Loss of reality testing and impairment in mental
functioning-manifested by delusions,
hallucinations, confusion and impaired memory.
• Severe impairment in social and personal
functioning
• With gross impairment in reality testing, persons
incorrectly evaluate the accuracy of their
perceptions and thoughts and make incorrect
inferences about external reality, even in the
face of contrary evidence.
PSYCHOSIS
DEVIATIONS FROM NORMAL BEHAVIOR
Disturbances of consciousness
Disorders of motor aspects of
behavior
Disorders of thinking
Disorders of affect
Disorders of perception
Disorders of memory
CONSCIOUSNESS
Consciousness: State of awareness
Apperception is perception modified by a
person’s own emotions and thoughts.
Sensorium is a state of cognitive functioning of
the special senses
A. Disturbances of consciousness:
1. Disorientation: disturbance of
orientation in time, place and person
A. Disturbances of consciousness:
(contd….)
2. Clouding of consciousness: incomplete
clear mindedness with disturbances in
perception and attitudes
3. Stupor: Lack of reaction to and
unawareness of surroundings
4. Delirium: bewildered, restless, confused,
disoriented reaction association with fear
and hallucinations.
5. Coma: Profound unconsciousness
6. Coma vigil: Coma in which patient appears
A. Disturbances of consciousness:
(contd….)
7. Twilight state: disturbed consciousness
with hallucinations
8. Dreamlike state: consciousness
disturbance and patient is not aware about
the surroundings
9. Somnolence: abnormal drowsiness
10. Confusion: disturbance of consciousness
in which reactions to environmental stimuli
are inappropriate, manifested by
disordered orientation in relation to time,
A. Disturbances of consciousness:
(contd….)
11. Drowsiness: a state of impaired awareness
associated with a desire or inclination to
sleep.
12. Sundowning: syndrome in older persons
that usually occurs at night and is
characterized by drowsiness, confusion,
ataxia, and falling as the result of being
overly sedated with medications
(sundowner’s syndrome)
B. Disturbances of attention:
C. Disturbances in suggestibility:
DISORDERS OF MOTOR ACTIVITY
Increased activity (Hyperactivity)
Decreased activity (Psychomotor
retardation)
Stereotype position
# catalepsy
#catatonic stupor
#catatonic rigidity
#catatonic posturing
#waxy flexibility
contd……
DISORDERS OF MOTOR ACTIVITY contd….
Stereotype movements
#Mannerisms
#Tics
#Echopraxia
Automatism
Negativism
DISORDERS OF THOUGHT
Form
Flight of ideas
Prolixity
Loosening of association
Circumstantiality
Tangentiality
Perseveration
Thought blocking
Word salad
Clang associations
Neologisms
DISORDERS OF THOUGHT
Content
Obsessions
Compulsions
Phobias
Suicidal and homicidal ideas (ideas of
hopelessness and worthlessness)
Hypochondriacal symptoms
Antisocial urges and impulses
Thought insertion, withdrawal,
broadcast
DISORDERS OF THOUGHT
Thought disturbances
Delusions
Ideas of references and ideas of
influence
DISORDERS OF MOOD/AFFECT
PLEASURABLE AFFECT: Expansive
mood, Euphoria, Elation, Ecstasy
UNPLEASURABLE AFFECT: Dysphoric
mood, sadness, anxiety, grief and
mourning
UNHEDONIA
ALEXITHYMIA
DISORDERS OF PERCEPTION
Imperceptions
Hypoesthesia
Anesthesia
Parasthesia
Hyperesthesia
Illusions
Hallucinations
De-personalization
De-realization
HALLUCINATIONS
Auditory
Visual
Olfactory
Tactile
Gustatory
First person
Second person
Third person
HALLUCINATIONS
Hypnogogic and hypnopompic
Mood congruent and mood incongruent
Command hallucinations
Visceral hallucination
Delusional zoopathy
Functional hallucination
contd….
