Fish's Clinical Psychopathology soon became an essential text for medical students, psychiatric trainees and all healthcare workers involved in the delivery of. PDF | Narayana Manjunatha and others published Fish's Clinical Psychopathology, Third Edition: The Beginning of Eclectic Psychopathology. Cambridge Core - Psychiatry and Clinical Psychology - Fish's Clinical Psychopathology - edited by Patricia Casey. PDF; Export citation. Contents. pp iii-iii.
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Fish's Clinical Psychopathology: Signs and Symptoms in Psychiatry (3rd edn) By Patricia Casey & Brendan Kelly. Gaskell. pp. £ Editorial Reviews. Book Description. Fish's Clinical Psychopathology has shaped the psychiatric training and clinical practice of several generations of. Psychopathology of everyday behavior and general appearance. 7 One program each used Kahlbaum's Catatonia and Fish's Schizophrenia.
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Description Fish's Clinical Psychopathology has shaped the psychiatric training and clinical practice of several generations of psychiatrists, but has been out of print for many years. The third edition of this modern classic presents the clinical descriptions and psychopathological insights of Fish to a new generation of students and practitioners.
This is an essential text for students of medicine, trainees in psychiatry and practising psychiatrists. It will also be of interest to psychiatric nurses, mental health social workers, clinical psychologists and all readers who value concise descriptions of the symptoms of mental illness and astute accounts of the many and varied manifestations of disordered psychological function.
Produced by the same editorial team who publish The British Journal of Psychiatry, they sell books for both psychiatrists and other mental health professionals; and also many written for the general public. RCPsych publishes in all areas of psychiatry and mental health, including but not limited to: Clinical psychiatric practice Intellectual disability Mental health services for children, adolescents, adults and the elderly Psychopharmacology Psychotherapy Rehabilitation psychiatry Family mental health Service provision RCPsych Publications books can help with the following disorders: Schizophrenia Sleep problems 4.
Book Details Author: Patricia Casey ,Brendan Kelly Pages: Paperback Brand: Delusions or overvalued ideas of jealousy seem to be the most dangerous kind of delusion and overvalued idea. Action is more likely to be taken on the basis of delusion-like or overvalued ideas than on the basis of true delusions.
Positive FTD: The pt. Bleuler: the outstanding feature of schizophrenic FTD is the lack of connection between associations, which gave rise to changeable and unusual concepts. The incompleteness of ideas is the result of: Condensation: 2 ideas with something in common are blended into a false concept. Displacement: one idea is used for an associated idea. Misuse of symbols: using the concrete aspects of the symbol instead of the symbolic meaning.
These concepts were borrowed from Freud, who pointed out that these mechanisms are characteristic of thinking in dreams. Cameron: grouped the symptoms of disorganization resulting from functional or organic psychiatric states into: 1 2 Inco-ordination Interpenetration: The speech contains elements which belong to the task in hand interspersed with a stream of fantasy which the pt.
Asyndesis: the lack of adequate connections between successive thoughts. Metonyms: the imprecise approximations in which pt. A companion to Fishs psychopathology Goldstein: in schizophrenia and in coarse brain disease there is a loss of 30 abstract attitude so that thinking becomes concrete in the former the pt.
Payne: tests of concrete thinking which are performed badly by schizophrenics with FTD are in fact tests of overinclusion. Schizophrenics who showed overinclusion showed marked psychomotor slowness. Chapman: the schizophrenic cannot free himself from the major meaning of a word.
Schneider: isolated 5 features of FTD. Substitution: a major thought is substituted by a subsidiary one. Omission: the senseless omission of a thought or part of it. Fusion: heterogeneous elements of thought are interwoven with each other. Drivelling: there is a disordered intermixture of constituent parts of one complex thought. Organization: the contents of the thoughts are related to each other in consciousness and do not blend with each other, but are separated in an organized way.
There are 3 corresponding varieties of objective thought disorder: 1 2 Transitory thinking: derailments, substitutions and omissions occur. Both grammatical and syntactical structures are disturbed. Drivelling thinking: the pt. Desultoriness: the continuity is loosened, Omission: the intention itself is interrupted and there is a gap.
