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Psychiatry > Definitions > Flashcards

Definitions Flashcards

1
Q

Define mood.

A

Refers to a patient’s sustained , experienced emotional state over a period of time. It may be reported subjectively (in the patient’s own words) or objectively as dysthymic (low), euthymic (normal) or elated (elevated).

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2
Q

Define affect.

A

Refers to the transient flow of emotion in response to a particular stimulus

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3
Q

Define mood disorder.

A

Otherwise known as an ‘ affective disorder ’, is any condition characterized by distorted , excessive or inappropriate moods or emotions for a sustained period of time

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4
Q

Define depressive disorder.

A

is an affective mood disorder characterized by a persistent low mood , loss of pleasure and/or lack of energy accompanied by emotional , cognitive and biological symptoms

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5
Q

Define recurrent depressive disorder.

A

A recurrent depressive episode refers to when a patient has another depressive episode after their first.

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6
Q

Seasonal affective disorder

A

Characterized by depressive episodes recurring annually at the same time each year, usually during the winter months.

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7
Q

Masked depression

A

A state in which depressed mood is not particularly prominent, but other features of a depressive disorder are, e.g. sleep disturbance, diurnal variation in mood.

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8
Q

Atypical depression

A

This typically occurs with mild– moderate depression with reversal of symptoms e.g. overeating, weight gain and hypersomnia. There is a relationship between atypical depression and seasonal affective disorder.

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9
Q

Dysthymia

A

Depressive state for at least 2 years, which does not meet the criteria for a mild, moderate or severe depressive disorder and is not the result of a partially-treated depressive illness.

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10
Q

Cyclothymia

A

Chronic mood fluctuation over at least a 2-year period with episodes of elation and of depression which are insufficient to meet the criteria for a hypomanic or a depressive disorder.

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11
Q

What psychotherapies are used to manage depression?

A

CBT: Depression causes negative thoughts, which can lead to negative behaviours. CBT allows people to identify and tackle negative thoughts; conducted in groups or individually.
IPT: Helps to identify and solve relationship problems, whether it is with family, partners or friends.
Behavioural activation: Encourages depressed patients to develop more positive behaviour or activities that they would usually avoid.
Counselling: Enables patients to explore their problems and symptoms. Counsellors offer support and guide patients to help themselves for a particular focus, e.g. bereavement or relationship counselling.
Psychodynamic therapy: Aim is to explore and understand the dynamics and difficulties of a patient’s life, which may have begun in childhood.

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12
Q

Define BPAD

A

is a chronic episodic mood disorder , characterized by at least one episode of mania (or hypomania ) and a further episode of mania or depression. Either one can occur first but the term bipolar also includes those who at the time of diagnosis have suffered only manic episodes, as all cases of mania will eventually develop depression.

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13
Q

Define hypomania

A

Mildly elevated mood or irritable mood present for ≥4 days . Symptoms of mania, where present, are to a lesser extent than true mania. Considerable interference with work and social life but not severe disruption . Partial insight may be preserved.

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14
Q

Define mania

A

As with hypomania but to a greater extent . Symptoms present for >1 week , with complete disruption of work and social activities. May have grandiose ideas and excessive spending could lead to debts. There may be sexual disinhibition and reduced sleep may lead to exhaustion .

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15
Q

Define Mania with psychosis.

A

Severely elevated or suspicious mood with the addition of psychotic features such as grandiose or persecutory delusions and auditory hallucinations that are mood congruent. Patient may show signs of aggression .

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16
Q

Define Bipolar 1, 2, and rapid cycling

A

Bipolar 1: Severely elevated or suspicious mood with the addition of psychotic features such as grandiose or persecutory delusions and auditory hallucinations that are mood congruent. Patient may show signs of aggression .

Bipolar 2: Severely elevated or suspicious mood with the addition of psychotic features such as grandiose or persecutory delusions and auditory hallucinations that are mood congruent. Patient may show signs of aggression .

Rapid cycling: More than four mood swings in a 12-month period with no intervening asymptomatic periods. Poor prognosis.