HALLUCINATIONS
Reflex hallucinations or synaesthesia
Extracampine hallucinations
Autoscopy or phantom mirror image
Negative autoscopy
Internal autoscopy
Pseudohallucinations
Perception =
Hallucination
Pseudohallu
cinations
Fantasy = Imagery
1.Experience is concrete, tangible,
objective, real
‘inner eye’ pictorial subjective
2.Location in outer objective
space
inner subjective
space
3.Definition definite outlines,
complete sound
indefinite,
incomplete only
individual details
4.Vividness full, fresh, bright most elements are
dim or neutral
5. Constancy retained evanescent
Perception =
Hallucination
Pseudohall
ucinations
Fantasy = Imagery
6.
Independence
from volition
Cannot be
dismissed, recalled
or changed at will
Requires voluntary
creation
7. Insight Has quality of
perception-no
distinction between
perceptions and
hallucinations
Fantasy has quality
of idea
8.Behavioral
relevance
Relevant to
emotions, needs,
actions
Not relevant
Perception =
Hallucination
Pseudohallu
cinations
Fantasy = Imagery
9. Sensory
modality
Could experience
object in another
modality
Could not
experience this
object in another
modality
10.Existence Object exists
independent of
observer
Depends on
observer for
existence
DISORDERS OF MEMORY
Hyperamnesia
Amnesia
Paramnesia
Confabulation
Complete
Partial
Circumscribed
Retrograde
Anterograde
Déjà Vu
Jamais Vu
-JINTO PHILIP

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Psychopathology of mental disorders

  • 1. JINTO PHILIP ASST. PROFESSOR MSc in Psychiatric Nursing DEFINITION: MENTAL HEALTH, MENTAL ILLNESS, MENTAL HEALTH NURSING TERMINOLOGY OF PSYCHIATRY
  • 2. MENTAL HEALTH “Mental health is a state of well-being in which each individual is able to recognize his or her own potential, cope with the normal stresses of life, work productively and fruitfully, and make a contribution to the society” [WHO] DEFINITION: MENTAL HEALTH, MENTAL ILLNESS, MENTAL HEALTH NURSING TERMINOLOGY OF PSYCHIATRY
  • 3. MENTAL ILLNESS “Mental illness is considered to be a clinically significant behavioral or psychological syndrome marked by the patient’s distress, disability or the risk of suffering disability or loss of freedom” [APA, 2000]
  • 4. MENTAL HEALTH NURSING “ A specialized area of nursing practice, employing a wide range of explanatory theories of human behavior as its science and purposeful use of self as its art” [ANA,2000]  Psychiatric nursing is an interpersonal process that promotes and maintains patient behavior that contribute to integrated functioning. The patient may be an individual, family, group, organization or community.
  • 5. PSYCHOPATHOLOGY OF MENTAL DISORDERS “Psychopathology is a term which refer to either a study of mental illness or mental distress, or the manifestations of behaviors and experiences which may be indicative of mental illness or psychological impairment, such as abnormal, maladaptive behavior or mental activity”
  • 6. Psyche- mind /social Pathos- traces disease Logos- study It refers to the study of the causes and nature of disease or abnormal behavior Signs and symptoms of mental illness
  • 7. Signs are observations and objective findings elicited by the clinician Symptoms are the subjective experience described by the patient, often expressed as chief complaints such as depressed mood or lack of energy. Syndrome is a group of signs and symptoms that together make up a recognizable condition.
