MENTAL STATUS ASSESSMENT

A. GENERAL APPEARANCE DAY 1 DAY 2 CRITERIA Good grooming Appropriate facial expression Appropriate posture Maintains eye contact B. MOTOR BEHAVIOR DAY 1 CRITERIA Automatism Hyperkinesthesia Waxy flexibility Cataplexy Catalepsy Stereotype Compulsion Psychomotor retardation Echopraxia Catatonic stupor Catatonic excitement Tics and spasm Impulsiveness Choreiform movement

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Automatism- spontaneous verbal or motor behavior; an act performed unconsciously Hyper kinaesthesia- The ability to feel movements of the limbs and body Waxy Flexibility- is a psychomotor symptom of catatonic schizophrenia which leads to a decreased response to stimuli and a tendency to remain in an immobile posture Cataplexy- is a sudden and transient episode of loss of muscle tone, often triggered by emotions Catalepsy- is a nervous condition characterized by muscular rigidity and fixity of posture regardless of external stimuli, as well as decreased sensitivity to pain.

Stereotype- is a commonly held popular belief about specific social groups or types of individuals. The concepts of "stereotype" and "prejudice" are often confused with many other different meanings. Stereotypes are standardized and simplified conceptions of groups based on some prior assumptions Compulsion- is behavior which a person does compulsivelyin other words, not because they want to behave that way, but because they feel they have to do so Psychomotor Retardation or psychomotor impairment comprises a slowing down of thought and a reduction of physical movements in an individual. Psychomotor Retardation can cause a visible slowing of physical and emotional reactions including speech and affect Echopraxia- is the involuntary repetition or imitation of the observed movements of another. It is closely related to echolalia, the involuntary repetition of another's speech Catatonic Stupor- a form of catatonia characterized by a marked decrease in response to the environment with a reduction in spontaneous movement. Patients with this disorder sometimes appear unaware of their environment Catatonic excitement- a state of extreme agitation that may occur when a patient is unable to maintain catatonic immobility Tics and spasms: A tic is a sudden, repetitive, nonrhythmic, stereotyped motor movement or vocalization involving discrete muscle groups spasm: a sudden, violent, involuntary muscular contraction Impulsiveness- is a personality trait characterized by the inclination of an individual to initiate behavior without adequate forethought as to the consequences of their actions, acting on the spur of the moment Choreiform movements- Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement C. SENSORIUM AND COGNITIVE DAY 1 DAY 2 CRITERIA Orientation Time Place Date Concentration Memory Remote Recent Immediate retention

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D. PERCEPTION DAY 1 CRITERIA Hallucination Visual Olfactory Auditory Tactile Gustatory Liliputian Illusions Delusions

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Hallucination defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid, substantial, and located in external objective space Visual Olfactory Auditory Tactile Gustatory Lilliputian Illusions- is a distortion of the senses, revealing how the brain normally organizes and interprets sensory stimulation. While illusions distort reality, they are generally shared by most people. Illusions may occur with more of the human senses than vision, but visual illusions, optical illusions, are the most well known and understood

Delusions- is a fixed belief that is either false, fanciful, or derived from deception. In psychiatry, it is defined to be a belief that is pathological (the result of an illness or illness process) and is held despite evidence to the contrary

E. ATTITUDES AND BEHAVIOR DAY 1 DAY 2 CRITERIA Cooperation Outgoing Withdrawn Evasive Sarcastic Aggressive Perplexed Apprehensive Arrogant Dramatic Submissive Fearful Seductive Uncooperative Impatient Resistant Impulsive

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Cooperation - or co-operation is the process of working or acting together, which can be accomplished by both intentional and non-intentional agents Outgoing- Going out or away; departing Withdrawn- Emotionally unresponsive and detached; introverted Evasive- tending or seeking to evade; characterized by evasion: an evasive answer; elusive or evanescent Sarcastic- is a sharp, bitter, or cutting expression or remark Aggressive- behavior between members of the same species that is intended to cause pain or harm Perplexed- Filled with confusion or bewilderment; puzzled Apprehensive- Anxious or fearful about the future; uneasy Arrogant- exaggerating or disposed to exaggerate one's own worth or importance often by an overbearing manner Dramatic- highly effective; striking: The silence following his impassioned speech was dramatic Submissive- inclined or ready to submit; unresistingly or humbly obedient: submissive servants. Fearful- Feeling or inclined to feel anxiety or apprehension; timid; nervous Seductive- tending to entice into a desired action or state Uncooperative- unwilling to cooperate Impatient- Unable to wait patiently or tolerate delay; restless Resistant- The act or an instance of resisting or the capacity to resist. Impulsive- Inclined to act on impulse rather than thought

