2. Types of personality
• Cyclothymic personality: person with cyclothymic
personality has alternating periods of elation and
depression. These people are predisposed to manic
depressive or affective psychosis.
• Hypomanic personality: these people are
outgoing ,cheerful, confident, aggressive, full of
energy. They do not like failure. They are pleasure
loving people. They are predisposing to manic
episodes.
3. • Melancholic personality: these kind of people
are kind, quite, submissive, sympathetic and
gloomy. They feel helpless and pessimistic. They
are predispose to depression.
• Paranoid personality: People with paranoid
personality suspects other people will harm them. These
people are predispose to paranoid schizophrenia.
• Schizoid personality: The persons having this type of
personality are quite, withdrawn and remain aloof. These
people are shy, timid and self conscious. They may
develop schizophrenia.
4. • Obsessive compulsive personality: people with
this type of personality are rigid to their behavior,
stick to what they say to want. They do their work
with perfection. They feel uncomfortable if
anything is changed or moved against their wish.
• Hysterical personality: People show the cluster of
traits emotional, exhibitionism, sexual
provocativeness, dependence, suggestibility and
aggressiveness.
5. Deviation from normal behavior
Disturbance of consciousness
Disorders of motor activity
Disorders of perception
Disorders of thought
Disorders of affect
Disorders of memory & intelligence
Disorders of orientation
6. Disturbances of consciousness
• Confusion- it is characterized by disturbance of
orientation to time, place and person and also
disturbance of associative functioning.
• Clouding of consciousness- the patient has
disturbance of clear mindedness. The capacity
to think, perceive, respond and remember is
impaired.
7. • Stupor- individual’s activity is reduced to minimum. The
patient remains motionless and mute but movement of
eyes and respiration occur.
• Delirium- A state of mental confusion and excitement
characterized by disorientation for time and place, often
with hallucinations, incoherent speech, and a continual
state of aimless physical activity.
• Dream state- it is an altered state of consciousness like a
dream state. It is accompanied by visual, auditory and
olfactory hallucinations and is believed to be associated
with temporal lobe lesions.
8. Disorders of motor activity
• Increased activity-the person impulsively ruses
about for an activity. The activity is not well
organized and it is purposeless. As in case of
manic patient, he first starts with an activity, then
with another and leaves it. Any activity taken up
by him is never completed.
• Decreased activity-(psychomotor retardation)
the patient takes too long to start the activity.
After starting the patient takes too much time to
complete it.
• Dysactivity- it include-
9. • Repititious activity- repetitious especially
needless or purposeless activity. When there
is continuous repetition of any action, it is
called stereotype activity. It can be in position,
movement and speech.
• Stereotype position- continous maintained
position without any movement. Also called
cateplexy or waxy flexibility.
10. • Stereotype movement- also known as
mannerism e.g. repeated touching the neck
while talking, lifting the shoulder and
swallowing the saliva while talking.
• Stereotype speech– repetition of words,
phrases or sentences.
11. • Negativism- the individual is aware of the
stimuli but he is trying to oppose these
actively or passively. The patient does the
opposite of what he is asked to do.
• Automatism- the condition in which activity is
carried out without conscious knowledge on
the part of the patient.
12. • Compulsion- repeatedly performing an act
which may look unreasonable to the viewers
and individual himself.
• Violence-it is an aggressive behavior in which
physical force is exerted.
• Suicide- violence towards self may lead to
suicide or an act of killing oneself.
13. Disorders of perception
• Illusions: These are misinterpretation of sense
impressions or stimuli. is a subjective
perversion of an objective content.
• E.g. A patient sees a rope and misinterpret it
as a snake.
• Hallucinations: It is a sensory experience or
perception of stimulus in the absence of a
stimulus or an object. Common types of
hallucinations are as follow:
14. • Auditory hallucination: It involves the sense of
hearing. The patient hears the voices of people
talking, buzzing sounds or ill defined sounds. The
patient may hear voices telling him what to do,
communication on his actions, criticising his actions
or giving suggestions.
• Visual hallucinations: It involves the sense of sight.
The patient sees version, usually of clearly defined
people or objects.
• Olfactory hallucinations: It involves the sense of
smell. The smell is commonly horrible and
unpleasant.
15. • Gustatory hallucinations: It involves the sense
of taste and smell.
• Tactile hallucination: It involve the sense of
touch.
• Kinesthetic hallucination: It is false perception
of movement or sensation as from phantom
limb.
• Macropsia: It is state in which the objects
appears larger than they are.
• Micropsia: It is state in which objects appears
smaller than they are.
16. Disorders of thought
There are three aspect of disorder.
• Form of thought
• Content of thought
• Rate of speech/progression of thought.
17. FORM OF THOUGHT-
• Circumstantiality- Patient includes in his
conversation many un necessary details and
explanation before the goal is finally reached.
• Incoherence-There is disordered and
disconnected thinking in which no sense can
be extracted from patient speech.
• Irrelevant- When the patient does not answer
appropriately to the question.
18. • Tangentiality- In this disorder, patient includes in
the conversation many unnecessary details and
explanations but goal is never reached.
• Neologism- Patient may invent his own language
and use new words. It is the coinage of new
words usually by condensing several other words
each of which has special meaning for the
patient.
• Word Salad- Isolated, disconnected words mixed
up in a hopeless jumble.
19. • Perseveration- It is the involuntary and
morbid repetition of a specific word or ideas
which persists inspite of patient efforts to
move on to a new idea.
