Signs & symptoms of psychiatric disorders

Basic Psychiatry

1. SIGNS & SYMPTOMS OF
PSYCHIATRIC DISORDERS

RICHARD OPOKU ASARE

COLLEGE OF NURSING, NTOTROSO
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2. Learning Objectives

•Describe the symptoms of common psychiatric
disorders

•Differentiate Normal anxiety from Pathological
anxiety

•Discuss the various signs of psychiatric disorders


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3. Introduction
•Symptoms are the complaints with which a
patient presents to the clinician.
•Signs are the ones which the clinician obtains
on examination of the patient.
•In psychiatry, the boundary between
symptoms and signs is not that distinct
because when explored further, a symptom
can become a sign.
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4. Common Psychiatric Disorders
•Anxiety disorders

•Depression

•Mania

•Schizophrenia

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5. Anxiety
•It is one of the most common experienced
emotions and disorders.

•Often experienced as excessive worrying
about almost everything, tension and fear of
the unknown.

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6. Forms of Anxiety
•There are two main forms of anxiety. These
are:

Normal Anxiety

Pathological (or Neurotic) Anxiety

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7. Normal Anxiety
•This is a normal response to an observable
threat, which some call fear.

•Fear is a reaction to danger from a specific
external source.
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8. Pathological/Neurotic Anxiety
•This is an
affective/cognitive/behavioral/physiological
response to an internal or external threat, real or
imagined, during which the person experiences a
“felt” unpleasant emotional state.
•Thus, it is an inappropriate reaction to a given
stimulus; it is the form of anxiety experienced by
those with anxiety disorders and is different from
fear.
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9. Differentiating Normal Anxiety from
Neurotic Anxiety
•Normal anxiety should be differentiated from neurotic
anxiety in the sense that:
1.It does not last longer and may not persist for
months, whereas pathological anxiety lasts longer and
persists for months.
2.In neurotic anxiety the threat is unidentified and the
cause may be psychogenic, whereas normal anxiety
has an identified threat or stimuli.
3.Normal anxiety may not lead to phobias, whereas
pathological anxiety leads to phobias that interfere
with life.
4.In neurotic anxiety the condition is more intense; less
intense for the normal anxiety.
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10. Subtypes of Anxiety Disorders
•The subtypes include the following:
Generalised Anxiety disorder
Panic disorder
Obsessive-Compulsive disorder
Phobias
Post-traumatic stress disorder.


Videbeck, S. L. (2010). Psychiatric-mental health nursing
(5th ed.). Philadelphia: Lippincott Williams & Wilkins.
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11. Common Symptoms of Anxiety
Disorders
•Feelings of fear or dread
•Increased heart rate
•Palpitations
•Sweating
•Cold and clammy hands & feet
•Dryness of mouth and throat
•Difficulty in talking & breathing
•Light headedness/giddiness
•Tremors of hands
•Restlessness

Whitley, J. (2020). Signs and symptoms of Psychiatric Disorders.
SlideServe Blog
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12. Depression
•Major depressive disorder is most closely
associated with persist sadness
•The most prominent symptom is depressed
mood which is clearly different from sadness
due to day events.
• Besides, there is decreased socialization
where the patient withdraws into solitude and
may become easily irritable.


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13. Vegetative symptoms of Depression
•Vegetative symptoms are disturbances of a person’s function
necessary to maintain life (vegetative functions).
•Normally represented with the acronym
S-I-G-E-C-A-P-S
S = Sleep changes
I = Inability to experience pleasure/loss of Interest in work or
surroundings
G = Feelings of guilt/worthlessness
E = Lack of energy/Easy fatigability
C = Lose of concentration/reduced cognition
A = Appetite changes
P = Psychomotor retardation/agitation
S = Suicide thoughts
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14. Mania
•This is characterized by the sustained
elevation of mood, i.e., marked happiness or
at times irritability.
•The patient commonly experiences an
increase in energy, a decreased need for sleep,
pressure of speech, with racing thoughts and a
low attention span; easily distracted and an
impaired judgement.
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15. Common Symptoms of Mania
•Persistent and undue happiness (at times marked
irritability)
•Increased self-esteem
•Over activity
•Increased and rapid speech
•Making big plans
•Spending money unnecessarily
•Poor self-control
•Increased socialization
•Decreased need for sleep
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16. Common symptoms of Mania – (Cont)
•DIG FAST is a mnemonic that helps in easy remembering of the
symptoms of mania.
D = Distractibility and easy frustration
I = Irresponsibility and uninhibited behaviour
G = Grandiosity
F = Flight of ideas
A = Activity increased with weight loss and increased libido
S = Sleep is decreased
T = Talkativeness


Duckworth, J. (2015). DIG FAST medical mnemonic–symptoms of
mania. Available at https://www.ignoranceantidote.com/example-real-
world-mnemonics/dig-fast-medical-mnemonic-symtpoms-of-mania/.
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17. Delirious Mania
•Severe form of mania characterized by extreme
excitement, anger, elation; has grandiose/religious
delusions. Patient becomes disoriented, incoherent
with the speech, and agitated.
•May injure self or others; shows poor personal hygiene,
disheveled, physically drained.
•Death from exhaustion may occur if goes untreated.