F. DEFENSE MECHANISM DAY 1 DAY 2 CRITERIA Denial Repression Suppression Rationalization Reaction formation Sublimation Compensation Projection Displacement Identification Introjection Conversion Symbolization Dissociation Undoing Regression Substitution Fantasy

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Denial- is a defense mechanism postulated by Sigmund Freud, in which a person is faced with a fact that is too uncomfortable to accept and rejects it instead, insisting that it is not true despite what may be overwhelming evidence. Repression- is the psychological attempt by an individual to repel its own desires and impulses towards pleasurable instincts. Such desires, impulses, wishes, fantasies or feelings can be represented in the mind as thoughts, images and memories. The repression is caused when an external force puts itself in contrast with the desire, threatening to cause suffering if the desire is satisfied, thereby posing a conflict for the individual; the repressive response to the threat is to exclude the desire from one's consciousness and hold or subdue it in the unconscious. Repression plays a major role in many mental illnesses, and in the psyche of average people. Repression is an involuntary or unconscious process Suppression- psychoanalysis . conscious inhibition of an impulse. Rationalization In psychology and logic, rationalization (or making excuses) is a defense mechanism in which perceived controversial behaviors or feelings are explained in a rational or logical manner to avoid the true explanation, to differentiate from the original deterministic explanation, of the behavior or feeling in question. It is also an informal fallacy of reasoning. This process ranges from fully conscious (e.g. to present an external defense against ridicule from others) to mostly subconscious (e.g. to create a block against internal feelings of guilt)

Reaction Formation: In psychoanalytic theory, reaction formation is a defensive process (defense mechanism) in which anxiety-producing or unacceptable emotions and impulses are mastered by exaggeration (hyperbole) of the directly opposing tendency Sublimation: In psychology, sublimation is a term coined by Freud which was eventually used to describe the spirit as a reflection of the libido. It has its roots in Freud's psychoanalytical approach, and is sometimes also referred to as a type of defense mechanism. According to Wade and Tavris, sublimation is when displacement "serves a higher cultural or socially useful purpose, as in the creation of art or inventions Compensation: In psychology, compensation is a strategy whereby one covers up, consciously or unconsciously, weaknesses, frustrations, desires, feelings of inadequacy or incompetence in one life area through the gratification or (drive towards) excellence in another area. Compensation can cover up either real or imagined deficiencies and personal or physical inferiority. The compensation strategy, however does not truly address the source of this inferiority. Positive compensations may help one to overcome ones difficulties. On the other hand, negative compensations do not, which results in a reinforced feeling of inferiority. There are two kinds of negative compensation Projection: Psychological projection or projection bias is a psychological defense mechanism where a person unconsciously denies their own attributes, thoughts, and emotions, which are then ascribed to the outside world, such as to the weather, or to other people. Thus, it involves imagining or projecting that others have those feelings. Projection reduces anxiety by allowing the expression of the unwanted unconscious impulses or desires without letting the conscious mind recognize them. An example of this behavior might be blaming another for self failure. The mind may avoid the discomfort of consciously admitting personal faults by keeping those feelings unconscious, and redirect their libidinal satisfaction by attaching, or "projecting," those same faults onto another. The theory was developed by Sigmund Freud - in his letters to Wilhelm Fliess, '"Draft H" deals with projection as a mechanism of defenses - and further refined by his daughter Anna Freud; for this reason, it is sometimes referred to as Freudian Projection. Displacement: In Freud's psychology, displacement (from German Verschiebung, literally meaning 'shift' or 'move') is an unconscious defense mechanism whereby the mind redirects affects from an object felt to be dangerous or unacceptable to an object felt to be safe or acceptable. For instance, some people punch cushions when they are angry at friends; a college student may snap at his or her roommate when upset about an exam grade. Displacement operates in the mind unconsciously and involves emotions, ideas, or wishes being transferred from their original object to a more acceptable substitute. It is most often used to allay anxiety. In scapegoating, aggression is displaced onto people with little or no connection with what is causing anger.

