Psychiatric Glossary

• Affect: Observed external expression of emotion. A pattern of observable behaviour that is the expression of a subjectively experienced feeling state.
• Agitation: Excessive motor activity with a feeling of inner tension
• Agoraphobia: Literally a fear of the market place. It may include a fear of crowds, open and closed spaces and travelling by public transport.
• Alexithymia: Difficulty in being aware of or describing one’s emotion.
• Ambivalence: The simultaneous presence of opposing impulses towards the same thing.
• Amnesia:The inability to recall past experiences.
• Amoke: Seen in South-east Asia. There is an outburst of aggressive behaviour in which the patient runs amoke after a depressive episode.
• Anhedonia: loss of interest in, and withdrawal from, all regular and pleasurable activities.
• Apathy: Detachment or indifference and a loss of emotional tone
• Attention: The ability to focus on an activity
• Belle indifference: the patient shows a bland emotional indifference to one situation; emotion associated with an event is dissociated.
• Bereavement literally means the state of being deprived of someone by death; it can also result from other losses.
• Blunted affect: A reduction in emotional expression.
• Capgras syndrome: A person who is familiar to the patient is believed to be replaced by a double.
• Catatonia: It literally means extreme muscular tone or rigidity; however, it commonly describes any excessive or decreased motor activity that is apparently purposeless. Note that catatonic symptoms are not diagnostic of schizophrenia; they may also be caused by brain disease, metabolic abnormalities, and psychoactive substances and can also occur in mood disorders.
• Circumstantiality: Slowed thinking incorporating unnecessary trivial details. The goal of thought is finally, but slowly, reached.
• Clang association: Speech in which words are chosen because of their sounds rather than their meanings. It includes rhyming and punning.
• Clouding of consciousness: Drowsiness and not reacting completely to stimuli due to disturbance of attention, concentration and memory, orientation and thinking.
• Compulsions or compulsive rituals: Repetitive, stereotyped, seemingly purposeful behaviour associated with obsessional thoughts e.g. excessive repetition of checking, counting and cleaning rituals.
• Concentration: The ability to think about something carefully or for a long time: a process in which you put a lot of attention, energy etc into a particular activity.
• Concrete thinking: A lack of abstract thinking, normal in childhood, and occurring in adults with organic brain disease or schizophrenia.
• Confabulation: Gaps in memory are unconsciously filled up with false memories.
• Cotard’s syndrome: A nihilistic delusional disorder in which, for example, the patient believes their money, friends or body parts do not exist. Nihilism is extreme. Some patients may complain that their bowels have been destroyed so that they will never pass faeces again. Still others may believe that their whole family had ceased to exist and that they themselves are dead.
• Counter transference: the therapist’s emotions and attitudes to the patient.
• Couvade syndrome: A hysterical disorder in which a prospective father develops symptoms characteristic of pregnancy.
• Couture-bound syndromes: certain pattern of unusual behaviour, which may reflect psychological mechanism of dissociation, occurring in non-western countries.
• Delirium: a global impairment in consciousness with disorientation to time and place, which typically fluctuates. In which the patient is bewildered and restless with associated with fear and hallucinations.
• Delusion: A false and fixed personal belief firmly held out of proportion to his or her cultural and educational background. It is unshakable or affected by rational argument or evidence to contrary.
• Delusion of doubles: The delusional belief that a person known to the patient has been replaced by a double.
• Delusion of infidelity (morbid/pathological jealousy, delusional jealousy, Orthello syndrome): The delusional belief that one’ spouse or lover is being unfaithful.
• Delusion of reference: the behaviour of others, objects, and events, e.g. television broadcasts or TV personalities, is believed to refer to oneself in particular; when similar thoughts are held with less than delusional intensity they are ideas of reference.
• Delusional perception: A new and delusional significance is attached to a familiar real perception without any logical reason.
• Dementia: A global organic impairment of intellectual functioning without impairment of consciousness.
• Depersonalization: One feels that one altered or not real in some way; experience of detachment from self as if looking at him or herself from a mirror. Depersonalization and de-realization are variants of dissociation that are not necessarily pathological.
