Glossary of Psychiatric Terms

Alexithymia

an inability to identify and describe one’s emotions (emotional blindness); considered to be a personality trait

Anhedonia

an inability to experience pleasure

Anosognosia

lack of insight into one’s own illness and its effects (this isn’t disagreeing with one’s diagnosis, but rather a lack of self-awareness); it is often a symptom of illness

Avolition

an inability to initiate and persist in goal-directed activities

Confabulation

the unconscious filling in of memory gaps by imagined events that doesn’t involve intentional lying. It can be caused by traumatic brain injury.

Depersonalization

a form of dissociation in which the self doesn’t feel real, which may include a feeling of looking at the self from a detached perspective

Derealization

this involves a sense that one’s surroundings aren’t fully real, and may feel like looking out at the world through a barrier; a form of dissociation

Ego-dystonic

thoughts that are unwanted and inconsistent with what someone normally believes when they are well

• Euthymic

• Expansive

• Incongruent

• Labile

• Restricted/blunted/flat

words to describe affect:

Euthymic

an expression of emotion that is neutral or “normal”

Affect

it refers to the facial expression of emotions

Expansive

an expression of feelings that is unrestrained

Incongruent

an expression of emotion that doesn’t match the reported mood, e.g., smiling while reporting feeling sad

Labile

an expression of rapidly changing one emotion to another, such as crying one minute and smiling brightly the next.

Restricted/blunted/flat

refers to decreased facial expressiveness. From mild to almost no emotional expression

• Catatonia

• Echopraxia

• Psychomotor agitation

• Psychomotor retardation

words to describe changes in movement:

Catatonia

markedly disrupted physical reactivity to the environment

Stupor

lack of psychomotor activity, unreactive to the environment

Catalepsy

fixed, rigid posture held against gravity

Waxy flexibility

allows limbs to be moved into positions, and then holds them there

Mutism

lack of verbal responsiveness

Negativism

Not responding to instructions and may actively oppose attempts to be moved

Echopraxia

imitation of movement that can be part of catatonia

Psychomotor Agitation

unintentional, purposeless movement, such as hand wringing or pacing

Psychomotor Retardation

slowing of thoughts and movement that can be seen in major depressive episodes

• Alogia

• Dysprosody

• Echolalia

• Logorrhea

• Pressured Speech

words to describe disturbances in speech

Alogia

lack of speech, implying impoverished thinking; can involve a decreased amount of speech production (may be referred to as poverty of speech) or a lack of content (may be referred to as poverty of thought)

Dysprosody

abnormal rhythm of speech

Echolalia

imitation of words/sounds

Logorrhea

(voluble speech); excessive amounts of speech. Colloquial term: verbal diarrhea

Pressured Speech

speech that is very rapid and difficult to interrupt; a common symptom in mania

Suicidal Ideation (SI)

refers to thoughts of suicide

Active (SI)

thoughts of acting to take one’s life; may or may not have a specific plan, and the intent to act on those thoughts can be variable

Passive (SI)

wishing to die, but not thinking about doing something to make that happen

Delusions

fixed beliefs that can’t be budged with evidence to the contrary and are not accounted for by culturally accepted beliefs and interfere with one’s ability to interact with reality.

• Capgras

• Delusions of control

• Erotomanic

• Grandiose

• Ideas of reference

• Paranoid/persecutory

• Religious

• Somatic

Types of delusions:

Capgras

believing that people have been replaced by imposters

Delusions of Control

belief that one’s thoughts are controlled by outside forces

Thought Broadcasting

believing that one’s thoughts can be heard by other people

Thought Insertion/Thought Withdrawal

believing that thoughts are being put into or taken out of one’s head

Erotomanic

believing that one is in a romantic relationship that doesn’t actually exist, often with a famous person

Grandiose

an inflated self, abilities, and connections that reaches delusional proportions, such as the belief that one is a key advisor to a major political figure.

Ideas of Reference

interpreting messages as being particularly directed at oneself, including things on billboards, tv, or radio; for example, something on a news broadcast might be perceived as containing a hidden message directed specifically at the individual.

