PS1.1-3 | Introduction to Psychiatry — Glossary

A reduction in the normal variability and expressiveness of emotional response, manifested as a diminished range and intensity of affect; a negative symptom of schizophrenia and a feature of severe depression.

A psychotic episode with abrupt onset and duration of less than 1 month, followed by full recovery to the premorbid level of functioning; distinguished from schizophrenia primarily by duration.

A neuropsychiatric syndrome characterised by motor immobility (stupor or mutism), waxy flexibility, posturing, negativism, or alternatively by excessive purposeless motor activity; can occur in schizophrenia, mood disorders, and organic states; malignant catatonia with fever and autonomic instability is a medical emergency.

Clinical information about the patient's behaviour, symptoms, and history obtained from a reliable informant (typically a family member or caregiver) when the patient's account alone may be incomplete due to impaired insight, memory disturbance, or psychotic distortion.

The co-occurrence of two or more distinct mental disorders in the same individual; common in psychiatry (e.g. major depression co-occurring with anxiety disorders; substance use disorders co-occurring with psychotic or mood disorders) and has important implications for treatment planning.

An acute, fluctuating neuropsychiatric syndrome characterised by disturbed attention, awareness, and cognition, with evidence of an underlying medical cause; the prototypical organic psychiatric disorder.

A fixed, false belief held with conviction and not amenable to reason or contrary evidence, inconsistent with the individual's cultural and educational background; the central feature of delusional disorder and a core positive symptom of schizophrenia.

An experience of feeling detached from or estranged from one's own mental processes, body, or sense of self (feeling like an outside observer of one's thoughts and actions); occurs in anxiety disorders, dissociative disorders, and as a transient experience in healthy individuals under stress.

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (2013), widely used in research and North American clinical practice; DSM-5-TR (2022) is the text revision.

A chronic, low-grade depressive disorder with a minimum duration of 2 years in adults (or 1 year in children and adolescents) that does not meet the full criteria for a major depressive episode; ICD-11 term is 'dysthymic disorder.'

An abnormality of thought form in which ideas succeed one another rapidly with discernible (though loose) links between them; characteristic of mania and distinguishable from the looser, more fragmented thought disorder of schizophrenia.

A structured framework for understanding aetiology in psychiatry: Predisposing factors (genetic vulnerability, developmental adversity, personality), Precipitating factors (stressors or triggers that initiated the current episode), Perpetuating factors (maintaining the illness — substance use, ongoing stressors, non-adherence), and Protective factors (resilience, social support, therapeutic relationships).

A mental disorder for which no demonstrable organic cause can be identified as the primary aetiology; diagnosed after systematic exclusion of organic causes; includes schizophrenia, bipolar disorder, and major depressive disorder.

A perception occurring without an external stimulus, experienced as real and located in external space; most commonly auditory in schizophrenia but can occur in any sensory modality.

The World Health Organization's 11th revision of the International Classification of Diseases, effective January 2022, used as the primary classification system for official health statistics and clinical practice in India and most of the world.

A type of delusional thinking in which the patient believes that neutral or random events in the environment (television programmes, strangers' conversations, newspaper articles) have specific, personal relevance or meaning directed at them.

An emotional expression that is inappropriate to the content of thought or conversation (e.g. laughing when describing a death); characteristic of schizophrenia and distinguishable from labile affect (rapid shifts between emotional states).

The patient's awareness and accurate understanding that their mental experiences are symptoms of a psychiatric illness; preservation of insight distinguishes neurotic from psychotic disorders and is a key prognostic indicator.

The degree to which a patient recognises that they have a mental illness, understands that their experiences are symptoms of that illness, and acknowledges that treatment is needed; graded from complete absence (Grade 0) to full awareness (Grade 6) in Ahuja's classification.

An abnormality of thought form in which connections between ideas are lost, making speech incoherent and difficult to follow; a characteristic feature of schizophrenia that differs from flight of ideas by the absence of even loose associative links.

The current Indian legislation governing the care and treatment of persons with mental illness, replacing the 1987 Act; decriminalised suicide attempt, established advance directives, nominated representatives, and mandated free treatment in government facilities.

A structured, systematic assessment of a patient's current mental functioning conducted at the time of the clinical encounter, covering appearance/behaviour, speech, mood, affect, thought, perception, cognition, insight, and judgement.

The diminution or absence of normal mental functions: flat or blunted affect (alogia), poverty of speech (alogia), lack of motivation (avolition), inability to experience pleasure (anhedonia), and social withdrawal.

A group of mental disorders characterised by distressing psychological symptoms (anxiety, obsessions, phobias, dissociation) in which reality testing is preserved and insight is typically maintained; now grouped under anxiety, OCD-related, stress-related, and dissociative disorders in ICD-11.

A mental disorder caused by a demonstrable systemic disease, primary brain lesion, or psychoactive substance, in which treating the underlying cause is the primary therapeutic intervention.

Beliefs that one's thoughts, feelings, or actions are under the control of an external force or agent; a Schneiderian first-rank symptom of schizophrenia (e.g. 'My arm is being moved by an outside force').

A fixed false belief that one is being harassed, followed, poisoned, conspired against, or otherwise harmed by others; the most common type of delusion across psychiatric disorders.

The systematic study and description of subjective mental experiences as reported by the patient and observed by the clinician, forming the basis of descriptive psychopathology and the cornerstone of modern psychiatric classification.

The presence of abnormal mental phenomena not seen in health: hallucinations, delusions, disorganised speech (formal thought disorder), and grossly disorganised or catatonic behaviour.

An abnormality of speech characterised by a rapid, continuous flow of words that is difficult or impossible to interrupt; a cardinal feature of mania and reflects the underlying acceleration of thought (flight of ideas).

A perceptual experience that the patient recognises as arising from within the mind rather than from external space, and does not ascribe to an external agent; distinguished from true hallucinations by the preserved recognition of its internal origin.

A structured clinical narrative synthesising history and MSE findings into a descriptive formulation (diagnosis/differential), aetiological formulation (predisposing/precipitating/perpetuating/protective factors), management plan, and prognosis; more comprehensive and clinically informative than a bare diagnosis.

A mental state involving a fundamental break with shared reality, manifest as hallucinations, delusions, or grossly disorganised thinking and behaviour, with characteristically impaired or absent insight into the illness.

A psychotic disorder in which episodes of schizophrenia symptoms co-occur with prominent mood episodes (depressive, manic, or mixed), without a history that meets criteria for schizophrenia or mood disorder independently.

A set of symptoms described by Kurt Schneider as highly characteristic of schizophrenia: third-person auditory hallucinations (running commentary, discussing the patient), thought insertion, thought withdrawal, thought broadcasting, and passivity phenomena (delusions of control).

An abrupt cessation of the stream of speech mid-sentence, attributed by the patient to thoughts being suddenly removed; when present, thought withdrawal (a Schneiderian first-rank symptom of schizophrenia) should be actively assessed.