(D). DISORDER OF THOUGHT, MOTOR ACTIVITY, PERCEPTION, MOOD, SPEECH, MEMORY, CONCENTRATION AND JUDGMENT.

THOUGHT DISORDERS

*Thinking disorders can be identified by a person’s writing and speech.

•Thinking Disorders

★Abnormal Thoughts Disorder

*Includes delusions and obsessions.

Delusions* :

*False belief is found in delusion. That is, a person’s false belief that does not go away despite explanation. which beliefs are not found in a person of the same race, age and education.

*There are many types of delusions:

*Grandiosity Delusion

In this, the person has a false belief that he is a powerful person and considers himself a king and a great person.

More common in patients with mania.

*Persecutory Delusion

This type of delusion is seen in paranoid schizophrenia. In this, the person thinks that friends, family and others are trying to kill me or poison me and try to harm me.

*Nihilistic Delusion

In this type of delusion, the patient feels that body parts are missing or that the body does not exist at all. These delusions are seen in severe depression.

*Delusion of reference

The patient believes that others are talking about me or that people are discussing about me. This delusion is seen in paranoid schizophrenia.

*Delusions of Guilt

The patient himself feels guilty and holds himself responsible despite the mistakes of others. Depression is common in patients.

• Delusion of control In this, the patient believes that someone is controlling my mind. It is common in schizophrenia.

*Hypochondrical delusions

In this type of delusion, the person shows his illness as a more severe illness. It is more common in old age person.

*Thought Possession Disorders.

*(1).Thought Insertion

Thought insertion means the person feels as if someone is implanting thoughts in the mind from outside.

*(2).Thought Withdrawal

Person thinks that someone removes from my thought mind.

*(3). Thought Broadcasting

Person feels that people know my thoughts and tell others through TV or Radio or other media..

*Thought Stream Disorders.

*(1). Flight of ideas

In this, the process of thoughts is very fast, the conversation of the person is very fast and he talks from one topic immediately to another topic. Not a single idea is complete.

Flight of ideas is seen in most of mania…

*(2). Circumstantiality

This is a type of disturbance in the flow of thoughts in which the patient, instead of answering the question being asked, discusses other things and finally gives the same answer.

*(3). Tangentiality

If the question is asked to the patient, he gives a response, but instead of giving a direct answer, the patient keeps saying many unnecessary things (which are not needed) but does not give the answer that needs to be answered, this is seen in schizophrenia.

*(4). Thought blocking

A person suddenly stops talking i.e. his thoughts are suddenly blocked.

*(5). Presser of Thought

Many ideas arise in the mind and they pass from the mind rapidly.

(6).Poverty of thought

The number and variety of thoughts are less and they pass through the mind very slowly.

(7).Neologism

When the patient spontaneously creates new words (words) on his own, it is called neologism.

MOTOR ACTIVITY DISORDERS

• Abnormalities in social behavior, facial expression and posture are frequently seen in every mental disorder.

*There are 3 main types of motor activity.

1. Increase activity *A person does activities that are not well organized and the activity has no purpose, such activities are seen in mania.
2. Decrease activity *Person does slow activities and cannot even complete the activities, this is seen in depression.
3. Dysactivity

• Which is a psychomotor activity, it is badly, difficult and very painful. It has 3 types.

A. Repetitious activity

*Anyone who repeatedly performs one activity without purpose or purpose is called a stereotyped activity.

*There are 3 other types.

(a). Stereo type position

1. Catalepsy: A person maintains a single position without any movement. which is seen in schizophrenia.
2. Vexi-Flexibility : Patient stays in one position for long time. The person’s arms and legs are bent like wax and they sit in awkward positions for hours. This is more common in catatonic schizophrenia.

(b). Stereo type movement

1. Mannerism: It is a stereotype movement, in which a person repeatedly performs the same movement or repeats the same movement again and again, it is called Mannerism. For example, a person raises his shoulders frequently while talking.

(c). Stereo Type Speech

1. Word salad or verbiage: The patient repeats one word or sentence repeatedly and is included in Stereotype speech.
2. Kaleng Association: It is the repetition of rhyming words like hat, bat, cat. rat, sat etc. In this, the person repeats the words coming in rhythm. It is called Clang Association.

(B). Automatism

• In this the person is not fully conscious level while performing any activity. Echolalia and echopraxia are seen.

