DSM-5-TR - Ch.2 Vocabulary

Psychosis

A state in which a person is out of touch with reality; can have many causes.

Delusion

A false belief that cannot be explained by the patient's culture or education and that the patient cannot be persuaded to reject, despite evidence or the weight of other people's opinions to the contrary.

Erotomanic delusion

Someone, often of higher social station, is in love with the person.

Grandeur delusion

A person is someone of exalted station, such as God or a movie star, or is hugely talented or insightful; some express the idea that they have a special relationship with a prominent person, or even are themselves famous.

Guilt delusion

An individual has committed an unpardonable sin or grave error.

Jealousy delusion

A spouse or partner has been unfaithful.

Nihilism delusion

The person is dead, obliterated, perhaps rotted, no longer an existing human being.

Passivity delusion

A person is being controlled or manipulated by some outside influence, such as radio waves.

Persecution delusion

An individual is being hounded, followed, or otherwise interfered with.

Poverty delusion

Contrary to evidence, the person faces destitution.

Reference delusion

The person interprets the gestures or comments of others or ordinary occurrences in the environment as having special personal meaning.

Somatic delusion

A person has a dread disease or altered body functions, or offensive body odor.

Thought control delusion

Others are putting thoughts or ideas into a person's mind.

Overvalued ideas

Beliefs that are not clearly false but continue to be held despite lack of proof that they are valid.

Hallucination

A false sensory perception that occurs in the absence of a related sensory stimulus; nearly always abnormal and can affect any of the five senses.

Hypnagogic hallucination

A hallucinatory experience that occurs when someone is falling asleep; common and normal, better referred to as imagery.

Hypnopompic hallucination

A hallucinatory experience that occurs when someone is awakening; common and normal, better referred to as imagery.

Illusion

A misinterpretation of actual sensory stimuli; typically occurs during conditions of decreased sensory input and usually carries no diagnostic weight.

Charles Bonnet syndrome

People who have significant loss of vision see complex visual imagery but with full realization that the experience is unreal.

Disorganized thinking

With or without delusions or hallucinations, mental associations governed not by logic but by rhymes, puns, and other rules not apparent to the observer, or by no evident rule at all; also called loose associations.

Loose associations

Another name for disorganized thinking.

Derailment

Two thoughts run together; an example of disorganized speech.

Disorganized behavior

Physical actions that do not appear to be goal-directed, such as disrobing in public, repeatedly making religious signs, or assuming and maintaining peculiar and often uncomfortable postures.

Negative symptoms

Reduced range of expression of emotion, markedly reduced amount or fluency of speech, and loss of the will to do things.

Flat or blunted affect

Reduced range of expression of emotion.

Avolition

Loss of the will to do things.

Catatonia

A specifier denoting behaviors that apply not just to schizophrenia but to mood disorders and physical illnesses.

Catatonia associated with another mental disorder

Patients have three or more of several characteristics of motor behavior; the specifier can be applied to disorders that include psychosis, mood disorders, autistic spectrum disorder, and other medical conditions.

Agitation

Excessive motor activity that appears to have neither a purpose nor an external cause.

Stupor

More or less the polar opposite of agitation; markedly reduced mobility.

Catalepsy

Maintaining an uncomfortable posture, even when told it is not necessary to do so.

Echolalia

Verbatim repetition of someone else's words when a different response is indicated.

Echopraxia

Imitating another person's physical behavior, even when asked not to do so.

Exaggerated compliance

At the slightest touch, moving in the direction indicated by another person; the old German term is mitgehen.

Grimace

A facial contortion not made in response to a noxious stimulus.

Mannerisms

Repeated movements that seem to have a goal but are excessive for the purpose.

Mutism

Absence or paucity of speech despite evident physical ability to speak.

Negativism

Without apparent motive, the patient resists passive movement or repeatedly turns away from the examiner.

Posturing

Voluntarily assuming an unnatural or uncomfortable pose.

Stereotypy

Repeated movement that is a nonessential part of goal-directed behavior.

Waxy flexibility

Active resistance when an examiner tries to change the patient's position, similar to bending a rubber or soft wax rod.

Psychological pillow

A form of posturing in which the patient holds the head unsupported above the mattress.

Retarded catatonia

Catatonic symptoms more likely in a patient with another medical condition; include posturing, catalepsy, and waxy flexibility; patients may also drool, stop eating, or become mute.

Schizophrenia

For at least 6 months, these patients have had two or more of these five types of psychotic symptom: delusions, disorganized speech, hallucinations, negative symptoms, and catatonia or other markedly abnormal motor behavior; significant mood disorders, substance use, and general medical conditions are ruled out as causes.

Schizophrenia spectrum

The spectrum of disorders that includes schizophrenia and related psychotic disorders.

Prodromal period

A period before becoming clinically ill characterized by abnormalities of thought, language, perception, and motor behavior that do not rise to the level of psychotic symptoms.

Premorbid personality

A withdrawn or otherwise peculiar personality present from earliest years in some patients.

Residual symptoms

Once acute psychotic symptoms have been treated, milder manifestations of the person's earlier delusions or other active psychotic symptoms may persist.

Cross-sectional symptoms

The symptoms a person is showing right now.

Course of illness

The longitudinal patterns and associated features of the disorder; includes duration, precipitating factors, previous course, premorbid personality, and residual symptoms.

Duration

How long the patient has been ill; at least 6 months is required for a DSM-5-TR diagnosis of schizophrenia.

Precipitating factors

Severe emotional stress sometimes precipitates a brief period of psychosis.

Previous course of illness

A prior history of complete recovery from a psychosis suggests a relatively good outcome for a later episode.

Family history of illness

A close relative with schizophrenia increases the patient's chances of having schizophrenia; bipolar I disorder with psychotic features also runs in families.

