PSYCHIATRIC NURSING
TYPICAL SIGNS AND SYMPTOMS OF PSYCHIATRIC ILLNESS DEFINED
I. CONSCIOUSNESS: State of awareness
o Apperception: Perception modified by one’s own emotions & thoughts
A. DISTURBANCES OF
CONSCIOUSNESS o Sensorium: State of cognitive functioning of the special senses
1. Disorientation Disturbance of orientation in time, place, or person.
2. Clouding of consciousness Incomplete clearmindedness w/ disturbances in perception & attitudes
3. Stupor Lack of reaction to & unawareness of surroundings.
4. Delirium Bewildered, restless, confused, disoriented reaction associated with fear & hallucinations.
5. Coma Profound degree of unconsciousness.
6. Coma Vigil Coma in w/c a px appears to be asleep but ready to be aroused (akinetic mutism)
7. Twilight state Disturbed consciousness w/ hallucinations
8. Dreamlike state Often used as a synonym for complex partial seizure or psychomotor epilepsy
9. Somnolence Abnormal drowsiness
10. Confusion Disturbance of consciousness in w/c reactions to environmental stimuli are inappropriate:
manifested by a disordered orientation in relation to TPP
11. Drowsiness A state of impaired awareness associated with a desire or inclination to sleep
12. Sundowning Syndrome in older people that usually occurs at night & is characterized by drowsiness,
confusion, ataxia & falling as the result of being overly sedated w/ medications (Sundowner’s
Syndrome)
Is the amount of effort exerted in focusing on certain portions of an experience;
B. Disturbances of Attention
Ability to sustain a focus on one activity ; Ability to concentrate
1. Distractibility Inability to concentrate attention; state in w/c attention is drawn to unimportant or irrelevant
external stimuli
2. Selective inattention Blocking out only those things that generate anxiety
3. Hypervigilance Excessive attention & focus on all internal & external stimuli, usually 2ndary to delusional or
paranoid states
4. Trance Focused attention & altered consciousness, usually seen in hypnosis, dissociative d/o’s, &
ecstatic religious experiences
C. Disturbances in suggestibility Compliant & uncritical response to an idea or influence
1. Folie a deux ( folie a trois) Communicated emotional illness bet 2 (3) persons
,2. Hypnosis Artificially induced modification of consciousness characterized by a heightened suggestibility
Complex feeling state w/ psychic, somatic, & behavioral components that is r/t affect & mood
II. Emotion:
A. Affect Observed expression of emotion
1. Appropriate affect Condition in w/c the emotional tone is in harmony w/ the accompanying idea, thought, or
speech
2. Inappropriate affect Disharmony bet the emotional feeling tone & the idea, thought, or speech accompanying it
3. Blunted affect Disturbance in affect manifested by a severe reduction in the intensity of externalized feeling
tone
4. Restricted or Constricted Reduction in intensity of feeling tone les severe than blunted affect but clearly reduced
5. Flat affect Absence or near absence of any signs of affective expression; voice monotonous, face
immobile
6. Labile affect Rapid & abrupt changes in emotional feeling tone, unrelated to external stimuli
B. MOOD A pervasive & sustained emotion, subjectively experienced & reported by a px & observed by
others
1. Dysphoric mood an unpleasant mood
2. Euthymic mood normal range of mood, implying absence of depressed or elevated mood
a person's expression of feelings without restraint, frequently with an overestimation of their
3. Expansive mood significance or importance.
oscillations between euphoria & depression or anxiety
4. Mood swings (labile mood)
5. Elevated mood Air of confidence & enjoyment; a mood more cheerful than usual
6. Euphoria intense elation with feelings of grandeur
7. Ecstasy Feeling of intense rapture
psychopathological feeling of sadness
8. Depression
9. Irritable A state in w/c a person is easily annoyed & provoked to anger
10. Anhedonia loss of interest in and withdrawal from all regular and pleasurable activities, often associated with
depression
sadness appropriate to a real loss
11. Grief or mourning
12. Alexithymia a person's inability to or difficulty in describing being aware of emotions or mood.
13. Suicidal ideation thoughts or act of taking one's own life.
14. Elation Feelings of joy, .euphoria, triumph, intense self-satisfaction, or optimism.
C. OTHER EMOTIONS
Feeling of apprehension caused by anticipation of danger, which may be internal or external.
1. Anxiety
, 2. Free-floating anxiety Pervasive, unfocused fear not att ached lo any idea.