1. Echolalia: In this a person repeats the words spoken by another person. In this, a person copies the speech of another person. As an example, the nurse will ask him why are you? So such a person will ask the nurse again the same sentence that why is it you?
2. Echopraxia: Tendency to repeat other persons’ activity, i.e. repeats the activity done by another person or copies the activity. For example, if a person keeps his hand on his head, he also keeps his hand on his head.

(C). Violence

In this, a person expresses his anger in a criminal form. For example, rape, murder and suicide etc. The behavior of the person is seen as aggressive.

(D).Suicide

It means self destruction.

(To harm or kill oneself.)

(E).Compulsion

Constant repetition of purposeless actions despite lack of will and cannot be controlled. Example washing hands frequently, checking whether the door is locked or not.

(F). Negativism

A type of psychological defense mechanism in which whatever you suggest to the person will always be blocked at times of opposition. It is often expressed in the form of mutism, refusal of food and resistance to efforts to care for the client.

PERCEPTION DISORDERS

• Whatever a person experiences through his sense organ is called perception. There are 5 types of perception, auditory, visual, olfactory, tactile and gustatory.

1. Illusion *Wrong Identification Or Misperception of sensory impression or Distortion Of Sense. In which a person makes a mistake or Misinterpretation (wrong perception) in identifying an object or thing. The original assumes something different from what it is. Example: A rope is mistaken for a snake.
2. Hallucinations *A False sensory perception occurring without the external stimulation of the sensory involvement. Hallucination means perceiving an object even though it is not there. Examples include hearing voices (auditory hallucinations), seeing someone hit (visual hallucinations), gustatory hallucinations, olfactory hallucinations.

Hallucinations and tactile hallucinations etc.

-Types Of Hallucinations

(a). Auditory hallucinations

*In auditory hallucinations, the sounds the patient hears are not actually there. This is common in schizophrenia.

(b).Visual hallucinations

*In this the patient sees hallucinatory objects when in fact there are no such objects. Visual hallucinations are seen in schizophrenia, affective disorders or organic disorders.

(c). Olfactory hallucinations

• In this, the patient gets a pleasing or unpleasant smell. Although there is no object around, the patient feels the smell of that object. This is seen in organic brain syndrome (epilepsy).

(d). Gustatory hallucinations

• In this the patient feels wrong teste. It is seen in very low amount. It is seen in schizophrenia and severe depression.

(c). Tactile hallucinations

• In this, the patient feels that someone touches or pricks his body. The patient believes that an insect is running on the body. This is seen in the patient of alcohol and cocaine abuse.

AFFECT OR MOOD DISORDERS

*Mood disorders are called affective disorders. Mood disorders are the most common and frequent serious mental disorders.

Classification is made into Pleaserable, Unpleaserable and other mood disorders.

*Pleaserable

1. Euphoria : Mild elevation in mood is seen. And the person feels emotional and physical well-being.
2. Elation : This involves a moderate elevation in mood. One feels enjoyment in this.

3.Exaltation: Severe elevation in mood and delusions of grandiosity are seen.

4. Ecstasy: There is a more severe elevation in mood, and a feeling of extreme joy. which is seen in delirious mania.

*Unpleasurable

B

Depression is a mood disorder characterized by feelings of sadness and hopelessness and loss of interest and pleasure in activities and social and occupational function is impaired. Sleep patterns and appetite also change.

2. Grief: A powerful emotional response to the death of a loved one or the loss of a valuable object is called grief.

Other

1. Anxiety: Anxiety is mental discomfort. Which appears with physical symptoms. In which the feeling of tension and fear is seen.
2. Apathy: A person is not interested in the surrounding environment and lack of feelings and emotions is called Apathy. This is seen in schizophrenia disorder.
3. Ambivalence : Showing opposite feeling or attitude and emotion towards the same person, thing or situation.

We have both feelings of love and hate towards our parents.

SPEECH DISORDERS

*Speech disorder is a condition in which a person has problems in communicating with others. A person cannot speak his words or fails to create a voice. There are many types of speech disorders.

1. Aphasia: This is a language disorder that causes communication problems. There is damage in the left part of the brain which is the language part, so aphasia occurs.
2. Dysarthria: This is a type of speech disorder that occurs due to muscle weakness, in which a person has speech problems. Dysarthria is called slurred speech.
3. Stuttering: Stuttering is a speech disorder in which there is a prolonged disturbance in the normal flow of sound, words and speech or the words inside the throat are blocked.
4. Dysphonia: This disorder affects the voice muscles of the voice box, arising from abnormalities in the structure and function of the muscles.

