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Ministry of Health of Ukraine

Bukovynian State Medical University


on the methodical meeting

of the Department of neurology, psychiatry

and medical psychology nm. S.M.Savenko

“____” ___________ 2009 (Report № __).

Chief of the Department


Professor V.M. Pashkovsky


for 4-th year students of medical faculty №2

(the speciality “medical affair”)

for independent work during preparing to practical class

Theme 4: Perception disorders


Topical module 2. General psychopathology

Сhernivtsi, 2009

1. Actuality Aim

Reflection of separate properties of objects and phenomena of the outer world and internal state of organism, that directly influence on analyzers (feeling) is difficult psychical activity in the process of which a man cognizes surrounding the world and internal state of organism. Feelings not only carry information about separate properties of the phenomena and objects but also execute activating a brain function. The result of operating on the analyzers of objective reality is synthesized with the pas practical experience in one whole.

Knowledge of the state of feeling and perception sick it needs a doctor on all stages of inspection and treatment.

^ 2. Educational purpose

2.1. A student must know:

  1. Classification of disorders of feelings and perception.

  2. Determination and clinical displays of illusion.

  3. Criteria of illusions, hallucinations.

  4. Objective signs of hallucinations.

  5. Phenomena of psychical automatism.

  6. Diagnostic value of disorders of feelings and perception.

  7. Syndromes of abnormal psychologies with overwhelming violation of feelings and perception, their diagnostic value.

^ 2.2. A student must be able:

  1. To determine the rightness of orientation of patients in an own person and in an environment.

  2. You to present disorders of feelings and perceptions.

  3. To distinguish the criteria of the hallucinations.

  4. To find out the objective signs of hallucinations.

  5. To diagnose phenomena of psychical automatism.

^ 2.3. To seize practical skills:

  1. Patients have collection of anamnesis with disorders of feelings and perception.

  2. Diagnosing disorders of feelings and perception.

  3. Conducting of differential diagnosis is between illusions and hallucinations.

  4. Diagnosing of pathopsychological syndromes with feelings and perception disorders.

^ 3. Educate purpose.

On practical employment attention of students is concentrated on knowledge of pathology of bases of conformity to the law of cognitive activity of patient, that allows a doctor to analyse diagnostic and medical processes, draw conclusions and give the correct estimation of the state of feelings and perception sick for giving him necessary medical assistance.

^ 4. Intersubject integration (base level of preparation).

Names of previous disciplines

Skills are got

1. Normal physiology

2. Medical psychology

  1. Physiology of HNS

  2. Classification of perception.

^ 5.1. Preparatory stage.

Practical employment from this theme is one of main, so as knowledge of the state of feeling and perception sick needs a doctor on all stages of inspection and treatment.

Attention applies on organizational questions of conducting of practical employment. A teacher determines an educational purpose, canvasses students on questions of pathology of feeling and perception.

    1. ^ Basic stage.

The basic stage foresees conducting with the students of educational activity and determination of feeling and perception.

Senestopatii are the various unpleasant feelings in the different areas of body, but more frequent from the side of internal organs which do not have (as a result of inspection) anatomical-physiology basis. Arise up after the mechanism of strengthening and distortion of the interoreceptive feelings which are not realized up to par.

Derealization is expressed in because the sick perceives surrounding the world not so as perceived him before, to illness. He asserts that all articles of environment became other, changed somehow. But unlike illusions and hallucinations, patients here always perceive objects such which they are, but something changed (megascopic, diminished, other form).

Depersonalization is characterized, that a patient perceives itself, the personality, changed – «he became not such, as was before, to illness; he perceives the awareness of itself as personalities other gates».

Illusions – perceptions of really existent objects and phenomena, which understanding of appearances of того, which is perceived, does not answer reality and has other maintenance, is at, are disfigured.

^ Hallucinations are imaginary perception, without a really existent object. After the mechanism of origin they are the painfully changed and involuntary presentations which become dominant in consciousness.

The real hallucinations are all characteristics of perception – extra projection, feeling of reality and absence of arbitrary change of appearance.

Hallucinosisthe plural proof verbal hallucinations of antagonism character (one protect a patient, and other threaten him) speak with a patient in the third person.

^ Psychical automatism unites symptoms which are characterized patients, as stranger in relation to their consciousness, independent of their will, violent.

Meet this at schizophrenia and psychoses which arise up as a result of easy organic defeats of cerebrum.

Different methods belong to the objective signs of hallucinations, that they are used by a patient(stopping ears at auditory hallucinations, deleting from the apartment of radio receiver), anxious look, expression of horror on face, attempts from someone to be hidden, laying of surrounding to the improper talks about him and others like that.

Students independently under the direction of teacher inspect mentally patients with different disorders of feeling and perception.

^ 5.3. Questions of controls:

      1. Classification of disorders of feelings and perception.

      2. Their diagnostic value.

      3. Determination.

      4. Illusions and hallucinations, their classification.

      5. What is the psychical automatism?

      6. Diagnostic value of illusions, hallucinations, symptoms of psychical automatism.

      7. Disorientation, double orientation, their diagnostic value.

      8. Objective signs of hallucinations.

      9. Psychopathological Syndromes of feelings and perception disorders.

^ 5.4. Final stage.

On the final stage of practical employment a teacher checks up the eventual level of professional abilities and practical skills, visits and progress of students works out the total of employment, answers question of students.

6. Tasks for self-control.

The patient was brought to the reception department of a psychiatric hospital by policemen. At the reception department the patient is tense and angry. He states that his neighbor has established in his flat an apparatus, with which he records all the patient's thoughts and inserts his own thoughts into his head. Sometimes with the help of special equipment the neighbor broadcasts pro-grams, in which offends the patient in different ways. Recently the neighbor made the patient walk in the wrong direction, use obscene language in public, and produced artificial cheerfulness in him. The patient attacked his neighbor and tried to stab him with a knife.

^ Name the probable syndrome:

A. Fregoly syndrome

B. Da Casta's syndrome

C. Cotard's syndrome

D. Syndrome of intermetamorphose

E. Clerambault-Kandinsky syndrome

A 15-year-old teenager girl during last 4 or 5 months began to pay excessive attention to her appearance. For hours she looks at herself in the mirror, finds some defects in her face, which make it look "horrible" (states that her nose is crooked and her ears are too protruding). Thinks that every­body laughs at her. It is impossible to persuade her that she isn't right. She consulted a cosmetologist and asked him to make a plastic operation on her face.

Name the probable syndrome:

A. Hypochondriac syndrome

B. Cotard's syndrome

C. Dysmorphomanic syndrome

D. Fregoly

E. Metamorphopsia


  1. Clinical Psychiatry from Synopsis of Psychiatry by H.I.Kaplan, B.J.Sadock. – New York: Williams @ Wilkins. – 1997.

  2. Psychiatry. Course of lectures. – Odessa: The Odessa State Medical University. – 2005. – 336 p.

  3. Lectures.

  4. Internet resource.

  5. Менделевич В.Д. Психиатрическая пропедевтика. – М.: Медицина, 1997.

  6. Морозов Т.В., Шумский Н.Г. Введение в клиническую психиатрию. – Н.Новгород: Изд-во НГМА, 1998.

  7. Попов Ю.В., Вид В.Д. Современная клиническая психиатрия. – М., 1997.

  8. Сонник Г.Т. Психіатрія: Підручник / Г.Т.Сонник, О.К.Напрєєнко, А.М.Скрипніков. – К.: Здоров’я, 2006.     

Prepared by assistant S.D.Savka


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