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Clinical Features Of Mental Diseases: Disorders Of Affect, Cognition And Thinking
A Clinical Overview And Disorders Of Effect
The symptoms of mental diseases are subjective in nature. The scope for objective evaluation is limited because of the functional nature of most of these diseases. The signs and symptoms go together. The symptoms are reflections of disordered psychological functions. These are the disorders of affect, cognition, connation and somatic functions.
Disorders Of affect
Affect is the feeling tone of the mind. Mood and emotion are the different terms for affect. The normal mood of a person is appropriate to the situation and ideas expressed. The affect is said to be congruous when it corresponds to the ideas expressed. Incongruity, elation, depression, anxiety, apathy and liability are the common disorders of affect. When the affect is contrary to the ideas expresses, it is said to be “incogrous”. For example, the subject may laugh on hearing a very sad news. Elation is a well sustained happy mood. Depression is an unhappy or sad state of the mood. “Anxiety” pertains to an unpleasant mood associated with fear. “Apathy” denotes the absence of any emotional expression. “Liability of affect” or “emotional incontinence” refers to unreasonable and uncontrolled frequent changes of mood. For example, weeping may suddenly merge into laughter or vice versa without any valid reason.
Disorders Of Cognition
These are the disorders associated with thinking, perception, memory, intelligence, consciousness, orientation, attention and concentration
Disorders Of Thinking: The common disorders of thinking are loosening of association, incoherence, irrelevance, pressure of thought, though block, flight of ideas, circumstantiality, mutism, delusion and obsessions.
“speech” or “talk” is the medium of expression of thought. So these terms are interchangeably used when the disorders of thinking are described. Normally the thought is goal-directed, it follows logic and leads to a conclusion. The ideas are closely associated in a well- knit pattern, making it sensible. This pattern may become disintegrated and disorganized and the talk may become insensible when “looseness of association” results. Thus looseness of association is a disorder in the form of thought. The thought is said to be “coherent” when the ideas expressed are meaningful and “incoherent” when it is otherwise. The thought is said to be “relevant” when the answer is relevant to the context and “irrelevant” when it is otherwise. The term “pressure of thought” denotes too much ideas being rushed into the mind. When the stream of talk suddenly stops in the midst of an idea and fails to proceed further, it is termed “thought block”. “Flight of ideas” is the frequent shift of ideas from one topic to another in quick succession. In “circumstantiality” unwanted details are described instead of coming to the right points. Absence of talk is referred to as “mutism”.
“Delusion” is a disorder of the thought content. Delusions are false notions which cannot be corrected even by giving evidence to the contrary. The delusions may be “persecutory or paranoid”, “influence”, “grandiose”, “hypochondriacal”, “poverty” and “nihilistic” in nature. In “persecutory” or “paranoid” delusions, the patient may retain the wrong notion that everybody is against him, he is being spied upon, secret plots are made against him, he is being talked about (delusions of reference); he would be murdered or poisoned, etc. In “delusion of influence” the false belief is that the patient is being influenced through magical means or he himself is capable of influencing others likewise. In the case of “grandiose delusion” the patient may retain the false notion that he is immensely rich, he is having intimate personal contact with people of very high caliber, he is a very big person, big scholar, scientist, etc. In the case of “hypochondriacal delusion” the patient believes that he is having some incurable physical disease. In the case of “delusions of poverty” the patient may believe falsely that he is extremely poor and may even start begging. In case of “nihilistic delusions” the patient wrongly believes that nothing exists, his body or he himself or the world itself does not exist. “Obesession” is another disorder of thought content in which ideas, images or doubts repeatedly come to the mind inspite of the subject’s effort to stop them.
© 2014 Funom Theophilus Makama