Download Psychiatry: Useful Definitions

Definitions compiled by Stephanie Reed
Psychiatry: Useful Definitions
Illusion – A false interpretation of a real perception
Hallucination – A false sensory perception in the absence of a real external stimulus. It is
perceived as being located in objective space and as having the same realistic qualities as
normal perceptions. It is not subject to conscious manipulation and only indicates a
psychotic disturbance when there is also impaired reality testing.
Pseudo-hallucination – A form of imagery arising in the subjective inner space of the mind
and lacking the substantiality of normal perceptions. It is not subject to conscious
manipulation.
Over-valued idea – An unreasonable and sustained preoccupation maintained with less
than delusional intensity. The belief is demonstrably false and not normally held by those
of the same subculture. There is a marked emotional investment.
Delusion – A false personal belief based on incorrect inference about external reality and
firmly sustained in spite of what almost everyone else believes and in spite of what
constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not
one usually held by those of the same subculture.
Delusional perception – A new and delusional interpretation is attached to a familiar and
real perception without any logical reason.
Thought alienation – The delusional belief that ones thoughts are under the control of an
outside agency, or that others are participating in one’s thinking. This includes thought
insertion, thought withdrawal and thought broadcast.
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 being removed from one’s
mind by an external agency.
Thought Broadcast – The delusional belief that your thoughts are being read by others, as
if they were being broadcast, or that one’s thoughts are being in some way transmitted to
others. For example, a patient believed that little men lived in the bushes opposite his
house who could hear his thoughts and they then shouted the thoughts so that everyone
in the village could hear them. So, that is not just thoughts being read, but really
broadcast.
Thought echo – A form of auditory hallucination in which the patient hears his thoughts
spoken out loud either simultaneously with them thinking it or a moment or two afterwards.
Thought blocking – A sudden interruption in the train of thought occurs, leaving a blank,
after which what was being said cannot be recalled.
Formal thought disorder – Disorder of the form of thought, usually recognised from speech
and writing but is sometimes evident from the patient’s behaviour.
Concrete thinking – A lack of abstract thinking, normal in childhood, and occurring in
adults with organic brain disease and schizophrenia.
 Dr R Clarke
www.askdoctorclarke.com
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Definitions compiled by Stephanie Reed
Loosening of association – Loss of normal structure of thinking. Patient’s discourse seems
muddled and illogical and does not become clearer when patient is questioned further.
Circumstantiality – Slow thinking incorporating unnecessary trivial details. The goal of
thought is finally, but slowly, reached.
Perseveration – (of speech and movement) Mental operations carry on beyond the point at
which they are appropriate. This term is usually used to describe repetition of a thought or
action or a type of response. In Alzheimer’s disease it commonly happens during the
MMSE – the patient is asked for the day of the week and they say “Wednesday”, then
they are asked what month it is and they say “Friday”.
Confabulation – Gaps in memory are (unconsciously) filled with false memories.
Somatic Passivity – The delusional belief that one is a passive recipient of bodily
sensations from an external agency.
Made Acts, Feelings and Drives – The delusional belief that one’s free will has been
removed and an external agency is controlling one’s actions, feelings or impulses. This is
another form of passivity.
Clouding of Consciousness – The patient is drowsy and does not react reliably to stimuli.
There is a disturbance of attention, concentration, memory, orientation and thinking.
Catatonia – A state of increased muscle tone affecting extension and flexion and
abolished by voluntary movement.
Stupor - A condition in which the patient is immobile, mute and unresponsive but appears
fully conscious. In that the eyes are usually open and follow external objects. If the eyes
are closed then the patient usually resists attempts to open them. Reflexes are normal and
resting posture is maintained.
Psychomotor retardation – In severe depression the patient walks and acts slowly.
Slowing of the thought is reflected in the patient’s speech; there is a long delay before
questions are answered, and pauses in conversation may be so long that they would be
intolerable to a non-depressed person.
Flight of ideas – The speech consists of a stream of accelerated thoughts, with abrupt
changes from topic to topic and no central direction. The connection between the thoughts
may be based on chance relationships, verbal associations (e.g. alliteration and
assonance), clang associations and distracting stimuli.
Pressure of speech – Increased quantity and rate of speech, which is hard to interrupt.
The defining feature of pressure is that it is difficult to get a word in edge-ways!
Anhedonia – Loss of enjoyment in life, activities and hobbies
Incongruity of affect - The patient’s mood does not match the patient’s circumstances and
thoughts.
Blunting – Reduced reactivity of mood
Belle indifference – The lack of concern about disability and the prospect for recovery. It
maybe a clinical feature of hysterical disorders.
 Dr R Clarke
www.askdoctorclarke.com
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Definitions compiled by Stephanie Reed
Depersonalisation – The patient feels that s/he is altered or not real in some way.
Derealisation – The surroundings do not seem real.
Conversion – Introduced by Freud for the conversion of distress into physical symptoms
and which he proposed as the fundamental mechanism in hysteria. Used now as a
diagnostic category to replace hysteria.
Dissociation – A mechanism whereby psychological processes relating to consciousness
are split or fragmented. Also dissociative symptoms and a personality trait.
Mannerism – Repeated involuntary movements that appear to be goal directed.
Stereotyped behaviour – A repeated regular fixed pattern of movement or speech that is
not goal directed.
Obsession – Repetitive senseless thoughts, recognised by the patient as being irrational
which, at least initially, are unsuccessfully resisted.
Compulsion – Repetitive, stereotyped, seemingly purposeful behaviour that is the motor
component of obsessional thoughts. Examples are checking and cleaning rituals.
Bibliography / Further Reading
Cameron A, Akhtar M , Bloye D, Davies S (2004) Crash Course Psychiatry
London: Mosby
Gelder M, Cowen P, Harrison P (2006) Shorter Oxford Textbook of Psychiatry
Oxford: OUP
Gelder M, Lopez-Ibor J, Andreason N (2003) New Oxford Textbook of Psychiatry
Oxford: OUP
Katona C, Robertson M (2000) Psychiatry at a Glance. Oxford: Blackwell
Laking P, Treasaden I, Puri, K (2002) Textbook of Psychiatry. London: Churchill
Livingstone
Semple D, Smyth R, Burns J, Darjee R, McIntosh, A (2005) Oxford Handbook of
Psychiatry. Oxford: Oxford University Press
Please Note
These notes were compiled by Stephanie Reed as a medical student in 2004. They are
presented in good faith and every effort has been taken to ensure their accuracy.
Nevertheless, medical practice changes over time and it is always important to check the
information with your clinical teachers and with other reliable sources. Disclaimer: no
responsibility can be taken by either the author or publisher for any loss, damage or injury
occasioned to any person acting or refraining from action as a result of this information.
 Dr R Clarke
www.askdoctorclarke.com
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