Displacement can act in a chain-reaction, with people unwittingly becoming both victims and perpetrators of displacement. For example, a man is angry with his boss, but he cannot express this so he hits his wife. The wife hits one of the children, possibly disguising this as punishment (rationalization). Though displacement is usually used to refer to the displacement of aggressive impulses, it can also refer to the displacement of sexual impulses Introjection is a psychoanalytical term with a variety of meanings. Generally, it is regarded as the process where the subject replicates in itself behaviors, attributes or other fragments of the surrounding world, especially of other subjects. Cognate concepts are identification, incorporation, and internalization. To use a simple example, a person who picks up traits from their friends (e.g., if someone exclaims "Ridiculous!" all the time and their friends start saying it too) is participating in introjection. Projection has been described as an early phase of introjection Conversion: Conversion disorder is a condition in which patients present with neurological symptoms such as numbness, blindness, paralysis, or fits without a physiological cause. It is thought that these problems arise in response to difficulties in the patient's life Symbolization the message that is intended or expressed or signified; "what is the meaning of this sentence"; "the significance of a red traffic light"; "the signification of Chinese characters"; "the import of his announcement was ambiguous" Dissociation- is a partial or complete disruption of the normal integration of a persons conscious or psychological functioning. Dissociation can be a response to trauma or drugs and perhaps allows the mind to distance itself from experiences that are too much for the psyche to process at that time. Dissociative disruptions can affect any aspect of a persons functioning. Although some dissociative disruptions involve amnesia, the vast majority of dissociative events do not. Since dissociations are normally unanticipated, they are typically experienced as startling, autonomous intrusions into the person's usual ways of responding or functioning. Due to their unexpected and largely inexplicable nature, they tend to be quite unsettling. Different dissociative disorders have different relationships to stress and trauma. Dissociative amnesia and fugue states are often triggered by life stresses that fall far short of trauma. Depersonalization disorder is sometimes triggered by trauma, but may be preceded only by stress, psychoactive substances, or no identifiable stress at all. Undoing- is a defence mechanism in which a person tries to 'undo' an unhealthy, destructive or otherwise threatening thought or action by engaging in contrary behaviour. For example, after thinking about being violent with someone, one would then be overly nice or accommodating to them. Regression: is a defense mechanism leading to the temporary or long-term reversion of the ego to an earlier stage of development rather than handling unacceptable impulses in a more adult way. The defense mechanism of regression, in psychoanalytic theory, occurs when thoughts are pushed back out of our consciousness and into our unconscious

Substitution: a person or thing acting or serving in place of another. Fantasy- is a genre that uses magic and other supernatural phenomena as a primary element of plot, theme, and/or setting. Many works within the genre take place in fictional worlds where magic is common. Fantasy is generally distinguished from science fiction in that it does not provide a logical (or pseudo logical) explanation for the scientifically impossible events that occur, though there is a great deal of overlap between the two (both are subgenres of speculative fiction)

G. AFFECTIVE STATE DAY 1 CRITERIA Euphoria Flat affect Blunting Elation Exultation Ecstasy Anxiety Fear Ambivalence Depersonalization Irritability Rage Lability Depression

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Euphoria: Euphoria (pronounced /jufri/, from Ancient Greek , "well", and . "to bear") is medically recognized as a mental and emotional state defined as a profound sense of wellbeing. Technically, euphoria is an affect, but the term is often colloquially used to define emotion as an intense state of transcendent happiness combined with an overwhelming sense of contentment. The word derives from Greek , "power of enduring easily, fertility". Euphoria is generally considered to be an exaggerated physical and psychological state, sometimes induced by the use of psychoactive drugs and not typically achieved during the normal course of human experience. However, some natural behaviors, such as activities resulting in orgasm or the triumph of an athlete, can induce brief states of euphoria. Euphoria has also been cited during certain religious or spiritual rituals and meditation Flat affect: A severe reduction in emotional expressiveness. People with depression and schizophrenia often show flat affect. A person with schizophrenia may not show the signs of normal emotion, perhaps may speak in a monotonous voice, have diminished facial expressions, and appear extremely apathetic. Also known as blunted affect. Blunting: is the scientific term describing a lack of emotional reactivity on the part of an individual. It is manifest as a failure to express feelings either verbally or non-verbally, even when talking