  • 8. • A neurosis is a chronic or recurrent nonpsychotic disorder characterized mainly by anxiety, which is experienced or expressed directly or is altered through defense mechanisms; it appears to be a symptom such as an obsession, a compulsion, a phobia or a sexual dysfunction. • Symptoms are distressing to the individual and is recognized as unacceptable and alien, reality testing is grossly intact. • Behavior does not actively violate gross social norms. • no demonstrable organic etiology. NEUROSIS
  • 9. • Loss of reality testing and impairment in mental functioning-manifested by delusions, hallucinations, confusion and impaired memory. • Severe impairment in social and personal functioning • With gross impairment in reality testing, persons incorrectly evaluate the accuracy of their perceptions and thoughts and make incorrect inferences about external reality, even in the face of contrary evidence. PSYCHOSIS
  • 10. DEVIATIONS FROM NORMAL BEHAVIOR Disturbances of consciousness Disorders of motor aspects of behavior Disorders of thinking Disorders of affect Disorders of perception Disorders of memory
  • 11. CONSCIOUSNESS Consciousness: State of awareness Apperception is perception modified by a person’s own emotions and thoughts. Sensorium is a state of cognitive functioning of the special senses A. Disturbances of consciousness: 1. Disorientation: disturbance of orientation in time, place and person
  • 12. A. Disturbances of consciousness: (contd….) 2. Clouding of consciousness: incomplete clear mindedness with disturbances in perception and attitudes 3. Stupor: Lack of reaction to and unawareness of surroundings 4. Delirium: bewildered, restless, confused, disoriented reaction association with fear and hallucinations. 5. Coma: Profound unconsciousness 6. Coma vigil: Coma in which patient appears
  • 13. A. Disturbances of consciousness: (contd….) 7. Twilight state: disturbed consciousness with hallucinations 8. Dreamlike state: consciousness disturbance and patient is not aware about the surroundings 9. Somnolence: abnormal drowsiness 10. Confusion: disturbance of consciousness in which reactions to environmental stimuli are inappropriate, manifested by disordered orientation in relation to time,
  • 14. A. Disturbances of consciousness: (contd….) 11. Drowsiness: a state of impaired awareness associated with a desire or inclination to sleep. 12. Sundowning: syndrome in older persons that usually occurs at night and is characterized by drowsiness, confusion, ataxia, and falling as the result of being overly sedated with medications (sundowner’s syndrome)
  • 15. B. Disturbances of attention: C. Disturbances in suggestibility:
  • 16. DISORDERS OF MOTOR ACTIVITY Increased activity (Hyperactivity) Decreased activity (Psychomotor retardation) Stereotype position # catalepsy #catatonic stupor #catatonic rigidity #catatonic posturing #waxy flexibility contd……
  • 17. DISORDERS OF MOTOR ACTIVITY contd…. Stereotype movements #Mannerisms #Tics #Echopraxia Automatism Negativism
  • 18. DISORDERS OF THOUGHT Form Flight of ideas Prolixity Loosening of association Circumstantiality Tangentiality Perseveration Thought blocking Word salad Clang associations Neologisms
  • 19. DISORDERS OF THOUGHT Content Obsessions Compulsions Phobias Suicidal and homicidal ideas (ideas of hopelessness and worthlessness) Hypochondriacal symptoms Antisocial urges and impulses Thought insertion, withdrawal, broadcast
  • 20. DISORDERS OF THOUGHT Thought disturbances Delusions Ideas of references and ideas of influence
  • 21. DISORDERS OF MOOD/AFFECT PLEASURABLE AFFECT: Expansive mood, Euphoria, Elation, Ecstasy UNPLEASURABLE AFFECT: Dysphoric mood, sadness, anxiety, grief and mourning UNHEDONIA ALEXITHYMIA
  • 24. HALLUCINATIONS Hypnogogic and hypnopompic Mood congruent and mood incongruent Command hallucinations Visceral hallucination Delusional zoopathy Functional hallucination contd….
  • 25. HALLUCINATIONS Reflex hallucinations or synaesthesia Extracampine hallucinations Autoscopy or phantom mirror image Negative autoscopy Internal autoscopy Pseudohallucinations
  • 26. Perception = Hallucination Pseudohallu cinations Fantasy = Imagery 1.Experience is concrete, tangible, objective, real ‘inner eye’ pictorial subjective 2.Location in outer objective space inner subjective space 3.Definition definite outlines, complete sound indefinite, incomplete only individual details 4.Vividness full, fresh, bright most elements are dim or neutral 5. Constancy retained evanescent
  • 27. Perception = Hallucination Pseudohall ucinations Fantasy = Imagery 6. Independence from volition Cannot be dismissed, recalled or changed at will Requires voluntary creation 7. Insight Has quality of perception-no distinction between perceptions and hallucinations Fantasy has quality of idea 8.Behavioral relevance Relevant to emotions, needs, actions Not relevant
  • 28. Perception = Hallucination Pseudohallu cinations Fantasy = Imagery 9. Sensory modality Could experience object in another modality Could not experience this object in another modality 10.Existence Object exists independent of observer Depends on observer for existence