• De-realization: the term used to describe the experience when external reality or environment seems or unreal. Depersonalization and de-realization may be caused by psychiatric illness (e.g. depression, anxiety, schizophrenia) physical illness (e.g. epilepsy), psychosocial stress and substance abuse.
• Dissociation: The event where a disruption occurs in the usually integrated functions of consciousness, memory, identity, perception and movement. There is some evidence of psychological causation (stressful events or disturbed relationships)
• Distractibility: The attention is frequently drawn to irrelevant external stimuli.
• Dysphoria: An unpleasant mood.
• Dysthymia: A chronic depression of mood for more than two years which does not fulfill the criteria for recurrent depressive disorder. Most of the time the patient feel tired and depressed.
• Echolalia: The automatic imitation of another’s speech.
• Echopraxia: The automatic imitation of another’s movement.
• Ecstacy: A feeling of extreme happiness.
• Elevated mood: A mood more cheerful than normal.
• Erotomania: the delusional belief that another person is deeply in love with one.
• Euphoric mood: An exaggerated feeling of well-being. It is pathological.
• Expansive mood: Feelings are expressed without restraint.
• Extracampine hallucination: The hallucination occurs outside’s sensory field.
• Flat affect: There is no emotional expression at all and the patient typically has an immobile face and monotonous voice.
• Flight of ideas: The speech consists of a stream of accelerated thoughts and connected concepts, with abrupt changes from one topic to another with no central direction. The link between concepts can be as in normal communication where one idea follows directly on from the next; through a pun or clang association; or through some vague idea which is not part of the original goal of speech.. as patient becomes increasingly manic. Their associations tend to become loosen as they find it increasingly difficult to link their thoughts. Eventually they start approaching the incoherent thoughts of schizophrenic patient.
• Formal thought disorder: see loosening of association
• Formication: A somatic hallucination in which insects are felt to be crawling under one’s skin.
• Fregoli syndrome: The patient believes that a familiar person, who is often believed to be his persecutor, has take on different appearances.
• Fugue: A state of wandering from usual surroundings and loss of memory.
• Functional hallucination: This occurs when a normal sensory stimulus is required to precipitate a hallucination of the same sensory modality, e.g. voices that are only heard when the doorbell rings.
• Grief: The emotional expressions that accompany bereavement.
• Hallucination: A false sensory perception without real external stimuli.\
• Hallucinosis: Hallucinations (usually auditory) occur in clear consciousness e.g. in alcoholism.
• Hypnagogic hallucination: Pseudo-hallucination occurring in the process of falling asleep. It occurs in normal people.
• Hypnopompic hallucination: Pseudo-hallucination occurring while waking from sleep. It occurs in normal people.
• Hypochondriaisi: A preoccupation with a fear of having a serious physical illness, not based on real organic pathology.
• Ideas of reference: see delusion of reference.
• Illness behavior: Actions of people who see themselves as ill, for the purpose of defining their health status and finding a remedy.
• Illusion: A misperception of a real external stimulus.
• Inappropriate affect: An affect that is inappropriate to the circumstances, for example appearing cheerful immediately following the death of a loved one.
• Induced psychosis (folie a deux): folie a deux (pronounced as desk) is shared by two people who are closely related emotionally.
• Koro: Seen in south East Asia, particularly Malaysians of Chinese extraction. Affected men have an overwhelming fear that their penis is retracting into the abdomen and that death will then occur.
• Labile affect: the affect repeatedly and rapidly shifts.
• Latah: Seen in Fareast and North Africa. It is a hysterical state in which patients exhibit echolalia, echopraxia and automatic obedience.
• Made actions (made acts, made feelings, made impulses): The delusional belief that one’s free will has been removed and an external agency is controlling one’s actions, feelings and impulses.
• Loosening of associations (derailment): The patient’s train of thought shifts suddenly from one very loosely connected or unrelated ideas to the next. It reflects deterioration in the capacity to think formally or logically. Commonly the schizophrenic patient uses a private logic, with over personalised concrete symbols. Conceptual boundaries are blurred and thinking patterns are metaphorical and idiosyncratic. Thus, to the observer, when such thoughts are expressed, they appear on the surface to be diffuse or bizarre. Some psychiatrists use the term ‘formal thought disorder’ synonymously.
