Psychiatry Flashcards

1
Q

Affect

A

expression of an experience of an emotion

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2
Q

Blunting of affect

A

an objective absence of normal emotional responses, without evidence of depression or psychomotor retardation

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3
Q

Loss of affect

A

a subjective sense of inability to feel deeply about anything or anyone

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4
Q

Incongruity of affect

A

objectively, emotional responses seem grossly out of tune with the situation or with the subject being discussed

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5
Q

Agitation

A

a state of motor restlessness with a background of anxiety, especially seen in depression

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6
Q

Psychic ambivalence

A

conflicting emotions or attitudes towards an object, person or idea

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7
Q

Physical ambivalence

A

abnormal psychomotor state seen in schizophrenia and some organic disorders, in which the patient physically vacillates between two opposing courses of action

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8
Q

Amnesia

A

loss or impairment of memory, whether psychogenic or due to cerebral disturbance

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9
Q

Anxiety

A

a state consisting of psychic (dread, apprehension, fear) and sometimes somatic (palpitations, tremor, dry mouth, loose stools) symptoms

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10
Q

Apathy

A

emotional indifference and lack of activity, often associated with a sense of futility

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11
Q

Autism

A
  • a form of thinking in which the individual withdraws from the real world to a private world of their own, monopolising their interest and attention
  • objectivity is lacking and there is a complete disregard of reality
  • serves to gratify unfulfilled desires and takes the form of daydreams, fantasies and delusions
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12
Q

Catalepsy

A

the patient maintains a fixed posture that can be changed by the examiner without any resistance

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13
Q

Catatonia

A

a state of excited or inhibited motor activity in the absence of mood disorder or neurological disease

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14
Q

Waxy flexibility

A
  • type of catatonia
  • the patients limbs feel like wax or lead when moved, and remain in position when they are left
  • found rarely in schizophrenia and structural brain disease
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15
Q

Echolalia

A
  • type of catatonia
  • automatic repetition of words heard
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16
Q

Echopraxia

A
  • type of catatonia
  • automatic repetition of movements made by the examiner
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17
Q

Logoclonia

A
  • type of catatonia
  • repetition of the last syllable of a word
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18
Q

Negativism

A
  • type of catatonia
  • the patient does exactly the opposite of what is required
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19
Q

Palilalia

A
  • type of catatonia
  • repetition of a word with increasing frequency
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20
Q

Verbigeration

A
  • type of catatonia
  • repetition of one or several sentences or strings of fragmented words, often in a monotonous tone
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21
Q

Cataplexy

A

abrupt loss of muscle tone leading to the patient falling to the floor; a frequent accompaniment to narcolepsy

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22
Q

Circumstantiality

A
  • irrelevant wandering in conversation
  • talking at great length around the point
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23
Q

Compulsion

A
  • repetitive, apparently purposeful behaviour performed in a stereotyped way and accompanied by a subjective sense that it must be carried out despite the recognition of its senselessness and often resistance by the patient
  • recognised as morbid by the patient
  • often associated with an obsession
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24
Q

Confabulation

A

giving a false account to fill a gap in memory

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25
Q

Conversion

A

unconscious mechanism of symptom formation that operates in conversion hysteria, or is the transposition of psychological conflict into somatic symptoms (which may be of motor or sensory nature)

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26
Q

Defence mechanism

A

a way of dealing with aspects of the self, which if consciously experienced, might give rise to unbearable anxiety or psychic pain

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27
Q

Déja vu

A

an intense feeling of having “been here before”

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28
Q

Delirium

A
  • acute confusional state
  • a syndrome due to brain disturbance and characterised by impairment of consciousness
  • mood in commonly one of terror and bewilderment, accompanied by transient delusions and hallucinatory experiences
  • following the episode there is more or less complete amnesia for external events that occurred during the illness
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29
Q

Delusions

A

false beliefs that are firmly held despite incontrovertible evidence to the contrary, and which are out of harmony with the individuals cultural and religious background

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30
Q

Primary delusions

A

delusions that arise “out of the blue”

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31
Q

Sudden delusional (autochthonous) ideas

A

delusional ideas suddenly entering consciousness “like a brainwave”, unrelated to previous real or psychic events

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32
Q

Delusional perception

A
  • a normal perception is suddenly interpreted in a delusional manner
  • a first rank symptom of schizophrenia
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33
Q

