Appendix:Glossary of psychiatry

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In this Glossary of Psychiatric Terms, initially mostly French and German and some English terms, as used in psychiatric literature, were defined. We have included many other terms with the passage of time and aim to broaden this article to include most of the psychopathological terms in use.

There are many psychiatric terms that are of foreign-language origin; and are thus not easily understood by many English speakers. Most of these terms refer to expressions dating from the early days of psychiatry in Europe. This glossary aims to make the meaning of these terms clearer.

Contents: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

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  • Abreaction - Abreaction is an emotional release or discharge following recall of a painful experience. Used sometimes by police, forensics after administering amobarbital.
  • Abulia -Aboulia or Abulia, in neurology, refers to a lack of will or initiative. The patient is unable to act or make decisions independently. It may range from subtle to overwhelming in severity.
  • Affect illusion - Illusions (Misperceptions) associated with and/or based on changes with mood for example at midnight a person may take a shadow as a ghost, but in the early part of night this may not be the case.
  • Akathisia - Is a feeling of 'inner restlessness' often brought on as a side effect of anti-psychotic medication. People with akathisia have a desire to keep moving and are unable to keep still even though their movements are voluntary (as opposed to other movement disorders such as tardive dyskinesia which is involuntary). It most often affects the legs. When mild it is usually worse at night.
  • Alexithymia - The term was coined by Dr Peter Sifneos to describe a condition where the person is unable to put into words the emotions he feels.
  • Alice in Wonderland Experience - In Alice in Wonderland Experience Subjects perceive objects (including animals and other humans, or parts of humans, animals, or objects) as appearing substantially smaller than in reality. Generally, the object appears far away or extremely close at the same time. Alternate term for this is somaesthetic aura. Also see #Lilliputian hallucinations
  • Alliteration -Alliteration refers to the repetition of initial consonant sounds in neighbouring words. For example, "When I struck and slapped my humble horse, he began to run rapidly."
  • Alogia - Literally , this term means "not having words". This refers to poverty of speech generally seen in chronic psychotic disorders such as schizophrenia. This may be seen in advanced dementia too.
  • Amok -Amok, or mata galap: The term comes from Malaysia in its origin. The phrase "running amok" also comes from this syndrome. This is a rare culture bound syndrome in which the subject (known as a pengamok) suddenly withdraws from his peers and family and gets violent towards people around him and may also use whatever weapon available to him. He is very difficult to be stopped at that stage. Ultimately he falls into a sleep or stupor and when wakes up having little knowledge of his violent behaviour.
  • Anosognosia -Anosognosia is a phenomenon in which a patient usually suffering from stroke is unaware and indifferent towards his disability. #Hemiasomatognosia is a subtype of anosognosia in which the person suffering from hemiplegia neglects one half of his body.
  • Anton's syndrome -Anton syndrome, occasionally known as Anton-Babinski syndrome, is a form of cortical blindness in which the patient denies the visual impairment. The patient may attempt to walk, bumping into objects and injuring himself. Anton syndrome is caused by damage to the occipital lobe which extends from the primary visual cortex into the visual association cortex.
  • Anwesenheit - Anwesenheit refers to the feeling of presence of something or some person. It can be seen in normal grief reaction, schizophrenia and some emotionally arousing situations.
  • Apophanous perception - This is an alternate term for delusional perception. It is one of the Schneiderian first rank symptoms and is defined as a true perception, to which a patient attributes a false meaning. For example, a person may see written "No Trespassing" on a board and may infer from this that intelligence agencies are spying on him.
  • Aphemia - Aphemia is the alternate term for mutism. Mutism is absence of speech with apparently normal level of consciousness. Mutism can be dissociative (hysterical) in which an individual (commonly a child or adolescent) stops speaking at once without involvement of any neurological or physical contributing factor; or it can be elective (selective) in which a child does not speak at all in certain situations (such as in school) but speaks well in other conditions (like at home or at play). A rare cause of mutism is akinetic mutism which results due to a lesion around 3rd ventricle of brain.
  • Apperception - Apperception is a normal phenomenon and refers to the ability to undestand sensory inputs in their context, to interpret them and to incorporate them into experience. Failure of apperception is seen in delirious states.
  • Astasia-abasia -Astasia abasia is a form of dissociative disorder in which gait becomes impaired in absence of any neurological or physical pathology. The person usually walks in a bizarre manner. He staggers and appears as if going to fall but always manages to catch hold of something in time. Sometimes these people cannot even stand but on the other hand they are well able to move their legs while lying down or sitting.
  • Asyndesis - Alternate term for Loosening of association. A milder form of derailment of thought, in which a person goes on jumping from one topic to another and there is little connection among the topics. This is in contrast to flight of ideas where a person jumps from one topic to another and there is a connection among the topics. See also #Entgleisen term introduced by (Cameron).
  • Autochthonous delusion -Jaspers defined this as a delusion arising without apparent cause. For example, suddenly, without apparent cause, having the delusional belief that you are an alien.
  • Autokabalesis - An uncommonly used term used for suicide committed by jumping from a very high place.
  • Automatic obedience - Automatic obedience is an exaggerated co-operation with an examiner's request, as if the patient were an 'automaton' robotically obeying a command. It is usually a sign of catatonia.
  • Automatism -Automatisms are sequences of activity that occur without conscious control. They may be simple and repetitive (tic-like) or complex, and are usually natural-looking but purposeless; for example, repeatedly going through the motions of buttering a piece of bread when there is no bread there. Automatic behaviour is not usually recalled afterwards.

