Loosening of Association A loss of the normal structure of thinking.  The patient’s discourse seems muddled and illogical and does not become clearer with further questioning; there is a lack of general clarity, and the interviewer has the experience that the more he/she tries to clarify the patient’s thinking, the less we understand it.   Loosening of associations occurs mostly in patients with schizophrenia. Earlier psychopathologists have described three kinds of loosening of association: Knight’s move thinking ( Derailment , Entgleisen ):  There is a change in the train of thought. There is retained but misled determining of the objective of thought. There is a disordered intermixture of constituent parts of one complex thought.  Talking past the point ( vorbeireden )  where the patient gets close to the point of discussion, but skirts around it and never actually reach it Verbigeration (word salad, schizophasia, paraphrasia)  where speech is reduced to a senseless repetition of so

Disorders of the Form of Thought Form of thought Form of thought is the way people experience or express thoughts and the way thoughts proceed one after the other irrespective of their quantity. It helps in the diagnosis of psychiatric disorders. Normal thinking forms include the following.  Dereistic Thinking (daydreams) Imaginative thinking Rational thinking Formal Thought Disorder The term ‘formal thought disorder’ is a synonym for disorders of conceptual or abstract thinking that are most seen in schizophrenia and organic brain disorders. In schizophrenia, disorders in the form of thinking may coexist with deficits in cognition, and these forms of thought disturbance may prove difficult to distinguish in certain cases. Cameron used the term ‘Asyndesis’ to describe the lack of adequate connections between successive thoughts. Cameron placed particular emphasis on ‘over-inclusion’, which is an inability to narrow down the operations of thinking and bring into action the organized att

Physical Examination in Case of Alcohol Use Disorder The examination begins with an inspection of the general demeanour and physique.  General Physical Examination  On general physical examination, observe signs of agitation, sweating, and bruises and note the respiratory rate.  Agitation or restlessness   Sweating   Bruises  Respiratory rate   Examination of hands and arms Examine the arms and hands for signs of hepatic disease or cerebellar dysfunction (tremor/dysdiadokokinesia and finger-nose test).  Inspect for Palmar erythema Dupuytren’s contracture   Clubbing   Koilonychia   Nicotine stains 

Foundation URI : http://id.who.int/icd/entity/822487798 ICD-11 Criteria For Seasonal Pattern Of Mood Episode Onset 6A80.4  Description In the context of recurrent depressive disorder, bipolar type I or bipolar type II disorder, there has been a regular seasonal pattern of onset and remission of at least one type of episode (i.e., depressive, manic, mixed, or hypomanic episodes), with a substantial majority of the relevant mood episodes corresponding to the seasonal pattern. (In bipolar type I and bipolar type II disorder, all types of mood episodes may not follow this pattern.) A seasonal pattern should be differentiated from an episode that is coincidental with a particular season but predominantly related to a psychological stressor that regularly occurs at that time of the year (e.g., seasonal unemployment). Diagnostic Requirements This specifier can be applied if: In the context of Bipolar Type I or Bipolar Type II Disorder there has been a regular seasonal pattern of onset and rem

ICD-11 Criteria for Rapid Cycling in Mood Disorder  6A80.5 Description In the context of bipolar type I or bipolar type II disorder, there has been a high frequency of mood episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood to the other, or the mood episodes may be demarcated by a period of remission. In individuals with a high frequency of mood episodes, some may have a shorter duration than those usually observed in bipolar type I or bipolar type II disorder. In particular, depressive periods may only last several days. If depressive and manic symptoms alternate very rapidly (i.e., from day to day or within the same day), a mixed episode should be diagnosed rather than rapid cycling. Diagnostic Requirements This specifier can be applied if the Bipolar Type I or Bipolar Type II Disorder is characterized by a high frequency of Mood Episodes (at least four) over the past 12 months. There may be a switch from one polarity of mood to the othe