Terminology in Mental Health

Definition: Psychiatry
It is a branch of medicine that deals with the
diagnosis, treatment and prevention of mental illness
• Psych : soul or mind
• Iatros : healer /Physician
• Health is a state of complete physical, mental
and social well-being and not merely the
absence of disease or infirmity.
 Mental health
• Is a life long process a sense of harmony
and balance for the individual, family,
friends and community
Common confusions within psychiatry
• Psychology : a science that investigates
behavior, experience, and normal functioning
of the mind
• Psychotherapy : the treatment of
psychological issues by non-physical means
• Psychoanalysis : a particular sort of
psychotherapy, or means of exploring the
unconscious mind
 Terminology in Mental Health
Disorders of the mind can have many causes such as:
• Heredity
• Environmental stress
• Medication
• Damage to the brain

• Most mental disorders must be assessed by a

specialist trained in understanding how a group of
symptoms equals a mental disorder and how to
treat that disorder.
Structure of mind
topographical model
Structural model of the mind
Psyche structure
(Id, Ego, Super-ego)
The id (or it):
demands immediate satisfaction
unconscious part of our psyche
The personality of the newborn child is all id.
 The Ego (or I)

• The ego is that part of the id which has been

modified by the direct influence of the external
world
• Mediate between the unrealistic id and the
external real world
 The superego

• It develop around the age of 3-5 during the phallic

stage of psychosexual development.
• The superego consists of two systems. The
conscience and the ideal self. The conscience can
punish the ego through causing feelings of guilt.
 Primitive Defense Mechanisms
Denial:
Denial is the refusal to accept reality or fact. Acting as if a
painful event.
Regression:
regression is the reversion to an earlier stage of development
in the face of unacceptable thoughts or impulses.
Projection:
projection is the misattribution of a person’s undesired
thoughts, feeling or impulses onto another person who
does not have.
 Primitive Defense Mechanisms
Repression:
Repression is the unconscious blocking of unacceptable
thoughts, and impulses.
Displacement is the redirecting of thoughts feelings and
impulses directed at one person or object.
Rationalization is putting something into a different light or
offering a different explanation for one’s perceptions or
behaviors in the face of a changing reality.
 Primitive Defense Mechanisms
• Fantasy
• Normadism
Signs and symptoms in Mental illness

Disorders
of
Perception
 Disorders of Perception

• Perception is the meaningful organization of

sensory data and their interpretation in the
light of one’s past experience.
 Disorders of Perception
Illusions: Misperceptions or misinterpretations of real
external sensory stimuli: e.g.
Shadows may be misperceived as frightening figures.
In a fading light rope is misperceived as a snake .
Hallucinations: Perception in the absence of real external
stimuli; experienced as true perception coming from the
external world (not within the mind). e.g.
Hearing a voice of someone when actually nobody is
speaking within the hearing distance.
categorized according to which sensory modality is involved
 Types
• Auditory hallucinations (voice, sound, noise). is a form
of hallucination that involves perceiving sounds without
auditory stimulus.
Types of auditory hallucination:
•Second-person hallucinations:
•Third-person hallucinations:
• 2nd Person: voice speaking to the person addressing him as
“you”.
• 3rd Person : voice talking about the person as “he” or “she”:
• Visual hallucination: A false perception of sight. the
content of the hallucination may be in anything (such as
shapes, colors, and flashes of light)
 Types
• Thought echo: hearing one’s own thoughts spoken
aloud.
• Olfactory hallucinations is the phenomenon of
smelling odors that are not really present. The most
common odors are unpleasant smells such as rotting
flesh ,vomit, urine, feces, smoke, etc.
• Gustatory hallucination is the perception of taste
without a stimulus.
 Types
• Tactile hallucinations :Tactile hallucination is the
false perception of tactile sensory input that creates a
hallucinatory sensation of physical contact with an
imaginary object.
• One subtype of tactile hallucination,
• formication, is the sensation of insects crawling
underneath the skin and is frequently associated with
prolonged cocaine use.
 Types