B

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  • Belle Indifference (‘La belle indifference’) - Belle Indifference or #La belle indifférence is characterized by a lack of concern and an indifference about a disability and is seen in hysteria or dissociative disorders.
  • Bouffée délirante -Bouffée délirante is a French term used in past for acute and transient psychotic disorders (F23 in ICD-10). In DSM-IV, it is described as "Brief Psychotic Disorder" (298.8). The symptoms usually have an acute onset and reach their peak within two weeks. The symptoms start resolving in a few weeks and complete recovery usually occurs within 2-3 months.

C

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  • Capgras' syndrome or Illusion des sosies - In Capgras syndrome, the patient feels that a person familiar to him , usually a family member has been replaced by a double i.e. an identical looking imposter. Capgras Syndrome and Fregoli syndrome along with some other conditions are classified as delusional misidentification syndrome. It is named after Joseph Capgras (1873-1950), a French psychiatrist who first described the disorder in a paper by Capgras and Reboul-Lachaux1,2 in 1923. They used the term l'illusion des sosies (the illusion of doubles) to describe the case of a French woman who complained that various doubles had taken the place of people she knew. However, the term illusion has a subtly different meaning from delusion in psychiatry so Capgras delusion is used as a more suitable name.
  • Catalepsy -Catalepsy is the term for catatonic rigidity of the limbs which often results in abnormal posturing for long intervals.
  • Cataplexy -Cataplexy is an attack of muscular flaccidity.
  • Cerea flexibilitas -Cerea flexibilitas, meaning "waxy flexibility," is characterized by a patient's movements having the feeling of a plastic resistance, as if the person were made of wax. This occurs in catatonic schizophrenia, and a person suffering from this condition can have his limbs placed in fixed positions as if the person were in fact made from wax.
  • Chorea -Chorea is manifest by abnormal voluntary movements. The term comes from Greek word khoreia, since large groups of muscles are usually involved which leads to writhing dancing movement.
  • Circumstantiality - Refers to a thought disorder wherein thinking takes a roundabout manner to get to an answer. Differentiable from tangentiality by the speaker eventually getting back to the point. For example: "My mother's job? She used to sit around the house doing nothing but drinking, she'd just sit there and stew, making noises, chugging her drinks. She threw my dad out of the house. I'll never forget that, the way she did it. Anyways, my mom was a waitress."
  • Clang association - Thought disorder wherein words are chosen or repeated based on similar sounds, instead of semantic meaning. "The train rain brained me. He ate the skate, inflated yesterdays gate toward the cheese grater."
  • Claparede's paradox - This refers to retention of non-verbal and implicit memory in sufferers of Korsakov's syndrome. 11
  • Clouding of consciousness - Clouding of consciousness is a global impairment in higher central nervous functioning. All aspects of cognitive funtioning are affected. On mental status examination it is manifest by disorientation in time, place and person, memory difficulties caused by failure to register and recall, aphasia, dyspraxia, and agnosia. Impaired perception functioning leads to illusions and hallucinations often in the visual sensory modality. This then causes agitation and distress and secondary delusions. The term 'confusion state' is sometimes used to mean clouding of consciousness, but should be avoided if at all possible because it is ambiguous.
  • Coenestopathic state - A patient in a coenestopathic state has a localized distortion of body awareness.
  • Confabulation -Confabulation is the confusion of imagination with memory, and/or the confusion of true memories with false memories.
  • Coprolalia -Coprolalia is the involuntary utterance of socially inappropriate phrases. It is a phonic tic associated with Tourette syndrome, although less than 15% of persons with Tourette's have coprolalia.
  • Cotard's syndrome -Cotard's syndrome is a nihilistic delusional syndrome in which, for example, patient believes that he denies his own existence or existence of his body parts and belongings etc. and has a firm conviction about that. This can be seen usually in schizophrenia and severe depressive states especially in context of a bipolar disorder.