• Mannerisms: repeated involuntary movements that appear to be goal directed.
• Mood: A pervasive and sustained emotion that colours the person’s perception of the world.
• Mutism: total loss of speech
• Negativism: A motiveless resistance to commands and attempts to be moved.
• Neologism: A word newly made up, or an every day word used in a special way or a new meaning for the patient.
• Nihilistic delusion: The delusional belief that others, oneself, or the world do nor exist or are about to cease to exist.
• Obsessions: repetitive senseless intrusive and unwelcome thoughts, recognized by the patient as his own thoughts but as irrational or ridiculous which, at least initially are unsuccessfully resisted.
• Overvalued ideas: An unreasonable and sustained intense preoccupation with less delusional intensity.
• Para-suicide (deliberate self-harm): Any act deliberately undertaken by a patient who mimics the act of suicide, which does not results in a fatal outcome.
• Passing by the point: The answers to questions, though obviously wrong, show that the questions have been understood. It is seen in Ganser syndrome, first describe in criminals awaiting trials.
• Passivity phenomenon: the delusional belief that an external agency is controlling aspects of the self which are normally entirely under’ one’s own control (e.g. alienation of thought. Made feelings. Made impulses, made actions, somatic passivity)
• Perseveration (of speech and movement): Mental operations carry on beyond the point at which they are appropriate.
• Posturing: An inappropriate or bizarre bodily posture is adopted continuously over a long period.
• Poverty of speech: Very reduce speech, sometimes with monosyllabic answers to questions.
• Pressure of speech: Increased quantity and rate of speech, which is difficult to interrupt.
• Primary delusion: A delusion arising fully formed without any discernible connection with previous events. It may be preceded by a delusional mood in which there is awareness of something unusual and threatening occurring.
• Pseudo-dementia: Clinically similar to dementia, but has a non-organic cause e.g. depression.
• Schneiderian first-rank symptoms: In the absence of organic cerebral pathology the presence of any of Schneider’s first-rank symptoms is indicative of, though not pathognomonic of, schizophrenia.
• Selective inattention: Anxiety-provoking stimuli are blocked out.
• Sick-role behaviour: Activity by individuals who consider themselves as ill for the purpose of getting well.
• Somatic passivity: the delusional belief that one is a passive recipient of bodily sensations from an external agency.
• Somnambulism: Sleep walking.
• Somnolence: Abnormal drowsiness.
• Stereotypy: A repeated regularly fixed pattern of movement or speech that is not goal directed.
• Stupor: A clinical presentation of akinesis  (lack of voluntary movement), mutism and extreme unresponsiveness in an otherwise alert patient staring blankly and taking nothing in.
• Systematized delusion: A group of delusions united by a single theme or a delusion, with multiple elaborations.
• Tactile hallucinations: Superficial somatic hallucinations
• Talking past the point: The point of what is being said is never quite reached.
• Thought alienation: It includes thought  broadcasting, thought insertion and thought withdrawal
• Thought broadcasting (thought diffusion): The delusional belief that one’s thoughts are being read by others, as if they were broad cast.
• Thought insertion: The delusional belief that thoughts are being put into one’s mind by an external agency.
• Thought withdrawal: The delusional belief that thoughts are removed from one’s mind by an external agency.
• Thought blocking: A sudden interruption in the train of thought occurs, leaving a blank, after which what was said cannot be recalled.
• Trailing phenomenon: Moving objects are seen as a series of discrete discontinuous images. It is associated with hallucinogens.
• Transference: The unconscious process in which emotions and attitudes experienced in childhood are transferred to the therapist.
• Unit of alcohol: the mass of alcohol contained in a standard measure of spirits, in a standard glass of table wine, and in a pint of beer. It is around 8-10 g.
• Visceral hallucinations: Somatic hallucinations of deep sensations.
• Waxy flexibility: When the part of the body is moved it gives a feeling of plastic resistance as if bending a soft wax rod. The bodily part remains moulded in a new position.
• Windigo: Seen in north American Indian tribes with a depressive disorder in which patients believe they have mutated in to cannibalistic monsters.
• Word salad (schizophasia or speech confusion): The speech is an incoherent and incomprehensible mix of words and phrases.