Paranoid/Persecutory

occurs when someone believes others are out to harm them despite evidence to the contrary. These delusions may be further described as non-bizarre (within the realm of possibility, like being monitored by the government) or bizarre (aliens trying to enter their home via the cat door to steal their right foot).

Religious

delusions such as that one is Jesus, that are a departure from an individual’s beliefs when non-psychotic, and are not in keeping with the accepted beliefs of their religious community

Somatic

false beliefs about things that are happening in one’s body, ranging from something non-bizarre like cancer to something bizarre, like believing one’s stomach is filled with dancing turtles

• Bizarre/non-bizarre

• Delusional proportions

• Mood-congruent

• Overvalued ideas

words to describe delusions

Bizarre

delusions that are very removed from the realm of possibility, such as aliens entering one’s home every night through the water pipes and removing one’s toes to implant them in one’s brain

Non-bizarre

delusions that are within the realm of possibilities, such as the government watching one’s every move.

Delusional Proportions

this refers to experiences, such as guilt or obsessions, that may be or may have been experienced non-psychotically, but they have intensified enough that they have reached the strength of delusions

Mood-congruent

people experiencing mood episodes may experience delusions that match their mood, such as delusions of guilt during a depressive episode or grandiose delusions during a manic episode

Overvalued Ideas

these are beliefs that someone is quite fixed on, but not to the extent that are delusional

• Auditory (AH)

• Gustatory

• Olfactory

• Tactile

• Visual (VH)

• Hypnogogic

• Hypnopompic

• Command hallucinations

• Responding to internal stimuli

Types of hallucinations:

Auditory (AH)

hallucinations involving sound — may be voices or other sounds, familiar or unfamiliar voices, and single voices at a time or more than one voice conversing

Gustatory

hallucinations involving taste

Olfactory

hallucinations involving odors

Tactile

hallucinations involving the sense of touch, such as bugs crawling on the skin

Visual (VH)

“seeing things”; these are less common than auditory hallucinations, and may indicative of a physical (“organic”) problem within the brain

Hypnogogic

these occur during the transition from awake to sleep and aren’t considered psychotic in nature.

Hypnopompic

these are similar to hypnogogic hallucinations, but happen while waking (is also considered normal rather than psychotic)

Command Hallucinations

these are hallucinations that instruct people to perform certain acts, which may involve harming the self or others

Responding to internal stimuli

This is sometimes used to describe someone who appears to be responding to hallucinations, such as if they appear to be listening to auditory hallucinations or talking back to them. They’re coming from within the mind rather than coming from the external environment via the senses. While many people talk to themselves, listening to someone who’s responding to internal stimuli sounds like you’re hearing only half of a conversation.

• circumstantiality

• clanging

• concrete

• loose associations

• neologisms

• overinclusive

• perseveration

• poverty of thought

• tangentiality

• word salad

words to describe thought form/thought process:

Circumstantiality

wandering away from the original idea, but eventually returning to it; like beating around the bush

Clanging

grouping unrelated words based on sound (such as rhyming) in a non-meaningful way

Concrete

This involves very literal interpretation of information, and can be tested by asking a patient to interpret proverbs, e.g. “it ain’t over til the fat lady sings” might be interpreted as an obese woman needing to sing O Sole Mio before something could be considered finished

Loose Associations

connecting ideas that seem to be totally unrelated

Neologisms

making up new words; in a psychiatric context, this refers specifically to words that arise due to thought disorder rather than intentional coining of new terms

Overinclusive

excessive, unnecessary amounts of detail

Perseveration

repeatedly returning to the same topic, and may be very difficult to redirect away from that topic

Poverty of thought

a cognitive symptom that reflects a slowed or diminished capacity to generate ideas.

Tangentiality

going off on a tangent that may be only slightly related, and losing the original idea, never to return to it again; often seen in mania

Word Salad

words put together in a completely incoherent manner, e.g “The purple Christmas fish road living pie.”

Alexithymia

Situation: Rohan’s partner asks him why he seems distant lately. Rohan pauses and says, “I don’t know. Nothing is wrong.” When pressed further, he mentions feeling tired and having frequent stomach aches, but he cannot explain what he feels emotionally. He changes the topic and talks about his work schedule instead.