D

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  • Defenestration - Literally jumping out of window. Usually used in context of attempted or completed suicide. Also see #autokabalesis. 11
  • Déjà vu - In Déjà vu, a person feels undue familiarity to an event or a person. For example, he feels that the same thing has happened before or he has met this person before, etc.
  • Déjà pensé - In Déjà pensé, a completely new thought sounds familiar to the person and he feels as he has thought the same thing before at some time.
  • Dementia pugilistica -Dementia pugilistica, also called "chronic traumatic encephalopathy", "pugilistic Parkinson's syndrome", "boxer's syndrome", and "punch-drunk syndrome", is a neurological disorder which affects career boxers and others who receive multiple dazing blows to the head. The condition develops over a period of years, with the average time of onset being about 16 years after the start of a career in boxing.
  • Dhat - In Dhat syndrome there is a complaint of premature ejaculation or impotence and a belief that semen is being passed in the urine.
  • Doppelgänger - The Doppelgänger is a phenomenon in which the person feels that his exact “double” is present alongside him every time and goes with him wherever he goes.

E

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  • Écho de la pensée - In écho de la pensée, meaning "thought echo" in French, thoughts seem to be spoken aloud just after being produced. The patient hears the 'echo' of his thoughts in the form of a voice after he has made the thought. See also #Gedankenlautwerden and #Thought Sonorization.
  • Entgleisen - Literally means jumping off the rails. Alternate term used for derailment of thought (a morbid form of loosening of association or #asyndesis). A Schneiderian term by origin. In this form of thought the patient jumps from one topic to another during conversation and both topics have literally no connection with each other. This is in contrast with flight of ideas where connection is present between one topic and another.
  • Extracampine - Extracampine hallucinations are hallucinations beyond the possible sensory field, e.g., 'seeing' somebody standing behind you is a visual extracampine hallucination experience.

F

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  • Fantasy -Fantasy is imagining that expresses desires and aims.
  • Fatuous affect - The moods of a patient with fatuous affect resemble the moods of a child. This condition is seen in hebephrenic schizophrenia.
  • Folie à deux - Also called induced psychosis, folie à deux is a delusional disorder shared by two or more people who are closely related emotionally. One has real psychosis while the symptoms of psychosis are induced in the other or others due to close attachment to the one with psychosis. Separation usually results in symptomatic improvement in the one who is not psychotic.
  • Folie communiquée, folie imposée, folie induite, and folie simultanée are the four subtypes of folie à deux.
  • Folie communiquée -Folie communiquée, or subtype C of folie à deux, occurs when a normal person suffers a contagion of his ideas after resisting them for a long time. Once he acquires these beliefs he maintains them despite separation.
  • Folie imposée -Folie imposée, or subtype A of folie a deux, is the most common form in which the dominant person imposes a delusion into a person who was not previously mentally ill. Separation of the two results in improvement of the non-dominant person.
  • Folie induite - In folie induite, or subtype D of folie a deux, a person who is already psychotic adds the delusions of a closely associated person to his own.
  • Folie simultanée - In folie simultanée, or subtype B of folie a deux, a delusional system emerges simultaneously and independently in two closely related persons, and the separation of the two would not be beneficial in the resolution of psychopathology.
  • Fregoli's syndrome - In Fregoli syndrome, the person feels that a person not known to him previously gets changed to a familiar person or one of his close family members. This is in contrast to Capgras syndrome in which he feels that his family member has changed into an unknown person or an impostor.

G

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  • Gedankenlautwerden - In Gedankenlautwerden , a patient hears thoughts spoken aloud. Thoughts are heard in the form of a voice at the same time as they are thought, not afterwards. See also Écho de la pensée and Thought Sonorization
  • Gegenhalten - Gegenhalten is a catatonic phenomenon in which the subject opposes all passive movements with the same degree of force as applied by the examiner. It is slightly different to negativism in which the subject does exactly the opposite to what is asked in addition to showing resistance.
  • Hemiasomatognosia - Hemiasomatognosia is a subtype of #anosognosia in which the person suffering from hemiplegia neglects one half of his body.