• Ambivalence- When two contradictory ideas,
emotions, attitude or wishes exist in the mind
of the patient and they are allowed to exist
without objection of either.
20. CONTENT OF THOUGHT: At the content level the
disorders the disorders of thought are described as
delusions, obsession, phobia, preoccupation and
fantasy.
• DELUSIONS-These are the false beliefs , which are
irrational and not shared by persons of same race , age
and standard of education, which is held by conviction,
which cannot be altered by logical arguments and
which are persistent. Delusions include:
• Persecutory delusions: In this the person beliefs that
he is being interfered with or threatened or mistreated
or being poisoned or discriminated against by his
family members, neighbours or friends.
21. • Delusions of reference: These refers to delusional beliefs that
either people are talking about him or referring to him or
action of people intended to have some special significance
for him.
• Delusions of influence: Delusional belief of an individual that
enemies are influencing him in many ways and that his
bodies, his emotions and his feelings are controlled by others.
• Delusions of guilt: Delusional belief of an individual that he
have committed some sins or committed some wickedness in
his past life that have brought calamity to others or have
ruined his family.
• Delusions of grandeur: Delusional belief of great power.
Wealth and influence. These are commonly seen in manic
states.
22. • Delusions of infadability: Delusional belief that his/her
spouse is having relations with other man/woman.
These are suspicious thoughts for spouse about his/her
character.
• Nihilistic delusions: Delusional belief that nothing
exists, that the whole world is destroyed, that some has
fallen on one or more of his relatives patient may also
state that he is dead or that certain part of his body is
died ceased to function. It has two forms:
a) Derealization: Delusional belief that all the things in
the environment have changed or destroyed.
b) Depersonalization: Delusional belief that patient
himself has changed or dead.
23. • OBSESSION- This refers to fixed and reoccurring
ideas, thoughts in the patients mind and that
cannot be eliminated from consciousness by
logical efforts.
• PHOBIA- It is irrational or morbid fear with
morbid anxiety or it is an exaggerated and
pathological dread of some specific type of
stimulus or situation.
• PREOCCUPATION-When thought content centres
around a particular idea and is associated with a
strong effective tone.
24. • FANATSY-It is a product of imagination. It is a
mental representation of a scene or
occurrence that is recognized as unreal but is
either expected or hoped for. Fantasy can be
of two type:
• CREATIVE: Which prepares the person for
some later action.
• DAY DREAMING: Which is the refuse for
wishes that cannot be fulfilled in reality.
25. • PROGRESSION OF THOUGHT/RATE OF SPEECH- It is referred to
as association of each idea with the one that has proceeded. It
is also known as stream of thought or stream of talk.
• Pressure of speech: The speech or flow of thought is too rapid
that it is difficult for the listener to interrupt. It is seen in the
state of excitement and over-activity.
• Flight of ideas: When pressure of talk is more severe, there is
tendency of the patient to start talking on one subject and then
switch to another subject and then another with little
connection between them.
• Thought retardation: In thought retardation, the initiation and
movement of thought is slow.
26. • Mutism: The patient may not talk at all.
• Aphonia: Patient is able to speak only in whisper.
• Thought block: The patient thought and speech are
proceeding at an average rate but are very suddenly and
completely. Interrupted in the middle, the gap may last for
several seconds, even upto a minute after which patient
resumes speaking either where he left off or on a
completely new topic.
• Clang Association: It is an associated disturbance in which
the patient may follow one word with another and where
the mere of word rather than its meaning touches a new
thought. The patient uses these word in rhythmic way like
” Bat Cat Rat Mat”.
27. Disorders of affect
Pleasurable effect-
• Euphoria- First moderate level in the scale of
pleasurable effect. It is the feeling of emotional
and physical well being.
• Elation- It is the second level of pleasurable
effect. It is characterised by definite effect of
gladness in which there is air of enjoyment, self-
confidence and increased motor activity.
• Exaltation- It is the intense elation with the
feeling of grandeur.
• Ecstasy- It is the feeling of extreme joy and
happiness. The patient feels detached from the
world.
28. Un pleasurable effect-
• Depression: It is the psychopathological
feeling of the sadness. It is characterised by
the feeling of inadequacy, hopelessness,
helplessness and worthlessness.
• Grief and Mourning: It is the sadness
appropriate to a real loss .It is self –limiting.
• Apathy: lack of emotional feeling.
29. Disorders of memory
• Hypermnesia: Hypermnesia or excessive retention of
memories as seen in paranoid psychosis and manic
state is limited to a specific period or specific events
which have an emotional factor.
• Amnesia: Amnesia or absence of memory may be
complete, partial, continuous or circumscribed.
• Anterograde amnesia: Amnesia of events occurring
prior to the episode which precipitated the disorder.
• Retrograde amnesia: Amnesia of events occurring
after the episode which precipitated the disorder
30. • Paramnesia: It is a false re-collection where the
patient talks about those events which never took
place of gives a false coloring to those that did
happen. For example confabulation ( patient fills the
gap in his memory by making up his own ideas).
• Deja vu: It is an illusion of recognition in which a new
situation is incorrectly regarded as a repetition of a
previous memory.
• James vu: vice versa of deja vu (unfamiliarity with
familiar event.
31. Disorders of orientation
• When a person is aware of his position in
reference to time, place, person and
circumstances, it is considered to be oriented.
In organic conditions orientation is most
frequently lost, wholly or partly.
32. Disorders of attention
• Distractibility: It is a common type of disorder
of attention in which the patient gives
attention to everything which is happening,
with the result his attention passes very
rapidly from one object to another.