Response to medication

Previous recovery with lithium treatment suggests a diagnosis of mood disorder.

Age at onset

Schizophrenia usually begins by a person's mid-20s; onset of illness after age 40 suggests some other diagnosis.

Bizarre delusions

Clearly implausible and not understandable to same-culture peers and not derived from life's ordinary experiences.

Nonbizarre delusions

Examples include being spied upon by neighbors or being betrayed by one's spouse.

Schizophreniform Disorder

The cross-sectional appearance is that of typical schizophrenia, but the patient has been ill for only 1 to 6 months; some later recover completely with no residual effects.

Brief Psychotic Disorder

Patients are psychotic for at least 1 day and return to baseline within 1 month; at least one of delusions, hallucinations, disorganized speech, or disorganized behavior is present.

With peripartum onset

Specifier for brief psychotic disorder; symptoms begin within 4 weeks of giving birth.

With marked stressors

Specifier for brief psychotic disorder; the stressors must appear to cause the symptoms, must occur shortly before symptom onset, and must be severe enough that nearly anyone would feel markedly stressed.

Delusional Disorder

Persistent delusions are the chief characteristic; behavior isn't much altered outside of responding to the delusions; delusions need last only 1 month and no other psychotic symptoms are present.

Shared delusions

A situation in which others develop delusions because of close association with another delusional person.

Shared psychotic disorder

DSM-IV term for shared delusions; also known as folie à deux.

Folie à deux

Madness for two; shared psychotic disorder.

Capgras phenomenon

Patients believe that close associates have been replaced by exact doubles.

Schizoaffective Disorder

During a continuous period of illness the person has principal symptoms of schizophrenia that coexist with those of a major depressive or manic episode; for at least 2 weeks delusions and/or hallucinations exist without a mood episode; the mood episode is present for over half of the total duration of the illness.

Substance/Medication-Induced Psychotic Disorder

Psychoses caused by mind-altering substances; predominant symptoms are typically hallucinations or delusions, which can occur during withdrawal or acute intoxication.

Psychotic Disorder Due to Another Medical Condition

Through physiological means, a medical condition appears to have caused an illness that features obvious hallucinations or delusions.

Catatonic Disorder Due to Another Medical Condition

Through physiological means, a medical condition appears to have caused an illness that features symptoms of catatonia, with at least three such symptoms.

Other Specified Schizophrenia Spectrum and Other Psychotic Disorder

Use this category when you want to write down the specific reason your patient cannot receive a more definite psychotic disorder diagnosis.

Unspecified Schizophrenia Spectrum and Other Psychotic Disorder

For symptoms or syndromes that don't meet guidelines for any of the disorders described earlier, and you do not wish to specify a reason.

Unspecified Catatonia

Mentioned when the context is unclear or there is insufficient detail for a more precise diagnosis.

Attenuated psychosis syndrome

A patient has psychotic symptoms that do not meet the full criteria for any psychotic disorder; symptoms tend to be brief and less disabling, with relatively good insight.

Persistent auditory hallucinations

The patient experiences repeated auditory hallucinations without other symptoms.

Delusional symptoms in the context of relationship with an individual with prominent delusions

Most people who develop delusions in response to close association with someone who is independently psychotic can be diagnosed as having delusional disorder; those who don't fulfill criteria for delusional disorder can be classified here.

Good prognostic features

For schizophreniform disorder: psychotic symptoms begin early, confusion or perplexity at peak of psychosis, good premorbid functioning, and affect not blunted.

Provisional

Qualifier appended when the diagnosis is made without waiting for recovery.

Hebephrenic schizophrenia

Disorganized schizophrenia; originally termed hebephrenia because it began early in life; patients can appear the most obviously psychotic of all, deteriorate rapidly, talk gibberish, and neglect hygiene and appearance.

Disorganized schizophrenia

Former subtype; more recent research has determined that the pattern of symptoms doesn't predict enough to make disorganized schizophrenia a useful diagnostic subcategory.

Catatonic type

Former schizophrenia subtype; catatonia has now been demoted to a specifier.

Paranoid type

Former schizophrenia subtype; no longer used.

Undifferentiated

Former schizophrenia subtype; now everyone's diagnosis is undifferentiated.

Residual type

Old diagnosis essentially equated to the course specifier of partial remission.

Endogenous psychoses

Psychoses that have no evident external cause.

Alcoholic auditory hallucinations

A disorder of withdrawal that typically occurs only after weeks or months of heavy drinking; psychosis with auditory hallucinations.

Delirium

Can have hallucinations or delusions; must be ruled out.

Major neurocognitive disorder

Can have hallucinations or delusions.

Mood disorder with psychosis

Severe major depressive episode or manic episode can experience hallucinations and mood-congruent delusions.

Schizoid personality disorder

Pattern including no close friends, not desiring relationships, choosing solitary activities, lack of pleasure in activities, and no sexual experiences.

Schizotypal personality disorder

Features include constricted affect, no close friends, odd beliefs, peculiar appearance, and suspiciousness.

Somatic symptom disorder

Patients may report pseudohallucinations or pseudodelusions.

Factitious disorder imposed on self

Patients may feign delusions or hallucinations to obtain hospital or other medical care.

Malingering

Some people feign delusions or hallucinations to obtain money, avoid work, or escape from punishment.

Specific phobia

Some phobic avoidance behaviors can appear quite strange without being psychotic.

Intellectual developmental disorder

Patients may at times speak or act bizarrely.

Delusional disorder, jealous type

A subtype of delusional disorder in which the patient believes a spouse or partner has been unfaithful.

Delusional disorder, persecutory type

By far the most common subtype of delusional disorder.

Delusional disorder, grandiose type

A common subtype of delusional disorder.