Delusional mood

A
  • a state of perplexity in which the patient has some sense of some inexplicable change in his environment
  • the patient senses “something going on” which he cannot identify, but which has a peculiar significance for him
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34
Q

Secondary delusions

A

delusions which arise from a morbid experience such as a hallucination

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35
Q

Depersonalisation

A
  • a feeling of some change in the self associated with a sense of detachment from one’s own body
  • perception fails to awaken a feeling of reality, actions seem mechanical and the patient feels like an apathetic spectator of their own activities
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36
Q

Depression

A
  • a subjective feeling of sadness, grief or dejection
  • the term can be used to describe a symptom and as a diagnostic label
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37
Q

Derealisation

A

a sense of one’s surroundings lacking reality, often appearing dull, grey and lifeless

38
Q

Denial

A

the patient refuses to recognise the reality of a traumatic perception

39
Q

Disorders of Form of Thinking (Formal Thought Disorder)

A
  • lack of logical association between successive thoughts
  • gives rise to incoherent speech (in the absence of brain pathology)
  • it is impossible to follow the patient’s train of thought
40
Q

Displacement

A

a defence mechanism where an idea’s emphasis, interest or intensity is liable to be detached from it and place onto other ideas which were originally of little intensity but are related to the first idea by chain of association

41
Q

Dissociation

A

process by which a mental structure loses its integrity and is replaced by two or more part-structures

42
Q

Dyskinesia

A
  • a wide variety of movement patterns e.g. choreoathetosis, rocking, pouting
  • wide range of causes e.g. drugs, schizophrenia, structural brain disease
43
Q

Emotional lability

A

fluctuation of emotions are more marked and intense than the circumstances might be expected to produce

44
Q

Flight of ideas

A

rapid skipping from one thought to distantly related ideas, the relation often being very tentative e.g. the sound of the utterances rhymes

45
Q

Forced grasping

A

patient repetitively and persistently takes the examiners hand whenever offered, might indicate dementia or chronic schizophrenia

46
Q

Fugue

A

a state of aimless wandering which is found in two conditions with different aetiologies: clouded consciousness, conversion disorder

47
Q

Clouded consciousness

A

the abnormal behaviour of the fugue state offers no psychological advantage for the patient

48
Q

Hallucination

A

a perception, indistinguishable from reality, occurring in the absence of an external stimulus

49
Q

Hypnagogic hallucination

A

hallucination occurring on falling asleep

50
Q

Hypnopompic hallucination

A

hallucination occurring on waking up

51
Q

Ideas of reference

A

patient incorrectly interprets remarks, incidents and eternal events as referring directly to themselves

52
Q

Delusion of reference

A

patient incorrectly interprets remarks, incidents and eternal events as referring directly to themselves (as in ideas of reference) but the value placed on the interpretation is of delusional intensity

53
Q

Illusion

A

misperception of a stimulus, usually occurring at times of environmental or personal dulling e.g. at night, when septic

54
Q

Identification

A

a defence mechanism where the patient assimilates an aspect of another person and is transformed, wholly or partially, in the model the other person provides

55
Q

Insight

A

four facets: morbid experiences are…

  • seen as abnormal
  • as the result of illness
  • as the result of a mental illness
  • open to medical intervention
56
Q

Intellectualisation

A

a defence mechanism consisting of an attempt to gain detachment from an emotionally threatening situation by dealing with it in abstract

57
Q

Introjection

A

a defence mechanism where, in fantasy, the patient transposes objects and their inherent qualities from the outside to the inside of themselves

58
Q

Jamais vu

A

feeling of strangeness in familiar surroundings, as though one had never been there before

59
Q

Malingering

A

conscious mimicry of physical disease to achieve material gain

60
Q

Mannerism

A

an ordinary gesture or expression that becomes abnormal through exaggeration or repetition

61
Q

Mood

A

pervasive and sustained emotion in the continuum between sad and happy

62
Q

Mutism

A

an inability (involuntary mutism) or unwillingness (elective mutism) to speak, resulting in the absence or marked paucity of verbal output

63
Q

Neologism

A
  • use of a word which holds no generally recognisable meaning in the given context
  • either completely new in form, the condensation of pre-existing words, or use of a known word given new meaning
  • found mainly in schizophrenia and structural brain disease
64
Q

Obsession

A

a recurrent persistent thought, image, or impulse that enters consciousness unbidden, is recognised as being ones own and often remains despite ones efforts to resist it