H

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  • Hyposchemazia; Aschemazia - Hyposchemazia is characterized by the reduced awareness of a patient's body image and Aschemazia by the absence of it. These disorders can have many varied causes such as physical injuries, mental disorders, or mental or physical states. These include transection of the spinal cord, parietal lobe lesions (e.g. right middle cerebral artery thrombosis), anxiety, depersonalization, epileptic auras, migraines, sensory deprivation, and vertigo (i.e. "floating on air").

I

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  • Idée fixe -Idée fixe is an alternate term for an overvalued idea. In this condition, a belief that might seem reasonable both to the patient and to other people comes to dominate completely the patient's thinking and life.
  • Ideas of reference - Delusional ideas wherein seemingly random stimuli is thought to be referring to the individual. For example, if a car beeps outside, the individual feels it was directed toward him or herself.

J

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  • Jargon aphasia -Jargon aphasia,is characterized by incoherent, meaningless, speech with a neologisms (newly invented words). These are unconscious thoughts that find expression when one is off one's guard and must be consciously repressed.

K

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  • Knight's Move thinking -Knight's Move thinking a phenomenon similar to derailment of thought or loosening of associations, is characterized by odd, tangential associations between ideas that lead to disruptions in the smooth continuity of speech. The name for this disorder likely derives from the odd movement pattern of knights in the game of Chess.
  • Koro -Koro is a culture-specific syndrome usually seen in Chinese people. It involves a morbid fear of retraction of the penis into the abdomen with the belief that this will lead to death.
  • Kuru -Kuru (also known as laughing sickness due to the outbursts of laughter that mark its second phase) was first noted in New Guinea in the early 1900s. Kuru is now known to be a prion disease, one of several known transmissible spongiform encephalopathies.

L

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  • Latah -Latah is a culture-specific syndrome usually seen in Southeast Asia and involves startle-induced disorganization, hypersuggestibility, automatic obedience, and echopraxia (a tendency to mimic examiner’s or other person’s actions). It is usually associated with women. There is controversy over whether Latah is a real psychiatric condition, or merely a display of exhibitionism that would otherwise not be socially acceptable.
  • L'homme qui rit - In l'homme qui rit, meaning "The man who laughs" in French, a patient displays inappropriate laughter accompanied by release phenomena of the frontal subdominant lobe.
  • Logoclonia - In logoclonia, the patient often repeats the last syllable of a word.
  • Logorrhoea -Logorrhoea, also known as "volubility," is characterized by a patient's fluent and rambling speech using numerous words.

M

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  • Mania a potu -Mania a potu is an alcohol intoxication state with violent and markedly disinhibited behavior. This condition is different from violent behavior in otherwise normal individuals who are intoxicated.
  • Mitgehen -Mitgehen is an extreme form of mitmachen in which very slight pressure leads to movement in any direction, also called the "anglepoise" effect. This is done despite instructions that the patient resist the pressure, as the patient often views the slight pressure as forcibly grasping and moving the patient.
  • Mitmachen - In mitmachen, the patient's body can be put into any posture, despite instructions given that the patient resist.
  • Moria -Moria is the condition characterized by euphoric behavior, such as fivolity and the inability to act seriously. In addition there is a lack of foresight and a general indifference. It is found in frontal lobe lesions, often along with #Witzelsücht particularly when the orbital surface is damaged. Recent research has shown its presence in frontotemporal dementia.

N

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  • Negativism - Negativism is found if, on examination, a patient resists attempts to move him and does opposite to what is asked. It is usually a sign of catatonia. It may progress to (catatonic) rigidity. It is slightly different to gegenhalten in which the patient resists movement but does not perform the opposite movement.

O

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  • Omega sign - The omega sign is the occurrence of a fold (like the Greek letter omega, Ω ) in the forehead above the root of the nose produced by the excessive action of the corrugator muscle. It is sometimes seen in depression.
  • Oneiroid state - From Greek oneiros, meaning dream. In the Oneiroid state one feels and behaves as though in a dream.

