What is a psychopathological symptom?

Psychopathological symptom (from the Greekσύμπτομα "case, coincidence, sign") is a characteristic manifestation or external sign of a disorder of mental activity (for example, disorders of consciousness, attention, will or volition, perception, thinking, intellect, memory, emotions, or a sign of a movement disorder). Manifestations, signs of mental functional or organic disorders and diseases, indicating a change in the normal or normal functioning of the body. Psychopathological symptoms are established by a psychiatrist when examining a patient and are used to make a diagnosis of a particular mental disorder. A set of such symptoms united by a single pathogenesis is called a psychopathological syndrome. For different mental disorders, different types of symptoms are present in the clinical picture, the differentiation of which is necessary for a more accurate diagnosis of the disorder. Psychiatric semiotics, or symptomatology, is the medical science of such signs and symptoms.

The English neurologist Hewlings Jackson (1835-1911) described a "layered" construction of mental activity and the double effect of brain lesions: "negative" manifestations due to the immediate effect of the lesion and "positive" ones in the form of secondary phenomena. Hewlings' ideas influenced psychiatry and descriptive psychopathology and became a tradition in the classification of symptoms.

Productive symptoms ("positive" or "plus-symptoms") are a nonspecific reaction of the intact layers of the nervous system to the cause of the disorder. They represent qualitatively new signs that were not present before the disorder. Examples include delusions, hallucinations, psychomotor agitation, catatonic states, mood disorders (depressive or manic states) and disordered thinking.

In spite of the fact that these symptoms are nonspecific manifestations of dysontogenesis, their prolonged influence can lead to the formation of one of its forms.

Negative symptoms ("deficit" or "minus-symptoms") are manifestations of the pathological process itself, associated with the etiological factor. They are characterized as a phenomenon of "falling out" in mental activity. They include: decreased energy potential and apathy, poor speech, deterioration of thinking processes, memory, intellectual activity, asociality, social isolation.

In the process of diagnosing children, there is often a problem of differentiating negative symptoms from phenomena of dysontogenesis, since sometimes the "loss" of one or another function can be a consequence of a disturbance in its development. For example, negative disorders in early childhood schizophrenia, which itself indicates irregular development of mental functions.

In addition, symptoms are divided into functional and organic, senestopathic and effector, adverse and favorable.

According to Snezhnevsky, the development of mental disorder is accompanied by an increase in the number of symptoms, changes in their interrelation and the occurrence of new psychopathological symptoms.

Psychopathological symptoms in child psychiatry

When working with children, a clear differentiation of psychopathological symptoms is necessary in order to distinguish symptoms of dysontogenesis from symptoms of a mental disorder.

Age-related symptoms are pathologically distorted and grotesque manifestations of normal age-related development. These symptoms are more specific to age than to the disease itself, and can manifest in various psychiatric pathologies: childhood-type schizophrenia, organic brain lesions, neurotic conditions.

Each age period has its own stage-specific age symptoms, which are caused by the ontogenetic level of the body's response to harm.

Child psychiatrists distinguish 4 levels of neuropsychological reactions in children and age-related symptoms peculiar to them:

• Somato-vegetative (0-3 years) - increased excitability, disorders of the gastrointestinal tract, sleep disorders, appetite, neatness skills, fears.
• The psychomotor level (4-10 years old) - hyperdynamic disorders prevail: tics, stuttering, motor disinhibition, fears.
• Affective level (7-12 years old) - fears, affective instability, dromomania, negativism and aggression. At this stage, the risk of development of psychogenias increases. It is caused by the beginning of formation of self-awareness in the teenager.
• Emotional-ideal (12-16 years old) - super-valuable ideas and interests ("metaphysical intoxication"), psychogenic reactions in the form of emancipation, protest, and also ideas of an imaginary ugliness (anorexia syndrome, dysmorphophobia), fears prevail.

However, these age-related symptoms may be combined, i.e. the subsequent stage of development may exhibit symptoms inherent in the previous level of neuropsychological reaction.