Anxiety caused by consciously recognized and realisti c danger.
3. Fear
4. Agitati on severe anxiety associated with motor restlessness.
increased and unpleasant motor and psychological activity.
5. Tension
6. Panic acute, episodic, intense att ack of anxiety associated with overwhelming feelings of dread and
autonomic discharge.
7. Apathy dulled emotional tone associated with detachment or indifference
8. Ambivalence coexistence of two opposing impulses toward the same thing in the same thing in the same person
at the same time.
emotional release or discharge after recalling a painful experience.
9. Abreaction
10. Shame failure to live up to self-expectations.
11. Guilt emotion secondary to doing what is perceived as wrong.
12. Impulse control ability to resist an impulse, drive, or temptation to perform an action.
13. Melancholia severe depressive state; used in the term involutional melancholia both descriptively and also in
reference to a disti nct diagnostic entity
signs of somatic (usually autonomic) dysfunction, most often associated with depression(Also
D. PHYSIOLOGICAL DISTURBANCES called vegetative signs).
ASSOCIATED WITH MOOD:
loss of or decrease in appetite.
1. Anorexia
increase in appetite and intake of food.
2. Hypcrphagia
3. Insomnia lack of or diminished ability to sleep.
a. Initial difficulty in falling asleep
b. Middle difficulty in sleeping through the night without waking up and diffi culty in going back to sleep.
c. Terminal early morning awakening
4. Hypersomnia excessive sleeping
mood is regularly worst in the morning, immediately after awakening, and improves as the day
5. Diurnal variation progresses.
decreased sexual interest, drive, and performance (increased libido is of ten associated with manic
6. Diminished libido states).
inability to defecate or diffi culty in defecating.
7. Constipation
a feeling of weariness, sleepiness, or irritability following a period of mental or bodily activity.
8. Fatigue
9. Pica craving and eating of nonfood substances, such as paint and clay (usually girls)
rare condition in which a patient has the signs and symptoms of pregnancy, such as abdominal
10. Pseudocyesis distention, breast enlargement, pigmentation, cessation of menses, and morning sickness.
11. Bulimia insatiable hunger and voracious eating; seen in bulimia nervosa and a typical depression
TYPICAL SIGNS AND SYMPTOMS OF PSYCHIATRIC ILLNESS DEFINED
I. CONSCIOUSNESS: State of awareness
o Apperception: Perception modified by one’s own emotions & thoughts
A. DISTURBANCES OF
CONSCIOUSNESS o Sensorium: State of cognitive functioning of the special senses
1. Disorientation Disturbance of orientation in time, place, or person.
2. Clouding of consciousness Incomplete clearmindedness w/ disturbances in perception & attitudes
3. Stupor Lack of reaction to & unawareness of surroundings.
4. Delirium Bewildered, restless, confused, disoriented reaction associated with fear & hallucinations.
5. Coma Profound degree of unconsciousness.
6. Coma Vigil Coma in w/c a px appears to be asleep but ready to be aroused (akinetic mutism)
7. Twilight state Disturbed consciousness w/ hallucinations
8. Dreamlike state Often used as a synonym for complex partial seizure or psychomotor epilepsy
9. Somnolence Abnormal drowsiness
10. Confusion Disturbance of consciousness in w/c reactions to environmental stimuli are inappropriate:
manifested by a disordered orientation in relation to TPP
11. Drowsiness A state of impaired awareness associated with a desire or inclination to sleep
12. Sundowning Syndrome in older people that usually occurs at night & is characterized by drowsiness,
confusion, ataxia & falling as the result of being overly sedated w/ medications (Sundowner’s
Syndrome)
Is the amount of effort exerted in focusing on certain portions of an experience;
B. Disturbances of Attention
Ability to sustain a focus on one activity ; Ability to concentrate
1. Distractibility Inability to concentrate attention; state in w/c attention is drawn to unimportant or irrelevant
external stimuli
2. Selective inattention Blocking out only those things that generate anxiety
3. Hypervigilance Excessive attention & focus on all internal & external stimuli, usually 2ndary to delusional or
paranoid states
4. Trance Focused attention & altered consciousness, usually seen in hypnosis, dissociative d/o’s, &
ecstatic religious experiences
C. Disturbances in suggestibility Compliant & uncritical response to an idea or influence
1. Folie a deux ( folie a trois) Communicated emotional illness bet 2 (3) persons
,2. Hypnosis Artificially induced modification of consciousness characterized by a heightened suggestibility
Complex feeling state w/ psychic, somatic, & behavioral components that is r/t affect & mood
II. Emotion:
A. Affect Observed expression of emotion
1. Appropriate affect Condition in w/c the emotional tone is in harmony w/ the accompanying idea, thought, or
speech
2. Inappropriate affect Disharmony bet the emotional feeling tone & the idea, thought, or speech accompanying it
3. Blunted affect Disturbance in affect manifested by a severe reduction in the intensity of externalized feeling
tone
4. Restricted or Constricted Reduction in intensity of feeling tone les severe than blunted affect but clearly reduced
5. Flat affect Absence or near absence of any signs of affective expression; voice monotonous, face
immobile
6. Labile affect Rapid & abrupt changes in emotional feeling tone, unrelated to external stimuli
B. MOOD A pervasive & sustained emotion, subjectively experienced & reported by a px & observed by
others
1. Dysphoric mood an unpleasant mood
2. Euthymic mood normal range of mood, implying absence of depressed or elevated mood
a person's expression of feelings without restraint, frequently with an overestimation of their