There are 3 symptom groups in schizophrenia which could occur separately or in combinations. Paranoid schizophrenia with systematized delusions. Critchley: there are considerable linguistic differences between the verbal productions of aphasics and schizophrenics. Classification: 1 speech disorders which are mainly functional: 2 stammering and stuttering mutism talking past the point neologisms speech confusion Receptive aphasias Intermediate aphasias Expressive aphasias 32 Aphasia Stammering: The normal flow of speech is interrupted by pauses or by the repetition of fragments of the word.
Often associated with grimacing and tic-like movements of the body. Usually begins about the age of 4 Much more common in boys. Often improves with time and only becomes noticeable when the patient is anxious for any reason. A companion to Fishs psychopathology Occasionally occurs during a severe adolescent crisis or at the onset of an 33 acute schizophrenia probably the result of severe anxiety bringing to light a childhood stammer which has been successfully overcome.
Mutism: The complete loss of speech. Disturbed children Hysteria Depression Schizophrenia Coarse brain disease Catatonic stupor Elective mutism: in children, who refuse to speak to certain people. Pure word dumbness: the pt.
Akinetic mutism: mutism, a lowering of the level of consciousness, anterograde amnesia, preserved awareness of the environment. Lesions at the base of the brain, especially space occupying lesions affecting the third ventricle, the thalamus and the midbrain. Commonest hysterical disorder of speech is aphonia.
Talking past the point vorbeireden, pseudo-pseudo-dementia : The content of the patients replies to questions shows that he understands what has been asked and is deliberately talking about an associated topic. A companion to Fishs psychopathology Described by Ganser in criminals awaiting trial for serious offences.
Ganser used the word Vorbeigehen Accompanied by lack of insight, fluctuating twilight diminution of consciousness of short duration, hysterical analgesia, and hyperaesthesia. Neologisms 4 types: 1 2 3 4 1 2 3 4 5 6 7 A completely new word whose derivation cannot be understood. A word which has been incorrectly constructed by the faulty use of the accepted rules of word formation. A distortion of another word. An ordinary word used in a special way. Neologisms in catatonics may be mannerisms or stereotypies Some schizophrenic neologisms could be regarded as the result of paraphasia Kleist A result of severe positive FTD.
Result of a derailment relativity relationship. Used in order to placate the voices or to protect himself from them. Paraphasias: wrong words, newly invented words, or words with distorted phonetic structure used by patients with aphasia, particularly those with motor aphasia superficially resembles neologisms.
Malapropisms: ludicrously misused words that may be used by bewildered dullards may be mistaken for neologisms. Speech confusion word salad : Utterly confused speech, talking utter nonsense. A companion to Fishs psychopathology There is gross thought disorder, but the pt.
Seen in some chronic schizophrenics, Bleuler called this type of schizophrenia schizophasia. The section on aphasias is excluded, since it is referring mainly to a book published in 35 A companion to Fishs psychopathology 36 MEMORY Seven stages in memory Welford : 1 2 3 4 5 6 7 Adequate perception, comprehension and response to the material to be learned.
Katathymic amnesia a set of ideas which are disturbing when conscious are repressed in an attempt to avoid the affect which they would otherwise produce. Hysteria Normal persons Hysterical dissociative amnesia there is a complete loss of memory and loss of identity, but the pt. Is often associated with a fugue or wandering state. Organic amnesias: Acute coarse brain disease: A companion to Fishs psychopathology Poor memory is due to disorders of perception and attention and the failure to make a permanent trace.
Retrograde amnesia: amnesia which embraces the events just before the injury; is the result of disturbance of the short-term memory. Anterograde amnesia: the pt. Alcoholic blackout Delirium Twilight state due to epilepsy Pathological drunkenness Transient global amnesia: A sudden onset of retrograde amnesia covering a period of a few days upto several years.
Perception and personal identity remain normal An anterograde amnesia continues until recovery upto several hours The amnesia subsequently shrinks to a period of half to five hours.