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17
Q

Define psychosis

A

A mental state where reality is greatly distorted which presents with delusions and hallucinations

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18
Q

Define delusions

A

A fixed false belief , which is firmly held despite evidence to the contrary and goes against the individual’s normal social and cultural belief system

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19
Q

Define hallucinations

A

A perception in the absence of an external stimulus . It is a common feature of psychosis.

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20
Q

Define thought disorder

A

An impairment in the ability to form thoughts from logically connected ideas.

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21
Q

Define Schizotypal Disorder

A

Also known as latent schizophrenia , it is characterized by eccentric behaviour , suspiciousness , unusual speech and deviations of thinking and affect that is similar to those suffering from schizophrenia.
These individuals however, do not suffer from hallucinations or delusions . There is an increased risk of schizotypal disorder in those who have first-degree relatives with schizophrenia.

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22
Q

Define Scute and transient psychotic disorders

A

A psychotic episode presenting very similarly to schizophrenia but lasting <1 month and so not meeting the criteria for schizophrenia.

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23
Q

Define schizoaffective disorder

A

Characterized by both symptoms of schizophrenia and a mood disorder (depression or mania) in the same episode of illness . The mood symptoms should meet the criteria for either a depressive illness or a manic episode together with one or two typical symptoms of schizophrenia

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24
Q

Define persistent delusional disorder

A

The development of a single or set of delusions for a period of at least 3 months in which the delusion is the only, or the most prominent, symptom with other areas of thinking and functioning well preserved, unlike in schizophrenia. The content of the delusion is often persecutory , grandiose or hypochondriacal in nature. The onset and content of the delusion is often related to the patient’s life situation. Symptoms often respond well to antipsychotics.

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25
Q

Define induced delusional disorder

A

Induced delusional disorder, also known as ‘ shared paranoid disorder ’, is an uncommon disorder characterized by the presence of similar delusions in two or more individuals. Folie imposée is where a dominant person (‘primary’) initially forms a delusional belief during a psychotic episode and imposes it on another person(s) (‘secondary’). Folie simultanée is when two people considered to suffer independently from psychosis, influence the content of each other’s delusions so that they become identical or very similar.

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26
Q

Define mood disorder with psychosis

A

Psychosis occurs secondary to depression or mania . On the other hand, schizophrenia usually develops spontaneously.

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27
Q

Define schizophrenia.

A

the most common psychotic condition , characterized by hallucinations , delusions and thought disorders which lead to functional impairment . It occurs in the absence of organic disease, alcohol or drug-related disorders and is not secondary to elevation or depression of mood.

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28
Q

Define grandiose delusions.

A

a fixed false belief that one has special powers, is talented, wealthy or important. Grandiose delusions may be religious in nature, e.g. one is chosen by God.

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29
Q

Persecutory delisions

A

A fixed false belief that other people are conspiring against them in order to inflict harm or destroy their reputation.

30
Q

Define reference delusions.

A

A fixed false belief that random events, objects or the behaviour of others, have a special significance to oneself.

31
Q

Define guilt delusions

A

A fixed false belief that one has done something sinful or shameful.

32
Q

Define hypochondriacal delusions.

A

A fixed false belief that one has a medical illness, despite sound medical evidence to the contrary.

33
Q

Define Nihilistic delusion.

A

A fixed false belief that they are worthless or dying. In severe cases they claim that everything is non-existent including themselves ( Cotard’s syndrome ).

34
Q

Define 3 types of loosening of associations.

A

Derailment of thought (Knight’s move thinking) - Discourse consisting of a sequence of unrelated or only remotely related ideas.

(2) Tangential thinking: The person diverts from the original train of thought but never returns to it. It is more indicative of psychopathology as opposed to circumstantiality.
(3) Word salad: Refers to speech that is reduced to a senseless repetition of sounds and phrases.

35
Q

Define circumstantiality.

A

Thinking proceeds slowly with many unnecessary details and digressions , before returning to the original point . This is seen in obsessional personalities and learning disability (LD).