3. Expansive mood significance or importance.
oscillations between euphoria & depression or anxiety
4. Mood swings (labile mood)
5. Elevated mood Air of confidence & enjoyment; a mood more cheerful than usual
6. Euphoria intense elation with feelings of grandeur
7. Ecstasy Feeling of intense rapture
psychopathological feeling of sadness
8. Depression
9. Irritable A state in w/c a person is easily annoyed & provoked to anger
10. Anhedonia loss of interest in and withdrawal from all regular and pleasurable activities, often associated with
depression
sadness appropriate to a real loss
11. Grief or mourning
12. Alexithymia a person's inability to or difficulty in describing being aware of emotions or mood.
13. Suicidal ideation thoughts or act of taking one's own life.
14. Elation Feelings of joy, .euphoria, triumph, intense self-satisfaction, or optimism.
C. OTHER EMOTIONS
Feeling of apprehension caused by anticipation of danger, which may be internal or external.
1. Anxiety
, 2. Free-floating anxiety Pervasive, unfocused fear not att ached lo any idea.
Anxiety caused by consciously recognized and realisti c danger.
3. Fear
4. Agitati on severe anxiety associated with motor restlessness.
increased and unpleasant motor and psychological activity.
5. Tension
6. Panic acute, episodic, intense att ack of anxiety associated with overwhelming feelings of dread and
autonomic discharge.
7. Apathy dulled emotional tone associated with detachment or indifference
8. Ambivalence coexistence of two opposing impulses toward the same thing in the same thing in the same person
at the same time.
emotional release or discharge after recalling a painful experience.
9. Abreaction
10. Shame failure to live up to self-expectations.
11. Guilt emotion secondary to doing what is perceived as wrong.
12. Impulse control ability to resist an impulse, drive, or temptation to perform an action.
13. Melancholia severe depressive state; used in the term involutional melancholia both descriptively and also in
reference to a disti nct diagnostic entity
signs of somatic (usually autonomic) dysfunction, most often associated with depression(Also
D. PHYSIOLOGICAL DISTURBANCES called vegetative signs).
ASSOCIATED WITH MOOD:
loss of or decrease in appetite.
1. Anorexia
increase in appetite and intake of food.
2. Hypcrphagia
3. Insomnia lack of or diminished ability to sleep.
a. Initial difficulty in falling asleep
b. Middle difficulty in sleeping through the night without waking up and diffi culty in going back to sleep.
c. Terminal early morning awakening
4. Hypersomnia excessive sleeping
mood is regularly worst in the morning, immediately after awakening, and improves as the day
5. Diurnal variation progresses.
decreased sexual interest, drive, and performance (increased libido is of ten associated with manic
6. Diminished libido states).
inability to defecate or diffi culty in defecating.
7. Constipation
a feeling of weariness, sleepiness, or irritability following a period of mental or bodily activity.
8. Fatigue
9. Pica craving and eating of nonfood substances, such as paint and clay (usually girls)
rare condition in which a patient has the signs and symptoms of pregnancy, such as abdominal
10. Pseudocyesis distention, breast enlargement, pigmentation, cessation of menses, and morning sickness.
11. Bulimia insatiable hunger and voracious eating; seen in bulimia nervosa and a typical depression
