Monday, February 29, 2016

depressed mood for 4 months-DrSudeepKC

A 32-year-old woman is seen in an outpatient psychiatric clinic for the chief complaint of a depressed mood for 4 months. During the interview, she gives very long, complicated explanations and many unnecessary details before finally answering the original questions.

Which of the following psychiatric findings best describes this style of train of thought?

a. Loose association
b. Circumstantiality
c. Neologism
d. Perseveration
e. Flight of ideas

The answer is b.  Circumstantiality indicates the loss of a goal-directed thought process: the patient brings in many irrelevant details and comments, but eventually will get back to the point. In loose associations, the thought process has also lost its goal-directedness;

however, the patient never gets back to the original point and there is no clear connection between sentences. A neologism is a fabricated word made up by the patient, which is usually a combination of existing words.

Perseveration, often associated with cognitive disorders, refers to a response that persists even after a new stimulus has been introduced—for example, a patient asked to repeat the phrase “no ifs, and, or buts” responds by saying, “no ifs, ifs, ifs, ifs.” Flight of ideas is a disorder of thinking in which the patient expresses thoughts very rapidly, with constant shifting from one idea to another, though the ideas are often connected.


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