36
Q

Define neologisms

A

Are words and phrases devised by the patient or a new meaning to an already known word. May be seen in schizophrenia and autism

37
Q

Define perseveration

A

Uncontrollable and inappropriate repetition of a particular response, such as a word, phrase, or gesture. This most often occurs in dementia.

38
Q

Define depersonalisation

A

Feeling of detachment from normal sense of self

39
Q

Define derealisation

A

Feeling of unreality in which the environment and people are experienced as unreal. The patient has got insight and realizes that these experiences are originating from their own mind.

40
Q

Define neurosis

A

a collective term for psychiatric disorders characterized by distress , that are non-organic , have a discrete onset and where delusions and hallucinations are absent.

41
Q

Define generalised anxiety disorder.

A

Generalized anxiety disorder (GAD) is a syndrome of ongoing , uncontrollable , widespread worry about many events or thoughts that the patient recognizes as excessive and inappropriate . Symptoms must be present on most days for at least 6 months duration.

42
Q

Define paranoid schizophrenia?

A

Dominated by positive symptoms

43
Q

Hebephrenic schizophrenia

A

Dominated by thought disorganisation (earlier onset of illness (15-25) and poorer prognosis

44
Q

Catatonic schizophrenia

A 
One or more catatonic symptoms 
psychomotor - posturing, rigidity, 
waxy flexibility
mutism
immobility
45
Q

Simple schizophrenia

A

Negative symptoms develop without psychotic symptoms

46
Q

Residual schizophrenia

A

1 year of chronic negative symptoms preceded by clear-cut psychotic episode.

47
Q

Define somatoform disorders

A

a group of disorders whose symptoms are suggestive of, or take the form of, a physical disorder but in the absence of a physiological illness , leading to the presumption that they are caused by psychological factors . Sufferers repeatedly seek medical attention even when it has consistently failed to benefit them.

48
Q

Define dissociative disorders

A

characterized by symptoms which cannot be explained by a medical disorder and where there are convincing associations in time between symptoms and stressful events , problems or needs. The unpleasant stressful events or problems are ‘converted’ into the symptoms.

49
Q

Define dissociation

A

A process of ‘separating off’ certain memories from normal consciousness. This is a psychological defence mechanism that is used to cope with emotional conflict that is so distressing for the patient, that it is prevented from entering their conscious mind.

50
Q

Define conversion

A

Distressing events are transformed into physical symptoms. This, like somatoform disorders, can lead to primary and secondary gain

51
Q

Define dissociative amnesia

A

Amnesia, either partial or complete for recent events or problems that were traumatic or stressful. Too extensive and persistent to be explained by ordinary forgetfulness.

52
Q

Define dissociative fugue

A

An unexpected physical journey away from usual surroundings followed by amnesia for the journey. Self-care is maintained.

53
Q

Define dissociative stupor

A

Profound reduction in, or absence of, voluntary movements, speech and normal responses to stimuli. Normal muscle tone.

54
Q

Define trance or possession disorders

A

Trance: temporary alteration in state of consciousness. • • Possession: absolute conviction by the patient that they have been taken over by a spirit, power or person.

55
Q

Define dissociative motor disorders

A

Loss of the ability to perform movements that are under voluntary control (including speech) or ataxia.

56
Q

Define dissociative convulsions

A

Sudden, unexpected spasmodic movements that resemble epilepsy but without loss of consciousness.

57
Q

Define dissociative anaesthesia and sensory loss

A

Partial or complete loss of cutaneous sensation, vision, hearing or smell.

58
Q

Define somatization disorder.

A

Multiple , recurrent and frequently changing physical symptoms not explained by a physical illness.

Must be at least 2 years of physical symptoms

59
Q

Define hypochondriacal disorder.

A

Patient misinterprets normal bodily sensations , which leads them to the non-delusional preoccupation that they have a serious physical disease , e.g. cancer.

refuse to accept reassurances from doctors.