Anhedonia

Situation: Neha used to enjoy listening to music and meeting her friends. Lately, even when she tries to do these activities, she feels nothing. She says, “I know these things used to make me happy, but now they don’t feel enjoyable or exciting at all.” She participates less, not because she is busy, but because nothing feels rewarding.

Anosognosia

Situation: After a stroke, Mr. Kumar is unable to move his left arm. When the doctor explains this to him, he insists, “There’s nothing wrong with me. My arm is fine.” Even when asked to lift it and failing, he appears confused and denies having any problem.

Avolition

Situation: Sameer spends most of his day lying in bed. He knows he should bathe, eat, or apply for jobs, but says, “I just can’t get myself to start.” Tasks are left unfinished, not because of sadness or tiredness, but due to a lack of motivation.

Confabulation

Situation: After a head injury, Mr. Adams is asked why he missed his appointment. He confidently replies, “I was meeting an old friend from college,” even though he has actually been in the hospital all day and has no memory of any such event.

Depersonalization

Situation: Riya says, “I feel like I’m watching myself from outside my body. My voice doesn’t feel like it’s mine, and I feel emotionally numb, like I’m not real.”

Derealization

Situation: While walking in a familiar street, Aman feels that everything around him looks strange and unreal. He says, “It feels like I’m in a dream or a movie, even though I know the world hasn’t changed.”

Ego-Dystonic

Situation: Shalini experiences repeated intrusive thoughts about harming loved ones. She feels distressed and ashamed by these thoughts and says, “These thoughts are not like me at all, and I wish they would stop.”

Euthymic

Situation: During a routine interview, Rahul speaks calmly and appropriately. He reports no persistent sadness or excessive happiness, and his emotional responses fit the situation.

Congruent

Situation: When talking about a recent failure, Neha’s face looks sad, her voice is slow, and she avoids eye contact. Her emotions are visible through her expression and tone.

Expansive

Situation: During the interview, Karen speaks rapidly, laughs loudly, uses grand gestures, and is overly friendly with the examiner, even in a formal setting.

Incongruent

Situation: Claire smiles and laughs while describing the recent death of her neighbor, despite the topic being sad.

Labile

Situation: During a short conversation, Ramesh suddenly shifts from laughing to crying and then to anger, with no clear reason for the changes.

Restricted/Blunted/Flat

Situation: Pooja’s facial expressions are limited, but she shows some emotional reaction when talking about important personal events.

Restricted/Blunted/Flat

Situation: Amit speaks in a monotone voice with very little facial expression, even when discussing emotional experiences.

Restricted/Blunted/Flat

Situation: During the entire interview, Sunil shows no facial expression or emotional reaction at all. His voice remains completely monotone regardless of the topic.

Echopraxia

Situation: During an interview, whenever the examiner crosses his legs or scratches his head, the patient immediately imitates the same movements without being asked.

Psychomotor Agitation

Situation: The patient is unable to sit still, constantly pacing the room, wringing his hands, and repeatedly getting up during the interview.

Psychomotor Retardation

Situation: The patient walks slowly, takes a long time to respond to questions, and moves with great effort, appearing slowed in both speech and actions.

Stupor

Situation: The patient lies motionless in bed, does not speak, and fails to respond to verbal commands, responding only minimally to painful stimuli.

Catalepsy

Situation: The examiner places the patient’s arm in an awkward raised position, and the patient maintains that posture for a prolonged period without resistance or discomfort.

Waxy Flexibility

Situation: When the examiner gently moves the patient’s arm, it feels slightly resistant at first but then stays exactly in the new position, like bending soft wax.

Mutism

Situation: Despite being awake and alert, the patient does not speak at all during the interview, even though there is no physical problem with speech.

Negativism

Situation: When asked to sit down, the patient stands up; when asked to open his mouth, he tightly closes it, showing resistance without a clear reason.

Alogia

Situation: During the interview, the patient gives very brief, one-word answers and often pauses for a long time, despite questions that normally require longer responses.

Dysprosody

Situation: The patient speaks in a flat, robotic tone with inappropriate changes in pitch and stress, making emotional content hard to recognize.

Echolalia

Situation: When asked, “How are you today?” the patient replies, “How are you today… today…,” repeating the examiner’s words instead of answering.