Sims’ Symptoms in the Mind Textbook of Descriptive Psychopathology This page intentionally left blank 7th Edition Sims’ Symptoms in the Mind Textbook of Descriptive Psychopathology Femi Oyebode, MBBS, MD, PhD, FRCPsych, FRCPsych (Honorary) Honorary Professor of Psychiatry University of Birmingham Birmingham, UK For additional online content visit ExpertConsult.com ©2023, Elsevier Limited. All rights reserved. First edition 1988 Second edition 1995 Third edition 2005 Fourth edition 2008 Fifth edition 2015 Sixth edition 2018 The right of Femi Oyebode to be identified as author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. 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ISBN: 978- 0- 7020- 8525- 3 Printed in Scotland Last digit is the print number: 9 8 7 6 5 4 3 2 1 Content Strategist: Trinity Hutton Content Project Manager: Arindam Banerjee Design: Bridget Hoette Marketing Manager: Belinda Tudin Contents Preface to the Seventh Edition, vi 13 D epersonalization, 197 Additional Materials Within Accompanying 14 Disorder of the Awareness of the Body, 207 Electronic Version, vii 15 The Psychopathology of Pain, 231 Section I Section V CONCEPTS AND METHOD, 1 EMOTIONS AND ACTION, 241 1 Fundamental Concepts of Descriptive Psychopathology, 3 16 Affect and Emotional Disorders, 243 2 Eliciting the Symptoms of Mental Illness, 19 17 Anxiety, Panic, Irritability, Phobia and Obsession, 265 Section II 18 Disorders of Volition and Execution, 279 CONSCIOUSNESS AND COGNITION, 29 19 Disorder of Aesthetic Perception and Praxis, 301 3 Consciousness and Disturbed Consciousness, 31 Section VI 4 Attention, Concentration, Orientation and VARIATIONS OF HUMAN NATURE, 313 Sleep, 43 5 Disturbance of Memory, 57 20 T he Expression of Disordered Personality, 315 Section III Section VII AWARENESS OF REALITY: TIME, PERCEPTION AND DIAGNOSIS, 327 JUDGEMENT, 71 21 Psychopathology and Diagnosis, 329 6 D isorder of Time, 73 Self-A ssessment 1, 339 7 Pathology of Perception, 85 Self-A ssessment 2, 345 8 Delusions and Other Erroneous Ideas, 111 Self-A ssessment 1: Answers, 349 9 Disorder of the Thinking Process, 137 Self-A ssessment 2: Answers, 357 10 Disorder of Speech and Language, 157 Index, 363 11 I nsight, 169 Section IV SELF AND BODY, 179 12 The Disordered Self, 181 v Preface to the Seventh Edition In this new seventh edition, as in the previous edi- our understanding and explanations regarding psy- tions, I have retained the original structure of the book chopathology. Descriptive psychopathology is today but made some changes and many additions. I have even more relevant to the endeavours of clinicians added a new chapter on abnormalities of aesthetic per- and researchers. The standard psychiatric nomencla- ception and praxis. This new chapter deals with a little ture is under strain. This means that the fundamental discussed but nonetheless important aspect of human abnormal phenomena, the infrastructure of nosol- existence, namely, our sense of the beautiful, which is ogy, must of necessity assume greater importance in fundamental to social life and that is very definitely clinical practice. Otherwise the ability to communi- affected by psychopathology. Other notable additions cate meaningfully across the profession will markedly include an expanded description of Ganser State, deteriorate. Charles Bonnet syndrome, autoscopy, jealousy, eroto- I am indebted to many more people than I can mania and thought disorder. I have also included a list. The Birmingham Philosophy Group has been section on musical hallucinations and on the nature of meeting regularly since 1992. Its members (Theo gestures and gestural abnormalities. These additions, Arvantis, Lenia Constantine, Simon O’Loughlin, Kate like the additions in earlier editions, are prompted by Robertson, Sandy Robertson and Persephone Sextou) my desire to ensure that readers fully appreciate that continue to influence my thinking about psychiat- psychopathology is not a dead subject but one that is ric phenomena as do the members of the European alive and is constantly in need of revision in response Psychiatric Association Section of Psychopathology to conceptual changes or new empirical findings. including Guenda Bernegger, Paolo Colavero, John It is my belief that descriptive psychopathology, as Cutting, Maria Luisa Figueira, Mircea Lazarescu, Luis a method, is the pre-e minent foundation for the prac- Madeira, Michael Musalek, Gilberto di Petta and Pedro tice of clinical psychiatry. This method allows us to Varandas. Finally, without the patients who experience observe and describe abnormal subjective phenom- and endure these abnormal phenomena, and the stu- ena and behaviours, and to categorize these in order dents and psychiatric trainees who ask awkward ques- to communicate more precisely about the world that tions and out of curiosity enquire into the nature of patients inhabit. The clinician trained in the phenom- these phenomena, this book would definitely be the enological approach is all the more aware of the need poorer. for empathic understanding, for assuming an atheo- retical stance and finally of the provisional status of Femi Oyebode vi Additional Materials Within Accompanying Electronic Version The searchable full text for Sims’ Symptoms in the • Nine author podcasts on the following topics: Mind, seventh edition, is available at www.expertcon- 1. What is psychopathology? sult.com, accessible via the enclosed pin code. Please 2. Consciousness follow the instructions on the inside front cover of 3. What are hallucinations? this book. Additional materials integrated within this 4. Critique of the nature of delusions enhanced electronic version include the following: 5. Embodiment • Four patient scenarios (videos with transcripts), 6. The self in psychopathology exploring: 7. Affect, mood and emotions 1. auditory verbal hallucinations, 8. Shame and Guilt 2. persecutory delusion, 9. The nature of obsessions 3. low mood and Look out for alongside the related sections within 4. obsessive compulsive phenomenon. this book. Look out for alongside the related sections within • Interactive question-a nd- answer sections for each this book. chapter to test your understanding of key topics. vii For my father, Jonathan Akinyemi Oyebode (1918–71) FEMI OYEBODE Section I CONCEPTS AND METHOD 11