Appendix A: Signs and Symptoms of Major Psychiatric Syndromes

SIGNS AND SYMPTOMS OF MAJOR PSYCHIATRIC SYNDROMES

SYNDROME BEHAVIOR SPEECH THOUGHT PROCESS THOUGHT CONTENT PERCEPTION AFFECT ORIENTATION AND MEMORY ONSET AND DURATION PHYSICAL FINDINGS

Delirium Agitation (occasionally) Nonspecific Tangentiality, incoherence Variable; delusions Illusions, hallucinations (especially visual) Fear, anxiety Disorientation, memory impairment, clouded consciousness Acute (hours to days), with fluctuating symptoms Abnormal vital signs

Dementia Apathy, apraxia, echopraxia Echdalia, aphasia Preservation Variable; few if any delusions Few if any hallucinations Liability Disorientation, memory impairment Insidious Frontal lobe release signs (such as grasp reflex)

Schizophrenia Social withdrawal, agitation Rambling, mutism Loose associations, blocking Bizarre, persecutory delusions, ideas of reference Hallucinations (usually auditory) Blunted, flat, inappropriate affect Intact Symptoms for 6 months None

Maria Hyperactivity, gregariousness Rapid, forceful Right of ideas Delusions of grandeur, paranoia Hallucinations possible Elation, frequent irritability Intact Symptoms for 1 week None

Depression Motor retardation, occasional agitation Lack of spontaneity, slow pace and monotonous tone Paucity of thought Helplessness. hopelessness, delusions of guilt, self-reproach, poverty, somatic delusions. Few if any hallucinations Depression, sadness, despondence Intact Symptoms for 2 weeks None

Source: Wan, W.R., and Weiss, K.J., "Emergency Psychiatry; in Psychiatry, vol. 2. Edited by Cavenar, J.O. Philadelphia: J.B. Uppincott Co, 1989. Adapted with permission of the publisher.

SIGNS AND SYMPTOMS OF MAJOR PSYCHIATRIC SYNDROMES
SYNDROME	BEHAVIOR	SPEECH	THOUGHT PROCESS	THOUGHT CONTENT	PERCEPTION	AFFECT	ORIENTATION AND MEMORY	ONSET AND DURATION	PHYSICAL FINDINGS
Delirium	Agitation (occasionally)	Nonspecific	Tangentiality, incoherence	Variable; delusions	Illusions, hallucinations (especially visual)	Fear, anxiety	Disorientation, memory impairment, clouded consciousness	Acute (hours to days), with fluctuating symptoms	Abnormal vital signs
Dementia	Apathy, apraxia, echopraxia	Echdalia, aphasia	Preservation	Variable; few if any delusions	Few if any hallucinations	Liability	Disorientation, memory impairment	Insidious	Frontal lobe release signs (such as grasp reflex)
Schizophrenia	Social withdrawal, agitation	Rambling, mutism	Loose associations, blocking	Bizarre, persecutory delusions, ideas of reference	Hallucinations (usually auditory)	Blunted, flat, inappropriate affect	Intact	Symptoms for 6 months	None
Maria	Hyperactivity, gregariousness	Rapid, forceful	Right of ideas	Delusions of grandeur, paranoia	Hallucinations possible	Elation, frequent irritability	Intact	Symptoms for 1 week	None
Depression	Motor retardation, occasional agitation	Lack of spontaneity, slow pace and monotonous tone	Paucity of thought	Helplessness. hopelessness, delusions of guilt, self-reproach, poverty, somatic delusions.	Few if any hallucinations	Depression, sadness, despondence	Intact	Symptoms for 2 weeks	None
Source: Wan, W.R., and Weiss, K.J., "Emergency Psychiatry; in Psychiatry, vol. 2. Edited by Cavenar, J.O. Philadelphia: J.B. Uppincott Co, 1989. Adapted with permission of the publisher.