MEMORY DISORDERS

*The ability of a person to remember something is called memory. When there is a problem in a person’s memory, it results in a disorder. There are several types of it.

1. Amnesia: Loss of memory. A person cannot recall his long time memory and stories.

*Anterograde amnesia: no memory of recent events (remembering what happened recently).

*Retrograde amnesia: no memory of past events (no memory of past events).

*Dissociative Amnesia: Loss of memory due to a traumatic event is called dissociative amnesia.

2. Hyperamnesia: Excessive loss of memory. The person has no memory of any time or event, which is seen in paranoid schizophrenia.
3. Paraamnesia: It is a memory disorder in which the person cannot differentiate between real and fantasy memory, i.e. bridge the gap between a real story or event and a false story and present that story or event to the public. .

*In this, a person forgets his main point and connects it with a gap in another point…that which has no existence is completely wrong, it is called confabulation.

*Deja Vu (Deja Vu)

In this one feels like I have seen this thing or person somewhere but can’t remember where and when.

*Jamais Vu

In this, a person cannot recognize his known environment. He cannot know his family situation. Example : Own house.

CONCENTRATION, JUDGMENT AND INSIGHT

*Concentration: The focus of more than one sensory organ on any stimulus or stimuli is called attention. Concentration is the ability to focus on anything. When this ability is impaired, a psychiatric disorder occurs.

*Judgment: The power to take right decisions is called judgment. Judgment is the ability to use knowledge from experienced information and make decisions.

• Judgment is impaired in psychosis and judgment is intact in neurosis.

*Insight : The condition in which the patient can understand his symptoms in his own situation is called Insight.

(E). PERSONALITY AND TYPES OF PERSONALITY RELATED TO PSYCHIATRIC DISORDERS.

PERSONALITY

Personality is a stable or permanent pattern of behavior and thought in a given time and situation, in which the personal trends of a person are observed in the environment along with the physical and mental properties.

PERSONALITY DISORDERS

* Impairment in behavior and disturbance in interpersonal relationships.

CLASSIFICATION OF PERSONALITY DISORDERS

(Classification of Personality Disorders)

(A).Cluster A Personality Disorder

(B).Cluster B Personality Disorder

(C).Cluster C personality disorder

*(A).Cluster A Personality Disorder

a. Paranoid Personality Disorder

A person with such a personality does not trust anyone and is very sensitive towards others and avoids interaction with other people. Argument is seen in paranoid personality. They feel themselves unsafe.

b. Schizoid Personality Disorder

A person with such a personality does not establish relationships with others and does not have any close friends. They are detached from people and do social withdrawal. They stay alone.

c. Schizotypal Personality Disorder

Odd thinking and behavior is observed

Social and interpersonal deficits and feeling more discomfort with others. The person experiences social isolation.

*(B).Cluster B Personality Disorder

a. Antisocial Personality Disorder

*Antisocial personality disorder is classified by chronic antisocial behavior.

which violates the rights of others or social norms. They are also called psychopaths.

b. Hysterical Personality Disorder

*Such a person has excessive emotions and shows sadness to get attention. Those people show attention seeking behavior to do what they want.

c. Narcissistic Personality Disorder

* In this, the person is self-centered, cannot understand the emotions of others and takes advantage of others to achieve his goals. He cannot face his own criticism.

d. Borderline Personality Disorder

* In this person cannot maintain IPR (Interpersonal Relationship). Self image and emotions are unstable. Mood, behavior also gets altered. Diagnosis can be made based on symptoms.

*(C)Cluster C Personality Disorder

a. Dependent Personality Disorder

* A person with this personality does not have mature self-confidence, depends on others to make his own decisions.

c. Obsessive Compulsive Personality Disorder

*Persons have a desire to be perfect, consider their standards high and are doubtful. They are regularly attached to their tasks and want any task to be completed faster. For example, keeping your books in one place, Repeating the same task etc.

ETIOLOGY OF PERSONALITY DISORDERS

*Biological factor

-Genetics (heredity)

-low serotonin levels

-Family history of alcoholism and psychiatric disorders.

* Developmental factor

-Traumatic experience

-Childhood Abuse

-Sexual abuse

– Lake of prenatal care

*Social and cultural factors

-Isolation

-long term psychiatric problems

– Loneliness

-Immigration

*Psychodynamic factor

-Anxiety

– Separation

-Dependency

– Coping problems

MANAGEMENT OF PERSONALITY DISORDERS

-Behavioral therapy

-Group therapy

-Family therapy

-Supportive therapy