60
Q

Define dysmorphophobia (ie. body dysmorphic disorder)

A

A variant of hypochondriacal disorder where there is an excessive preoccupation with barely noticeable or imagined defects in their physical appearance (e.g. the size and shape of their nose). The preoccupation causes significant distress

61
Q

Define somatoform autonomic dysfunction.

A

a group of disorders whose symptoms are suggestive of, or take the form of, a physical disorder but in the absence of a physiological illness , leading to the presumption that they are caused by psychological factors . Sufferers repeatedly seek medical attention even when it has consistently failed to benefit them.

The symptoms experienced are related to the autonomic nervous system.

Multiple autonomic symptoms must be present such as palpitations , tremor , sweating , dry mouth , flushing and hyperventilation . Symptoms may be objective (sweating, tremor) or subjective (pain, paraesthesia). • • Patients attribute symptoms to a specific system under autonomic control. For instance respiratory ( psychogenic hyperventilation ), gastrointestinal ( irritable bowel syndrome ) or cardiovascular ( Da Costa’s syndrome ).

62
Q

Define persistent somatoform pain disorder.

A

Persistent (of at least 6 months’ duration) and severe pain that cannot be fully explained by a physical disorder.

Pain usually occurs as a result of psychosocial stressors and emotional difficulties .

Differs from somatization disorder in that pain is the primary feature and multiple symptoms from different systems are not present

63
Q

Define personality disorder.

A

A deeply ingrained and enduring pattern of inner experience and behaviour that deviates markedly from expectations in the individual’s culture, is pervasive and inflexible , has an onset in adolescence or early adulthood , is stable over time and leads to distress or impairment

64
Q

List the PDs.

A

Cluster A (Odd/eccentric): Paranoid, schzoid

Cluster B (Dramatic/emotional): Emotionally unstable (borderline), dissocial, histrionic

Cluster C (anxious/fearful): Dependent, avoidant (anxious), anankastic (obsessional)

65
Q

Features of paranoid PD

A

SUSPECTS

Suspicious of others
Unforgiving
Spouse fidelity questioned
Percevies attack
Envious
Cold Affect/Criticism not liked
Trust in others reduced
Self-reference
66
Q

Features of Schzoid PD

A

DISTANT

Detached/flattened affect
Indifferent to praise or criticism
Sexual drive reduced
Tasks done alone
Absence of close friends
No emotion (cold)
Takes pleasure in few activity
67
Q

Features of Emotionally unstable (borderline) PD

A

AM SUICIDE

Abandonment fear
Mood instability
Suicidal behaviour
Unstable relationships
Intense relationships
Control of anger poor
Impulsivity
Disturbed sense of self
Emptiness (chronic)
68
Q

Features of Dissocial PD?

A

CORRUPT

Callous 
Others blamed
Reckless disregard for safety
Remorseless (lack of guilt)
Underhanded (deceitful)
Poor planning (impulsive)
Temper/tendency to violence
69
Q

Features of Histrionic PD

A

PRAISE

Provocative behaviour
Real concern for physical appearance
Attention seeking
Influenced easily
Shallow/Seductive inappropriately
Egocentric (vain)/Exaggerated emotions
70
Q

Features of dependent PD?

A

RELIANCE

Reassurance required
Expressing disagreement is difficult
Lack of self-confidence
Initiating projects is difficult
Abandonment feared
Needs others to assume responsibility
Companionship sought
Exaggerated fear
71
Q

Features of Avoidant (anxious) PD?

A

CRIES

Certainty of being liked needed before becoming involed with people
Restriction to lifestyle in order to maintain security
Inadequacy felt
Embarrassment potential prevents involvement in new activitoes
Social inhibition

72
Q

Features of Anankastic PD?

A

LAW FIRMS

Loses point of activity (due to preoccupation with detail)
Ability to complete tasks compromised (due to perfectionism)
Workaholic at the expense of leisure

Fussy (excessively concerned with minor details) 
Inflexible 
Rigidity 
Meticulous attention to detail 
Stubborn

Psychiatry (4 decks)

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