Depression, varying from low mood to clinical depression • Emotional flatness/blunting – loss of ability to have any ‘feelings’ • Emotional lability (mood swings) • Hopelessness • Social withdrawal; loss of initiation of activity or ideas; apathy; lethargy • Major depression Anger, ranging from irritability to full blown rage • Irritability and hostility, • Poor impulse control • Outbursts of physical and verbal violence against others, self and objects • Unprovoked anger, sometimes manifesting as rage Cognitive disturbances, ranging from lack of concentration to confusional states • Short attention span • Poor concentration • Poor memory • Confused thought processes; disorientation. Perceptual distortions, ranging from hypersensitivity to hallucinations • Hypersensitivity to noises and smells • Distortions of sensation (e.g. walls closing in) • Disorientation in time and space • Depersonalisation/derealisation • Hallucinations affecting all five senses, visual, auditory, tactile, olfactory and gustatory (e.g. hallucinations of objects or people appearing in the cell, or hearing voices when no-one is actually speaking). Paranoia and Psychosis, ranging from obsessional thoughts to full blown psychosis • Recurrent and persistent thoughts (ruminations) often of a violent and vengeful character (e.g. directed against prison staff) • Paranoid ideas – often persecutory • Psychotic episodes or states: psychotic depression, schizophrenia.