Adedotun, A. (2000). Basic psychiatry and psychiatric
nursing. Nigeria: Monisola Printing Press.
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18. Schizophrenia
•Regarded as most common and disabling of
the psychotic disorders affecting 20 million
people world wide (WHO, October 4, 2019).
•Characterized by the presence of two main
symptoms among others:
Delusions such as disturbances of thought
process (derailment, illogical thoughts), and
Psychosis such as disturbances of perception
(sensory hallucinations).
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19. Common Symptoms of Schizophrenia
•Inappropriate affect
•Talking to self
•Poor work performance
•Neglect personal hygiene
•Hearing voices
•Suspiciousness
•Decreased socialization
•Unusual and illogical thoughts
•Aggressive behaviour
•Lack of interest in surroundings and activities
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20. Paraphrenia
•This is a type of schizophrenia that starts late in life and
occurs in the elderly population.
•Possible symptoms include incoherent speech, confused
thoughts, strange (possibly, dangerous) behaviour, slowed
or unusual movements, loss of interest in personal hygiene.
•Other symptoms are loss of interest in activities, problems
at work and with relationships, inability to express
emotions (appears cold and detached), and mood swings.


Asare, R. O. (2019). Lessons in basic psychiatry and mental
health nursing (Rev. ed.). Ghana, Sunyani: Johnson Press
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21. Common Signs of Psychiatric
Disorders
•The onset of a mental illness can be sudden, where it
will be obvious to others that something is wrong. In
this case the description of the disease phase is said to
have an acute onset.
•On the other hand, if the onset of the illness is gradual
or emerges slowly over a period of months or even
years before it is discovered, where the individual
becomes severely ill, the disease phase is said to have
an insidious onset.

Nambi, S. (2005). Psychiatry for nurses. Bangalore: Jaypee
Brothers
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22. Disorders of Motor Activity
(Conation)
•Commonly seen motor disorders include:
Hyperactivity
Mannerisms
Stereotypies
Tics
Psychomotor agitation
Waxy flexibility

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23. Disorders of Motor Activity
(Conation) – Cont’d
Psychomotor retardation
Stupor
Muteness
Echopraxia
Echolalia
Ambitendency
Negativism
Restlessness
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24. Disorders of Emotion
1.Disorders of Mood
•Euthymic
•Dysphoria
•Irritable
•Euphoria
•Expansive, elated, exaltation
•Ecstasy
•Depression
•Anxiety
•Apathy

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25. Disorders of Emotion – Cont’d
2.Disorders of affect
•Inappropriate
•Labile
•Emotional incontinence
•Blunted
•Flat

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26. Disorders of Thought Process,
Language and Communication
•These can be categorized under:
Disorders of possession
Disorders of form
Disorders of stream
Disorders of content
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27. Disorders of Thought Process,
Language and Communication – Cont’d
•Circumstantiality

•Clang associations

•Delusions

•Dysarthria

•Echolalia

•Flight of ideas

•Incoherence

•Loosening of association

•Neologism

•Obsessions

•Perseveration

•Phobia

•Poverty of speech

•Pressure of speech

•Tangentiality

•Thought block

•Thought broadcast

•Thought insertion

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28. Disorders of Perception
•Perception is the process of transferring
physical stimulation into psychological
information. It is a mental process by which
sensory stimuli are brought to awareness.
•Disorders of include hallucinations and
illusions.
•Hallucinations are false sensory perceptions
without adequate stimulus.
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29. Disorders of Perception – Cont’d
•Depending upon the sensory organ involved,
hallucinations can be auditory, visual, tactile
(haptic), gustatory or olfactory.
•Other forms of hallucinations include the
following:
Somatic – false sensation of things occurring
in or to the body, most often visceral in origin
(also known as cenesthetic hallucination).


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30. Disorders of Perception – Cont’d
Hypnagogic – false sensory perception
occurring while falling asleep.

Trailing phenomenon – perceptual
abnormality associated with hallucinogenic
drugs in which moving objects are seen as a
series of discrete and discontinuous images.

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31. Disorders of Perception – Cont’d
•Illusions are false sensory distortion of a real
sensory stimulus.

•In other words, illusions are misperception or
misinterpretation of real external sensory
stimuli.
•For example, a rope is misinterpreted as a
snake; a white cloak at night as a ghost, etc.
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32. Disorders of Perception – Cont’d
•Other perceptual disturbances that need worth
mentioning are:

Depersonalization: This is a subjective sense of
being unreal, strange, or unfamiliar to oneself.

Derealization: This is a subjective sense that the
one’s environment is strange or unreal.

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33. Disturbance of Consciousness
•Clouding of consciousness

•Delirium

•Coma


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34. Disturbances in Attention
•Distractibility

•Poor concentration

•Selective attention

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35. Disturbances in Orientation
•Disorientation to:

Time
Place
Person, or
Situation/Circumstance



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36. Disturbances of Memory
•Amnesia
Retrograde
Anterograde

•Confabulation

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37. Impaired Judgement
•Inability to discern

•Poor decision making

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38. Poor insight (Anosognosia)
•Impair ability to understand and perceive
his/her illness

•Lack of awareness of illness

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39. Disturbances in Biological Function
(Physical symptoms)
•Vital signs changes
•Nausea
•Weight gain
•Vomiting
•Insomnia
•Anorexia
•Hypersomnia

•Headache
•Sexual dysfunction
•Loss of appetite
•Increased appetite
•Pain
•Constipation
•Loss of weight
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40. ACKNOWLEDGEMENT
I wish to express my gratitude to all distinguished
personalities, authors, and institutions whose data
valuable information were retrieved from for the
purposes of this presentation.



THANK YOU
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