about issues that would normally be expected to engage the emotions. Expressive gestures are rare and there is little animation in facial expression or in vocal inflection. Elation: is an emotion of happiness. Exultation The act or condition of rejoicing greatly. Ecstasy: a trance or trance-like state in which an individual transcends normal consciousness Anxiety: Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either the absence or presence of psychological stress, anxiety can create feelings of fear, worry, uneasiness and dread. Anxiety is considered to be a normal reaction to stress. It may help a person to deal with a difficult situation by prompting one to cope with it. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder. The intensity and reasoning behind anxiety determines whether it is considered a normal or abnormal reaction. Fear: is a distressing emotion aroused by a perceived threat. It is a basic survival mechanism occurring in response to a specific stimulus, such as pain or the threat of danger. In short, fear is the ability to recognize danger and flee from it or fight, also known as the Fight or Flight response. Some psychologists such as John B. Watson, Robert Plutchik, and Paul Ekman have suggested that fear belongs to a small set of basic or innate emotions. This set also includes such emotions as joy, sadness, and anger. Fear should be distinguished from the related emotional state of anxiety, which typically occurs without any external threat. Additionally, fear is related to the specific behaviors of escape and avoidance, whereas anxiety is the result of threats which are perceived to be uncontrollable or unavoidable. Worth noting is that fear almost always relates to future events, such as worsening of a situation, or continuation of a situation that is unacceptable. Fear could also be an instant reaction to something presently happening. Ambivalence: is a state of having simultaneous, conflicting feelings toward a person or thing. Stated another way, ambivalence is the experience of having thoughts and emotions of both positive and negative valence toward someone or something. A common example of ambivalence is the feeling of both love and hate for a person. The term also refers to situations where "mixed feelings" of a more general sort are experienced, or where a person experiences uncertainty or indecisiveness concerning something. The expressions "cold feet" and "sitting on the fence" are often used to describe the feeling of ambivalence. Ambivalence is experienced as psychologically unpleasant when the positive and negative aspects of a subject are both present in a person's mind at the same time. This state can lead to avoidance or procrastination, or to deliberate attempts to resolve the ambivalence. When the situation does not require a decision to be made, people experience less discomfort even when feeling ambivalent Depersonalization: is a malfunction or anomaly of the mechanism by which an individual has self-awareness. It is a feeling of watching oneself act, while having no control over a situation. It can be considered desirable, such as in the use of recreational drugs, but it usually refers to the severe form found in anxiety and, in the most intense cases, panic attacks. Sufferers feel they have

changed, and the world has become less real, vague, dreamlike, or lacking in significance. It can be a disturbing experience, since many feel that, indeed, they are living in a "dream". Depersonalization is a subjective experience of unreality in one's sense of self, while derealization is unreality of the outside world. Although most authors currently regard depersonalization (self) and derealization (surroundings) as independent constructs, many do not want to separate derealization from depersonalization Irritability: is an excessive response to stimuli. The term is used for both the physiological reaction to stimuli and for the pathological, abnormal or excessive sensitivity to stimuli; It is usually used to refer to anger or frustration. Irritability may be demonstrated in behavioral responses to both physiological and behavioral stimuli including environmental, situational, sociological, and emotional stimuli Rage: is a state of anger so intense that one loses control of one's actions, sometimes regretting what one did in this state afterwards. It can be caused by anything, the actions of another person, failure of technology, even small things may set it up when there has been a previous build-up of stress or anger. The feeling can sometimes lead to a state of mind that will push a person to thinking that he is capable of doing things that may normally seem to be physically impossible. Lability: refers to something that is constantly undergoing change or something that is likely to undergo change. Depression: Major depressive disorder (MDD) (also known as recurrent depressive disorder, clinical depression, major depression, unipolar depression, or unipolar disorder) is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. This cluster of symptoms (syndrome) was named, described and classified as one of the mood disorders in the 1980 edition of the American Psychiatric Association's diagnostic manual. The term "depression" is ambiguous. It is often used to denote this syndrome but may refer to any or all of the mood disorders. Major depressive disorder is a disabling condition which adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, around 3.4% of people with major depression commit suicide, and up to 60% of people who commit suicide had depression or another mood disorder. The diagnosis of major depressive disorder is based on the patient's self-reported experiences, behavior reported by relatives or friends, and a mental status examination. There is no laboratory test for major depression, although physicians generally request tests for physical conditions that may cause similar symptoms. If depressive disorder is not detected in the early stages it may result in a slow recovery and affect or worsen the persons physical health. The most common time of onset is between the ages of 20 and 30 years, with a later peak between 30 and 40 years Typically, patients are treated with antidepressant medication and, in many cases, also receive psychotherapy or counseling although the effectiveness of medication for mild or moderate cases is questionable. Hospitalization may be necessary in cases with associated selfneglect or a significant risk of harm to self or others. A minority are treated with