In some pts. The immediate cause is probably from bilateral temporal or thalamic lesions. Subacute coarse brain disease: A companion to Fishs psychopathology The pt. The amnestic state: 38 There are 3 faults: difficulty in forming permanent traces, difficulty in recall and thought disorder. There is disorientation for place and time, euphoria and confabulation.
Is related to damage to the floor and walls of the third ventricle and those parts of the brain, eg. The disorder of thinking is an inability to change set, called tram-line thinking.
Once thought is proceeding in a given direction it continues in that direction for an unnecessarily long time, and instead of being corrected by the incoming information it distorts the information that is getting registered and makes recall difficult. Chronic coarse brain disease: The amnesia extends over many years. Ribots law of memory regression: in dementing illnesses the memory for recent events is lost before the memory for remote events.
Normal people degree of retrospective falsification is inversely related to the degree of insight and self-criticism of the individual Hysterical personality Depressive illness Agitated depression Mania Retrospective delusions: The pt. Could be regarded as delusional retrospective falsification. Schizophrenia Confabulations: A false description of an event, which is alleged to have occurred in the past.
Could be influenced by the examiner. Could be explained as a result of tram-line thinking. Some amnestic pts. Organic states Hysterical psychopaths Amnestic syndrome Chronic schizophrenia Some chronic schizophrenics confabulate, producing detailed descriptions of fantastic events which have never happened.
Leonhard suggests that these A companion to Fishs psychopathology 40 pts. Bleuler preferred to call them memory hallucinations, since the memories are false and unchangeable. But the hallucinatory flashbacks which occur in temporal lobe epilepsy may better merit the designation memory hallucinations.
Disorders of recognition: Dj vu: The subject has the experience that he has seen or experienced the current situation before. The sense of recognition is never absolute. Normal people Temporal lobe lesions Dj vu and deja vecu Misidentification Misidentification: Positive misidentification Negative misidentification Positive misidentification: The pt. Some pts. Confusional states Acute schizophrenia can be based on a delusional perception Chronic schizophrenia false identity to every fresh person met Capgras syndrome: pt.
Schizophrenia commonest cause Involutional depression Very hysterical women 41 Amphitryon illusion: pts. Sosias illusion: pt. Syndrome of Fregoli: the pt.
Negative misidentification: The pt. Could result from an excessive concretization of memory images. Disorders of A companion to Fishs psychopathology 42 emotion Definitions: Feeling: a positive or negative reaction to some experience The subjective experience of emotion.
Emotion: a stirred up state due to physiological changes which occurs as a response to some event and which tends to maintain or abolish the causative event. The emotion is designated by the content of consciousness which has evoked the physiological changes.
Affects: waves of emotion in which there is a sudden exacerbation of emotion usually as a response to some event. Sthenic affects: anger, rage, hate and joy. Asthenic affects: anxiety, horror, shame, grief and sadness. Affectivity: the total emotional life of the individual Mood: the emotional state prevailing at any given time.
The dominant hedonic tone of the moment: Deese. Mood state: a lasting disposition, either reactive or endogenous, to react to events with a certain kind of emotion. Classification of emotional disorders: 1 2 3 4 5 Abnormal emotional predispositions Abnormal emotional reactions Abnormal expressions of emotion Morbid disorders of emotion Morbid disorders of the expression of emotion Abnormal: excessive responses of a normal kind.
A companion to Fishs psychopathology - 43 Morbid: those phenomena which appear to be the result of a morbid process within the nervous system. Abnormal emotional predisposition: Hyperthymic personality: the person is overcheerful and is not touched by the minor irritations of life.
Dysthymic personality: the person always looks on the sad side of life and is miserable. The hyperthymic, dysthymic, cyclothymic and irritable temperaments, which are often found in pts. Other predispositions to emotional disorders are probably partly, if not wholly, determined by childhood experiences.
Abnormal emotional reactions: Anxiety: an unpleasant affective state with the expectation, but not the certainty of something untoward happening. Anxious disposition: a low threshold for the development of anxiety. Phobias: Fears restricted to a specific object, situation or idea. Agoraphobia is not a true phobia.