P

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  • Palilalia -Palilalia is characterized by the repetition of a word or phrase ie the subject continues to repeat a word or phrase after once having said. It is a perseveratory phenomenon.
  • Palinacousis - Palinacousis refers to a phenomenon in which the subject continues to listen to a word, a syllable or any sound, even after the withdrawal of stimulus. It is a type of #perseveration.
  • Palinopsia - In palinopsia a visual image persists after the stimulus has gone (similar to an afterimage seen after looking into a bright light).
  • Paraschemazia -Paraschemazia is characterized by a distortion of a patient's body image. It can be caused by hallucinogenic drugs such as LSD and mescalin, epileptic auras, and sometimes migraines.
  • Pareidolia - In pareidolia a vague or random stimulus is mistakenly perceived as recognizable. A common example is perceiving the image of a face in clouds. Pareidolia is a type of illusion and hence called pareidolic illusion.
  • Perseveration - This term refers to uncontrollable repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of the original stimulus. Usually it is seen in organic disorders of brain , head injury, delirium or dementia, however can be seen in schizophrenia as well.
  • Pseudologia fantastica -Pseudologia fantastica is a condition in which a person grossly exaggerates his symptoms or even tells a lie about his symptoms in order to get medical attention . Seen in malingering and Munchausen syndrome.
  • Psychological pillow - Where the individual holds his/her head a few centimetres above the bed. No explanation is offered for this. It is a symptom of catatonia and can last for many hours.
  • Psychopathology -Psychopathology is a term which refers to either the study of mental illness or mental distress or to the manifestation of behaviours and experiences which may be indicative of mental illness or psychological impairment.

R

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  • Rabbit syndrome - This syndrome is characterized by rapid rhythmic movements of lips so that it resembles a rabbit chewing. 11
  • Reduplicative paramnesia - A misidentification in which the patient’s surroundings are believed to exist in more than one physical location.
  • Reflex hallucination - Is when a veridical perception in one modality produces a hallucination in another, e.g. seeing a doctor writing (visual) and then feeling him writing across one’s stomach (tactile).
  • Retardation - Mental retardation is a term used when a person has certain limitations in mental functioning and in skills such as communicating, taking care of him or herself, and social skills.
  • In Children: These limitations will cause a child to learn and develop more slowly than a typical child. Children with mental retardation may take longer to learn to speak, walk, and take care of their personal needs such as dressing or eating. They are likely to have trouble learning in school. They will learn, but it will take them longer. There may be some things they cannot learn.[1]
  • Left-Right disorientation - Left-Right disorientation is one of the four cardinal signs of Gerstmann's syndrome.

S

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  • Schizophasia -Schizophasia, or colloquially "word salad", is characterized by a patient's speech being an incoherent and incomprehensible mix of words and phrases. This occurs in schizophrenic patients.
  • Schnauzkrampf - A schnauzkrampf is a grimace resembling pouting sometimes observed in catatonic patients.
  • Sensitiver beziehungswahn -Sensitiver beziehungswahn, is an alternate term for ideas of reference. In this the person thinks as people are talking about him or observing him or a talk is going on about him on television or radio. Seen in social phobia, depression and in schizophrenia where they are often present up to a delusional extent.
  • Synaesthesiae -(also spelled synæsthesia, synaesthesia, or synesthesia -- plural synesthesiae) -- from the Greek syn- meaning union and aesthesis meaning sensation -- is a neurological condition in which two or more bodily senses are coupled.

T

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V

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  • Verstimmung - It refers to an ill humoured mood state often accompanied by low mood and depressive symptoms. The people surrounding the patient often feel upset by this.
  • Vorbeigehen; Vorbeireden - In vorbeigehen or vorbeireden, a patient will answer a question in such a way that one can tell the patient understood the question, although the answer itself may be very obviously wrong. For example "how many legs does a dog have?" - "six". This condition occurs in Ganser syndrome and has been observed in prisoners awaiting trial. Vorbeigehen (giving approximate answers) was the original term used by Ganser but Vorbeireden (talking past the point) is the term generally in use (Goldin 1955). This behaviour is also seen in people trying to feign psychiatric disorders (hence association with prisioners)
  • Wahneinfall - Wahneinfall is alternate term for autochthonous delusions. This is one of the types of primary delusions in which a firm belief comes into the patient's mind 'out of the blue' or as an intution , hence called delusional intuition. Other types of primary delusions include delusional mood (or atmosphere), delusional (apophanous perception) and delusional memories.
  • Word-salad -(from the German Wortsalat) is characterized by confused, and often repetitious, language with no apparent meaning or relationship attached to them. It is often symptomatic of various mental illnesses, such as psychoses, including schizophrenia.
  • Wurgstimme - Wurgstimme refers to speaking in an odd muffled or strangled voice. It is mainly seen in schizophrenia. Click hereto listen to an example.
  • Witzelsücht - Witzelsücht is a tendency to tell inappropriate joke and creating excessive facetiousness and inappropriate or pointless humor. It is seen in Frontal lobe disorders usually along with #moria. Recent research has shown that it may also be seen in frontotemporal dementia.

References

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  1. ^ http://www.nichcy.org/pubs/factshe/fs8txt.htm
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