electroconvulsive therapy (ECT), under a short-acting general anaesthetic. The course of the disorder varies widely, from one episode lasting weeks to a lifelong disorder with recurrent major depressive episodes. Depressed individuals have shorter life expectancies than those without depression, in part because of greater susceptibility to medical illnesses and suicide. It is unclear whether or not medications affect the risk of suicide. Current and former patients may be stigmatized. The understanding of the nature and causes of depression has evolved over the centuries, though this understanding is incomplete and has left many aspects of depression as the subject of discussion and research. Proposed causes include psychological, psycho-social, hereditary, evolutionary and biological factors. Certain types of long-term drug use can both cause and worsen depressive symptoms. Psychological treatments are based on theories of personality, interpersonal communication, and learning. Most biological theories focus on the monoamine chemicals serotonin, norepinephrine and dopamine, which are naturally present in the brain and assist communication between nerve cells. H. SPEECH CRITERIA Verbigeration Rhyming Punning Mutism Aphasia Unusual rates of speech Unusual volume of speech Unusual intonation Unusual modulation

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Verbigeration: Obsessive repetition of meaningless words and phrases, especially as a symptom of mental illness. Rhyming: is a repetition of similar sounds in two or more words and is most often used in poetry and songs. The word "rhyme" may also refer to a short poem, such as a rhyming couplet or other brief rhyming poem such as nursery rhymes. Punning: The pun, or paronomasia, is a form of word play which suggests two or more meanings, by exploiting multiple meanings of words, or of similar-sounding words, for an intended humorous or rhetorical effect

Mutism- Selective mutism (SM) is a communicative disorder in which a person, most often a child, who is normally capable of speech is unable to speak in given situations, or to specific people. Selective Mutism often co-exists with shyness or (often severe) social anxiety. Aphasia- (pronounced /fe/ or pronounced /fezi/), from the Greek root word "aphatos", meaning speechless, is an acquired language disorder in which there is an impairment of any language modality. This may include difficulty in producing or comprehending spoken or written language. I. THOUGHT PROCESS DAY 1 CRITERIA Blocking Flight of Ideas Word salad Perseveration Neologism Circumstantialities Echolalia Condensation Delusion Phobia Obsession Hypochondriac

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Thought blocking, a phenomenon that occurs in people with psychiatric illnesses (usually schizophrenia), occurs when a person's speech is suddenly interrupted by silences that may last a few seconds to a minute or longer. They may interpret this experience as a saying, for example, that their thoughts have been removed by another person. Blocking is often brought on by questioning or discussing something of particularly large personal significance. When the person begins speaking again, after the block, they will often speak about a subject unrelated to what was being discussed when blocking occurred. It is experienced as an unanticipated, quick and total emptying of the mind (Gelder, Mayou and Geddes 2005). Schizophrenic patients commonly experience thought blocking and may comprehend the experience in peculiar ways (Gelder, Mayou and Geddes 2005). For example a schizophrenic might remark that another person has removed their thoughts from their brain (Gelder, Mayou and Geddes 2005). When doctors diagnose thought blocking, it is important that they consider other causes of pauses in speech and expression, such as petit mal seizures, hesitation brought on by anxiety, or slow thought processes Flight of Ideas is one of the symptoms of bipolar mania as well as schizophrenia and ADHD. Some web definitions include; a nearly continuous flow of rapid speech that jumps from topic to topic, usually based on discernible associations, distractions, or plays on words, but in severe cases so rapid as to be disorganized and incoherent. It is most commonly seen in manic episodes but may also occur in other mental disorders such as in manic phases of schizophrenia

