Mental disorders are disorders in which abnormal mental activity is the main manifestation. The science devoted to the study of the regularity of mental symptoms is called symptomatology of mental disorders, i.e., psychopathology in a narrow sense.
In internal medicine, symptoms and signs can be strictly distinguished from each other, while in psychiatry they are both found through the patient’s description, so the two are not strictly distinguished, but are collectively referred to as symptoms. For a diagnosis to be made on the basis of a symptom, the symptom must be frequent and representative of the disorder being diagnosed.
Currently, there are no objective biological tests for the clinical diagnosis of psychiatric disorders, relying to a large extent on the collection of medical history and analysis of mental status, and the analysis of psychiatric symptoms remains the basis of clinical diagnosis. Descriptive symptomatology does not attempt to explain the patient’s feelings or behaviors, but to objectively observe and describe them; it does not focus on possible inner conflicts of the subconscious, but emphasizes the patient’s conscious feelings and external manifestations; it is not possible to localize the brain, but to judge the nature of symptoms based on the patient’s description.
Sensory perception disorder
Sensation is the reflection of individual properties of things, such as shape, color, size, weight, and smell, produced by objective stimuli acting on sensory organs; perception is the overall impression formed in the brain when various different properties of a thing are reflected to the brain for synthesis and combined with previous experience.
Impostor syndrome: First described by the French psychiatrist Capgera in 1923, also known as Capgera’s syndrome, this symptom usually arises as a result of some external shock. The central manifestation is the patient’s perception that a real person is being impersonated or replaced by another person, both of whom exist at the same time and who look and have the same other characteristics. The impersonated prototype may also be other acquaintances, anyone seen, the patient himself, or even robots, aliens, objects, houses, environments, etc. The patient rarely pursues the impersonator as to who he or she really is.
Sensory disorders: Most often seen in organic diseases of the nervous system and hysteria, including sensory hypersensitivity, hyperalgesia, and endosensory inappropriateness.
Sensory hypersensitivity: also known as sensory enhancement, caused by a lowered sensory threshold or strong emotional factors. The clinical manifestation is that the patient reacts particularly strongly and unbearably to stimuli of general intensity, such as feeling particularly harsh sunlight, particularly harsh sound, and painful to the slightest touch of the skin. Most often seen in thalamic or peripheral neuropathy, psychiatry is common in neurasthenia, hypochondria, anxiety disorders, etc.
Hyperalgesia: It is a decrease in the perception of external general stimuli, an increase in the sensory threshold, and the patient feels slight or completely unable to perceive strong stimuli. It is mostly seen in neurological disorders, delirium or other types of disorders of consciousness, and in psychiatry in depressive states and xerostomia.
Internal sensory discomfort: It is a variety of discomfort or unbearable abnormal sensations arising from within the body, such as a feeling of obstruction in the throat, upward flow of air in the abdomen, twisting or pulling pain in the internal organs, etc. It is mostly seen in hypochondria, dissociative disorders, somatoform disorders, etc.
Perceptual disorders: Common perceptual disorders are illusion, hallucination and perceptual syndrome.
Illusion: It is a false perception of objective things. The premise of illusion is the existence of objective stimuli, we are familiar with the “wind and crane”, “cup and snake” are all illusions. Illusions can occur in the following four situations.
1, poor sensory conditions so that the level of sensory stimuli is reduced, such as when the light is low will be hanging clothes hanger mistaken for a person.
2, fatigue, inattention, perceived clarity is reduced, such as concentrating on reading when you hear a loud sound and think someone called you.
3. When the level of consciousness decreases due to disorders of consciousness, such as treating an infusion of leather strips as a snake when delirious.
4.Emotional factors when in a strong state of mind, such as fear, tension, anticipation when seeing a stranger as a familiar person.
Perceptual disorder hallucinations
Hallucination: It is a perceptual experience that occurs when there is no realistic stimulus acting on the sensory organs, and is an illusory perception.
Aetiological theories of hallucinations.
There are 3 etiological theories.
1. overstimulation of different levels of information processing.
2. de-inhibition of cortical functions.
3. impairment of sensory information at the level of interpretation.
Classification of hallucinations.
By the nature of hallucinations: true hallucinations and false hallucinations.
By the conditions of hallucination:
Perceptual syndrome refers to patients who can perceive objective things, but produce false perceptions of certain individual attributes such as size, shape, color, distance, spatial location, etc., mostly seen in epilepsy. Commonly.
1. Visual deformation disorder: patients feel that the size, shape, and volume of people or objects around them have changed. The image of the object is larger than the actual size, such as seeing his father become a giant, with his head on the roof of the house; the size of the object is smaller than the actual size. For example, an adult male patient feels that the bed he sleeps in is only the size of a child’s bed and thinks that he cannot fit his body and sleeps sitting down.
2. Spatial perception disorder: Patients feel that the distance of the surrounding things has changed, such as waiting for the bus has pulled into the platform, but the patient still feels that the car is far away from him.
3. Time perception syndrome: Patients have incorrect perceptual experience of the speed of time. For example, the patient feels that time is flying, as if he or she is in a “time tunnel”, and that things in the outside world are changing abnormally fast; or he or she feels that time is frozen, that the years are no longer passing, and that things in the outside world are stagnant.
4, non-real sense: the patient feels that the surrounding things and environment have changed, become unreal, see things like a layer of curtain, like a stage set, surrounding houses, trees, etc. like cardboard paste, lifeless; surrounding people like lifeless puppets, etc.. The patient has self-awareness in this regard. See depressive neurosis and schizophrenia.
Thought disorder
Thinking is the highest form of human cognitive activity, which is the reflection of the human brain’s indirect generalization of objective things. The material obtained from perception is analyzed, compared, synthesized, abstracted and generalized by the brain to form a concept on the basis of which judgment and reasoning are made. Normal human thinking is purposeful, logical, coherent and practical.
The realization of the thinking process is related to the external reality and goal directedness. From this point of view, thinking can be divided into 3 types according to the presence of clear boundaries and the degree of relevance of everyday events: fantasy, imagination and rational thinking. The difference between fantasy and rational thinking can be understood by analyzing the difference between the 3 types.
Fantasy-generated thinking has no external reality, and even if the thinker is sometimes aware of the state of mind, emotion, or motivation that initiated the thought, the process of its generation lacks any goal orientation at all. In some cases, fantasies purposely exclude reality because they may involve behaviors that the person does not want or cannot accomplish. Normal people occasionally have fantasies on their own. However, when the content of the fantasy is mistaken for reality by the thinker, it is an anomaly. This denial of reality can be limited to a certain degree or completely disconnected from reality.
Rational thinking is a logical approach to problem solving that excludes fantasy altogether. The accuracy of the process is related to the individual’s intelligence, but can be influenced by a variety of different factors in the understanding and reasoning process.
Imagination is intermediate between fantasy and rational thinking. It forms an object or situation through fantasy, but there is rationality and possibility. This type of thinking is goal directed, but usually produces rough plans rather than direct solutions to problems. The central difference between imaginative and rational thinking is that the former ignores Popper’s point of view and any theoretical assumptions must be falsified or refuted by falsification. It is pathological if the patient leans too heavily on his or her imaginary things or situations without heeding possible rational explanations. In hypervalent ideas, imaginative explanations outweigh all other possible explanations; in delusions, all other explanations are ruled out.
Delusions of thought disorder
Delusion, a distorted belief, pathological reasoning and judgment based on pathology, is the most common and important symptom of thought content disorder.