A 23-year-old man points to his left elbow and says he could hear voices coming from it.
Which of the following symptoms is he exhibiting?
D. In this example, the best description for the patient’s symptom of hearing voices is auditory hallucination. It cannot be somatic hallucination where touch sensations are involved. Abnormal bodily sensations called as ‘cenesthesias’ are well associated with psychopathological symptoms in schizophrenia. ‘Cenesthopathic schizophrenia’ is included but undefined within the category ‘other schizophrenia’ (F20.8) in the ICD-10 classification. Anosognosia refers to lack of awareness of having neurological deficits akin to loss of insight in schizophrenia. It is not somatization as this example describes a psychotic symptom. It is not extracampine as the patient’s sensory fi eld contains the source of the voice, that is his elbow is within the reach of his eyesight and auditory fi eld.
Which of the following symptoms denotes an abnormal psychopathology whenever present?
B. Most psychopathological symptoms are noticeable in so-called normal population in the absence of diagnosable mental conditions. For example hypnagogic hallucinations are very common. Depersonalization can occur during fatigue in normal persons. Obsessions are noted in a child’s developmental period even in the absence of any pathological processes. Amnesia is also common in the general population. But delusions are almost always pathological. It is argued that beliefs exist in a dimension from normalcy through overvalued ideas up to delusions. Even if this is true, when delusions are identified clinically, they almost always mean a pathological process.
When a patient is asked where she is living, she says ‘Helltown’ instead of ‘Hilton’. She quickly corrects her error after saying the word.
This is an example of which of the following phenomena?
A. A parapraxis is an unintentional act that is explained in psychoanalytic terms as perfectly motivated but unconsciously determined failures of ego defence. According to Freud, parapraxes include failures of memory, slips of the tongue, mistaken identity or activities, etc. Confabulation refers to filling memory gaps in patients with organic memory difficulties such as Korsakoff’s syndrome or dementia. A confabulating patient makes no attempt to correct the validity of his statement. In pseudologia fantastica, seen in Munchausen’s syndrome and histrionic personality, ‘fantastic’ fluent lies are told without full awareness of their implications.
Pronominal reversal is a symptom associated with which of the following disorders?
D. In pronominal reversal a subject reverses the usage of the pronouns ‘I’ and ‘you’. The patient may say ‘You want a biscuit’ when in fact she/ he wants a biscuit. This is seen in autistic children. This is more or less characteristic and not seen in other psychiatric illnesses as often as in autism. In conduction aphasia, repetition is affected while motor production of speech and comprehension are preserved. Pronominal reversal is not a part of schizophrenic speech disturbances or manic thought disorders.
Which of the following refers to the sign present in autistic children who continually rotate in the direction in which their head is turned?
D. Twirling is often noted in children with autism. The repetitive behaviours often seen in autism include hand flapping, finger flicking, rocking, jumping, and head banging. Repetitive use of a particular object or a part of the object is often observed in people at the lower functioning end of the autistic spectrum and in children rather than adults with autism. This is not a catatonic phenomenon.
© 2010-2030 Your Doctor - Dr.Khalil Al-Yousifi - Kuwait - Contact Us