65
Q

Obsessive Compulsive Disorder (OCD)

A

an illness characterised by the presence of obsessions and/or compulsions

66
Q

Overvalued idea

A
  • an idea that takes disproportionate precedence in the individual’s mind despite its content which is often trivial
  • it is firmly held but may be swayed with considerable effort
67
Q

Paramnesia

A

inaccurate recall of memory

68
Q

Passivity phenomena

A
  • subjective experience that one’s thoughts and/or actions are being controlled by some external agency
  • found in schizophrenia
69
Q

Perseveration

A

repetition of a word, theme, or action beyond the point at which is was relevant and appropriate

70
Q

Phobia

A

an irrational, disproportionate fear or an object or situation leading to avoidance behaviour

71
Q

Pressure of speech

A
  • rapid rate of speech delivery
  • wealth of associations which may be unusual, e.g. rhymes and puns
  • often wandering from the point of the original conversation
  • highly suggestive of mania
72
Q

Projection

A

a defence mechanism where our own undesirable idea are perceived to reside in an exaggerated amount in others

73
Q

Psychomotor retardation

A
  • slowing of thoughts and movements to variable degrees
  • occurs in depression but also caused by psychotropics, PD etc
74
Q

Psychotic

A

symptoms which are qualitatively different to the normal experience (as opposed to quantitatively different, as in anxiety and depression)

75
Q

Rationalisation

A

a defence mechanism where the person attempts to present an explanation for their true motives, feelings, ideas, or actions, that is logical or socially acceptable

76
Q

Reaction formation

A

a defence mechanism where disturbing ideas are kept unconscious by the presence of strong opposing ideas in the consciousness

77
Q

Regression

A
  • a defence mechanism where there is a reversion to an earlier state or mode of functioning
  • the patient avoids psychic pain by returning to an earlier state of libidinal and ego development
78
Q

Repression

A

a defence mechanism where a threatening impulse or idea is excluded from the conscious awareness

79
Q

Reversal

A

a defence mechanism where the aim of an instinct is transformed into it’s opposite in the transition from activity to passivity

80
Q

First rank symptoms

A

A group of symptoms that Schneider proposed were diagnostic of schizophrenia (in the absence of overt brain disease):

  • specific auditory hallucinations (thought echo, two or more voices discussing the patient in the third person, voices that comment on the patient’s behaviour)
  • thought alienation
  • passivity phenomena
  • delusional perceptions
81
Q

Stereotypies

A
  • uniform, repetitive, non-goal-directed actions
  • may take a variety of forms from simple movements to utterances
  • usually ascribed to schizophrenia but can be due to organic disorder
82
Q

Stupor (Akinetic autism)

A
  • more or less total loss of activity with no response to stimuli
  • may mark a progression of motor retardation
  • found in a range of neurological and psychiatric conditions
83
Q

Sublimation

A

human activities and pursuits which have no apparent connection with sexuality but are assumed to be motivated by the force of sexual instinct

84
Q

Thought broadcasting

A

the experience of thoughts escaping from he boundaries of the self and being known to others, even strangers and people some distance away

85
Q

Thought alienation

A

The collective name for the group of symptoms which includes:

  • thought insertion
  • thought withdrawal
  • thought broadcasting
86
Q

Thought block

A
  • objective phenomenon in which the patient abruptly breaks off their conversation and is silent for a few seconds and then resumes on a different topic
  • subjectively they experience a cessation of all thought
87
Q

Thought echo

A

a form of auditory hallucination in which a patient hears their thoughts spoken aloud either simultaneous to, or within a few moments of, thinking them

88
Q

Thought insertion

A

subjective feeling that the thoughts in one’s mind are not one’s own, often explained by the secondary delusion that they are inserted by an external agency

89
Q

Thought withdrawal

A

subjective feeling that thoughts are missing from one’s mind, often explained by the secondary delusion that the thoughts are being extracted by an external agency

90
Q

Twilight state

A

a chronic state of clouding of consciousness that lasts for several hours to several weeks

91
Q

Undoing

A

a defence mechanism that is an action designed to prevent of atone some unacceptable thought or impulse

92
Q

Word salad

A
  • sometimes called schizophasia
  • speech is an incomprehensible jumble of words recounted with normal intonation
  • apart from language use, the patient is usually reasonably capable