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5 results

  • Chapter 3 - Psychopathology and the Mental Status Examination

  • Edited by Marsal Sanches, McGovern Medical School, Texas, Jair C. Soares, McGovern Medical School, Texas
  • Book:
    Fundamentals of Clinical Psychiatry
    Published online:
    02 January 2025
    Print publication:
    16 January 2025, pp 9-18

  • Summary

    A formal psychiatric evaluation must include an itemized description of the mental status exam (MSE). For purposes of documentation, the MSE is considered, by most practitioners, the “objective” portion of the psychiatric assessment, in contrast with history data, which comprise the “subjective” part of the examination. The present chapter provides a succinct description on the MSE and of the main psychopathological concepts of interest for its proper description.

  • Schizoaffective disorder about 57 cases

  • I. Kammoun
  • Journal:
    European Psychiatry / Volume 64 / Issue S1 / April 2021
    Published online by Cambridge University Press:
    13 August 2021, p. S812
    • Article
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  • Introduction

    Schizoaffective disorder remains relatively unknown today compared to other psychiatric disorders. This disorder is however recognized by the international medical classifications DSM 5 and mainly affects many people.

    Objectives

    Describe the socio-demographic and contextual clinical characteristics of patients with schizoaffective disorder

    Methods

    We conducted a descriptive retrospective study including patients with schizoaffective disorder (DSM 5) in the psychiatric department G at Razi hospital and who were hospitalized for a period of 1 year from 1 January to 21 December 2020. We collected 57 patients.

    Results

    The average age of our sample is 40.16 years. The majority of patients (75.4%) were single and the school level did not exceed secondary studies in 64.9% of cases. Most of these patients were unemployed previously working as a day laborer in 47.4%. In addition, the type of schizoaffective disorder was dominated by the bipolar type (94.7%). These patients had a personality disorder in 26.3% mainly schizoid. The psychiatric interview of these patients revealed irritable mood in 47.4%, inappropriate affects in 59.6%, speech of a maniac in 52.6%, delusions of persecution and grandeur in 70.2% with intuitive mechanism (47.4%) and hallucinatory (auditory 45.6%). Disorganized behavior in 50% and catatonic behavior in 5.3% Mental automatism and morbid rationalism in 29.8% Insomnia: 94.7% and concentration disorder: 56.1% Type of treatment was the combination of atypical antipsychotics, mood stabilizers and benzodiazepines 33.3% with regular follow-up in 49.1%

    Conclusions

    Schizoaffective disorder is one of the most misdiagnosed psychiatric disorders in clinical practice and the need to know its characteristics is a necessity.

    Disclosure

    No significant relationships.

  • An exploration of psychopathology for clinical practice

  • Abdi Sanati
  • Journal:
    BJPsych Advances / Volume 26 / Issue 5 / September 2020
    Published online by Cambridge University Press:
    25 August 2020, pp. 296-298
    Print publication:
    September 2020
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  • Psychopathology is an integral part of the theory and practice of psychiatry. This commentary explores the importance of psychopathology, especially with regard to clinical practice. The concept of lifeworld is introduced as an important component of attributing meaning to a person's experience of mental disorder. It is also argued that the advance of neuroscience does not preclude the importance of psychopathology.

  • 41 - Psychiatric Discourse: Scientific Reductionism for the Autonomous Person

  • from Section 14
  • Edited by Kenneth S. Kendler, Virginia Commonwealth University, Josef Parnas, University of Copenhagen, Peter Zachar, Auburn University, Montgomery
  • Book:
    Levels of Analysis in Psychopathology
    Published online:
    02 April 2020
    Print publication:
    02 April 2020, pp 495-509

  • Summary

    Scientific reductionism is necessary for progress in psychiatry. The psychiatric clinician reduces complex mental states and behaviors into diagnosis and formulation before considering the need for and the modality of treatment. The psychiatric researcher explains human behavior with mechanistic models of disease progression and outcome. The resulting psychiatric discourse is confusing, with competing explanatory models, terminologies, and treatment philosophies. Here I will develop the idea that hypothesis testing in psychiatry is shaped by two questions: 1) How strongly can we reduce mental states and behavior? and 2) How much does the person seek and require treatment?If answers to these questions are aligned, it facilitates research and preserves autonomy. Misalignment impedes scientific progress and leads to wasteful debates. Psychiatry needs to balance scientific reductionism with respect of agency and self-efficacy.

  • Case 37 - Jumping and yelling while asleep

  • from Part VII - Sleep-related movement disorders
  • Edited by Antonio Culebras
  • Book:
    Case Studies in Sleep Neurology
    Published online:
    10 November 2010
    Print publication:
    23 September 2010, pp 262-265

  • Summary

    This chapter discusses the case of a 32-year-old married man presented with a chief complaint of fondling his wife during sleep. He was an alert, healthy-looking, white male in no distress. The oropharynx was clear, without redundant tissue, and he had a normal neck circumference. A psychiatric interview was unremarkable, apart from some dysphoria over the long-standing, involuntary sleep-sex with his wife. The PSG study documented clinically significant obstructive sleep apnea (OSA), but no other sleep disorder or abnormal polysomnography (PSG) finding. A diagnosis was made of OSA with confusional arousals and sexsomnia, together with sleep-talking. According to the man's history, the sexsomnia began in close association with the onset of snoring, and both progressed in tandem over time. Sexsomnia may be triggered by OSA through confusional arousals with abnormal sexual behaviors during sleep. Nasal continuous positive airway pressure (CPAP) therapy controls both OSA and the associated sexsomnia.