• Thought echo : hearing one’s own thoughts being

spoken
aloud; the voice may come from inside or outside the
head.
• Running commentary hallucinations:
are usually abusive and often talk about sexual
topics.
• Lilliputian hallucinations: A term used to denote a
hallucination featuring miniature individuals,
animals,
objects, or fantasy figures.
 Abnormalities of Though
Flight of ideas: the thoughts follow each other rapidly and
there is no general direction of thinking.
Flight of ideas describes excessive speech at a rapid rate that
involves fragmented or unrelated ideas. It is common in mania.
Pressure of thoughts: Rapid abundant varying thoughts
associated with pressure of speech and flight of ideas.
Poverty of thoughts: Few, slow, unvaried thoughts
associated with poverty of speech.
Thought block: Sudden cessation of thought flow with
complete emptying of the mind not caused by an external
influence.
 Abnormalities of Though
Loosening of Association: (Loose Association)
A thought disorder in which series of ideas are
presented with loosely apparent or completely in
apparent logical connections.
Tangentiality: Wandering from the topic and never
returning to it or providing the information requested. e.g.
"Where are you from?“
"My dog is from England. They have good fish and
chips there. Fish breathe through gills."
 Abnormalities of Though
Neologism:
completely new word or phrase whose deviation cannot
be understood.
 Types of delusions

Delusions: Fixed false beliefs which are not shared by

others ,are out of keeping with one’s educational ,social and
cultural background and are unshakable in the face of evidence
to the contrary.
Delusional Contents:
Persecutory (paranoid) delusion: Delusion of being persecuted
(cheated, mistreated, etc.)
Grandiose delusion: Delusion of exaggerated self-
importance, power or identity.
Delusion of reference: Delusion that some events and others
behavior refer to oneself.
 Types of delusions
“Idea of Reference”: misattribution of events as
referring to oneself.
Delusion of jealousy: Delusion that a loved person
(wife/husband) is unfaithful (infidelity delusion)
Delusions of love (‘fantasy lover’, ‘erotomania’):
Delusion that someone, (usually inaccessible, high social
class person) is deeply in love
Nihilistic delusion: Delusion of nonexistence of self,
part of the body, belongings, others or the world
 Types of delusions

Bizarre Delusion - Totally odd and strange delusional

belief, e.g. delusion that person’s acts are controlled by
stars.
Obsessions: –Repetitive ideas, images, feelings or
urges insistently entering person’s mind despite
resistance. They are unwanted, distressful and
recognized as senseless and irrational. Obsessions are
frequently followed by compelling actions
(compulsions).
Common obsessional Contents: –
dirt/contamination/cleaning –orderliness
–doubts/checking/counting
 Types of delusions
Thought Alienation phenomena –
Thought Insertion:
Delusion that some of person’s thoughts being put into
the mind by an external force (other people, certain
agency).
Thought Withdrawal: Delusion that some of person’s
thoughts being taken out of the mind.
Thought Broadcasting: Delusion that others can read or
hear the person’s thoughts, as they are broadcast over the
air, radio or some other unusual way.
 Abnormalities of Mood /Emotion
Affect: is the outward objective expression of the immediate
cross-sectional emotion at a given time.
Euthymia: a normal mood state, neither depressed nor manic.
Anxiety: feeling of apprehension accompanied by autonomic
symptoms (such as muscles tension, perspiration and
tachycardia), caused by anticipation of danger.
 Signs and symptoms in Mental illness
Anhedonia:
lack of pleasure in acts which are normally pleasurable.
Ambivalent Mood:
coexistence of two opposing emotional tones towards the
same object in the same person at the same time.
Grandiosity:
feeling and thinking of great importance (in identity or ability)
Flat affect: absence of emotional expression.
Apathy:
lack of emotion, interest or concern, associated with detachment.
Labile Affect:
rapid, abrupt changes in emotions in the same setting, unrelated to
external stimuli.