Reactive depression: pts. Morbid thinking is not present. Threats of suicide are not infrequent, even suicidal attempts are made. Often anger and resentment are ill-controlled. They enjoy sympathy. Loss of weight, loss of interest and loss of libido are not common. Sleep is almost invariably disturbed. Verstimmung ill-humored mood state : Irritable, angry depressive states. The borderline between reactive depression and Verstimmung is not well marked.
Disturbed adolescents Abnormal personalities, particularly psychopaths. Morbid depression often the expression of an abnormal personality, occasionally result of a mixed affective state Schizophrenia Organic states Mania pt. The hyperthymic individual is usually euphoric.
May be the result of learning or may be subsumed under the term emotional lability. Dissociation of affect: A lack of manifestation of anxiety or fear under conditions where this would be expected. Is said to be an unconscious defense reaction against anxiety. The term covers a no. Belle indifference: seen in hysteria the pt.
Traumatic depersonalization Situations of hopelessness, like prisons Malnutrition A companion to Fishs psychopathology 46 Perplexity: a state of puzzled bewilderment. Anxiety Mild clouding of consciousness Acute schizophrenia Morbid disorders of emotion: Depressed mood state: Vital hypochondriacal depression Schneider : the type of depression in which precordial anxiety a sense of oppression in the chest associated with anxiety occurs.
Morbid anxiety often occurs in association with morbid depression and gives rise to the clinical picture of agitated depression. Organic neurasthenia: mild anxiety mixed with depression and irritability, occurring in mild acute and chronic coarse brain disease. Anxiety or fear seen in schizophrenia is difficult to be regarded as morbid, since it can be understood as a natural reaction to the delusions and hallucinations.
Irritability: A liability to outbursts A state of poor control over aggressive impulses directed towards others, most frequently to those nearest and dearest. May be a trait of personality the explosive personality and it occurs in morbid states. Is very commonly a manifestation of the tension accompanying anxiety.
Appears episodically in women as part of the premenstrual syndrome. May occur in any organic state, but is rarely seen in the amnestic syndrome.
A companion to Fishs psychopathology 47 Ictal moods in temporal lobe epilepsy are most commonly of depression and anxiety, and less commonly of euphoria or extremely unpleasant feelings.
Apathy: apathetic hebephrenia Leonhard : chronic schizophrenia in which pt. The anergic state seen in depression is not apathy because the pt. Chronic organic states, particularly those in which the frontal lobes are affected, may be associated with apathy.
Morbid euphoria and elation: Mania Organic states Schizophrenia occasional there is a silly cheerfulness and flight of ideas is rarely present. The manic, in contrast with the general paretic, does not have well-held grandiose delusions.
Lesions of the hypothalamus may produce clinical pictures resembling mania with flight of ideas. Euphoria classically occurs in disseminated sclerosis. Euphoria and a general passive attitude are characteristic features of the amnestic syndrome. Moria Witzelsucht : silly euphoria with lack of foresight and general indifference; found in frontal lobe lesions, particularly when the orbital surface is damaged.
According to Ey , Esquirol brought together psychiatry and the patient with hallucinations. Who would dare to say visions of hearing, visions of taste, visions of smell? The activity of the brain is so energetic that the visionary or the hallucinated gives a body and reality to images and ideas that memory reproduces, without the intervention of the senses.
This last question arises from the first, and goes back to the self-report of two patients suffering from these symptoms. In this work, Nicolai described his own visual hallucinatory experiences, where insight had been preserved.
This case was considered paradigmatic of pathological hallucinations Berrios, In this context Baillarger proposed two types of hallucinations: psycho-sensorial arising from a combination of the action of imagination and the sensory organs and psychological independent of the sense organs. Tamburini questioned the accepted view particularly defended by the French school that proposed the origin of hallucinations to be predominantly psychological. According to Tamburini all hallucinations were a result of excitation of the centers of formation of images and other sensations in the brain.
Several authors of this time, such as Chaslin , accepted this position and developed it. This unitary vision of hallucinations promoted a divorce between history and the social context of the patient and the content of the hallucinations, which was caused by random stimulation of the nerve centers.