Word Salad: Word salad is a mixture of random words that, while arranged in phrases that appear to give them meaning, actually carry no significance. The words may or may not be grammatically correct, but the meaning is hopelessly confused. A famous example is Noam Chomsky's phrase, "Colorless green ideas sleep furiously". People who suffer from this affliction attempt to communicate their idea, but the random words come out instead. Often, the person is unaware that he or she did not make sense. It appears in people with dementia and schizophrenia. It may be present as: Wernicke's aphasia Schizophasia, a mental condition characterized by incoherent babbling (compulsive or intentional, but nonsensical) Logorrhea (psychology), a mental condition characterized by excessive talking (coherent or otherwise, but compulsive) Clanging, a speech pattern that follows rhyming and other sound associations rather than meaning. Perserveration: is the repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus, usually caused by brain injury or other organic disorder. If an issue has been fully explored and discussed to a point of resolution, it is not uncommon for something to trigger the re-investigation of the matter. This can happen at any time during a conversation. This is particularly true with those who have had traumatic brain injuries. Several researchers have tried to connect perseveration with a lack of inhibition; however, this connection could not be found, or was small Neologism- The invention of new words regarded as a symptom of certain psychotic disorders, such as schizophrenia. Circumstantiality- a disturbed pattern of speech or writing characterized by delay in getting to the point because of the interpolation of unnecessary details and irrelevant parenthetical remarks. Echolalia- is the automatic repetition of vocalizations made by another person. It is closely related to echopraxia, the automatic repetition of movements made by another person. The word "echolalia" is derived from the Greek meaning "echo" or "to repeat", and (lali) meaning "babbling, meaningless talk" (of onomatopoeic origin from the verb (lalo) meaning "to talk"). Condensation- Psychology The process by which a single symbol or word is associated with the emotional content of several, not necessarily related, ideas, feelings, memories, or impulses, especially as expressed in dreams. Delusion Phobia (from the Greek: ,phbos, meaning "fear" or "morbid fear") is an irrational, intense and persistent fear of certain situations, activities, things, animals, or people. The main symptom of this disorder is the excessive and unreasonable desire to avoid the feared stimulus. When the

fear is beyond one's control, and if the fear is interfering with daily life, then a diagnosis under one of the anxiety disorders can be made. This is caused by what are called neutral, unconditioned, and conditioned stimuli, which trigger either conditioned or unconditioned responses. An example would be a person who was attacked by a dog (the unconditioned stimulus) would respond with an unconditioned response. When this happens, the unconditioned stimulus of them being attacked by the dog would become conditioned, and to this now conditioned stimulus, they would develop a conditioned response. If the occurrence had enough of an impact on this certain person then they would develop a fear of that dog, or in some cases, an irrational fear of all dogs. Phobias are a common form of anxiety disorders. An American study by the National Institute of Mental Health (NIMH) found that between 8.7% and 18.1% of Americans suffer from phobias. Broken down by age and gender, the study found that phobias were the most common mental illness among women in all age groups and the second most common illness among men older than 25. Phobias are generally caused by an event recorded by the amygdala and hippocampus and labeled as deadly or dangerous; thus whenever a specific situation is approached again the body reacts as if the event were happening repeatedly afterward. Treatment comes in some way or another as a replacing of the memory and reaction to the previous event perceived as deadly with something more realistic and based more rationally. In reality most phobias are irrational, in that the subconscious association causes far more fear than is warranted based on the actual danger of the stimulus; a person with a phobia of water may admit that their physiological arousal is irrational and over-reactive, but this alone does not cure the phobia. Some phobias are generated from the observation of a parent's or sibling's reaction. The observer then can take in the information and generate a fear of whatever they experienced. Obsession: the domination of one's thoughts or feelings by a persistent idea, image, desire, etc. Hypochondriac: Hypochondriasis, hypochondria (sometimes referred to as health phobia or health anxiety) refers to excessive preoccupation or worry about having a serious illness. An individual suffering from hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical symptoms they detect, no matter how minor the symptom may be, they are convinced that they have or are about to have a serious illness. Often, hypochondria persists even after a physician has evaluated a person and reassured them that their concerns about symptoms do not have an underlying medical basis or, if there is a medical illness, the concerns are far in excess of what is appropriate for the level of disease. Many hypochondriacs focus on a particular symptom as the catalyst of their worrying, such as gastro-intestinal problems, palpitations, or muscle fatigue. The duration of these symptoms and preoccupation is 6 months or longer.