ABPN C-L Psychiatry key terms

An acute, fluctuating disturbance of attention and awareness with altered cognition, usually caused by a medical condition, medication, or substance. It develops over hours to days and represents a medical emergency requiring identification and treatment of the underlying cause.

A neuropsychiatric syndrome marked by abnormal motor, vocal, and behavioral signs such as stupor, mutism, posturing, negativism, rigidity, and waxy flexibility. It occurs with mood disorders, psychosis, and medical or neurologic illness and often responds to benzodiazepines or electroconvulsive therapy.

The clinical determination that a patient can understand relevant information, appreciate how it applies to themselves, reason about options, and communicate a choice. It is task-specific and assessed by clinicians, unlike legal competence, which courts determine.

A brief structured bedside tool for detecting delirium. It identifies delirium when acute onset and fluctuating course plus inattention are present, along with either disorganized thinking or altered level of consciousness.

A rare, potentially fatal reaction to dopamine antagonists characterized by hyperthermia, severe rigidity, autonomic instability, and altered mental status, with elevated creatine kinase. Treatment includes stopping the offending agent, supportive care, and sometimes dantrolene or bromocriptine.

A toxic state from serotonergic drugs marked by mental status change, autonomic hyperactivity, and neuromuscular abnormalities such as clonus, hyperreflexia, and tremor. It ranges from mild to life-threatening; treatment is discontinuation of agents and supportive care, with cyproheptadine used in some cases.

Lengthening of the heart-rate-corrected QT interval on electrocardiogram, which raises risk of torsades de pointes. Many psychotropics, especially some antipsychotics and antidepressants, prolong QTc; risk increases with cardiac disease, electrolyte abnormalities, and interacting drugs.

Blocking of hepatic drug-metabolizing enzymes by one drug, slowing clearance of another and raising its blood level. Potent inhibitors such as fluvoxamine, fluoxetine, and paroxetine can cause toxicity when combined with narrow therapeutic index substrates.

Measurement of plasma drug concentrations to guide dosing, especially for medications with narrow therapeutic ranges, nonlinear kinetics, or significant interaction risk. Examples include lithium, valproate, clozapine, and tricyclic antidepressants.

A somatic treatment using brief, controlled seizures under anesthesia to treat severe major depression, catatonia, and other conditions. It is effective in medically ill patients and requires preprocedure risk assessment, especially for cardiac and neurologic disease.

Primitive reflexes such as grasp, snout, and glabellar signs that reappear when frontal lobe pathways are impaired. They suggest diffuse or frontal brain dysfunction but are nonspecific and may occur with delirium, dementia, and normal aging.

A brief cognitive screening instrument covering attention, executive function, memory, language, visuospatial ability, and orientation. It is more sensitive than the Mini-Mental State Examination for mild cognitive impairment but must be interpreted in light of education and sensory deficits.

A condition in which psychological distress is expressed through persistent bodily symptoms that cause significant impairment and excessive health-related thoughts, feelings, or behaviors. Symptoms need not be medically unexplained; the diagnosis centers on disproportionate response to symptoms.

Intentional production or feigning of symptoms to assume the sick role, without external gain. It differs from malingering, which seeks tangible rewards, and from somatic symptom disorder, in which symptom production is not deliberate.

Deliberate fabrication or exaggeration of symptoms for identifiable external incentives such as money, drugs, avoiding work, or legal advantage. It is a behavior or condition, not a psychiatric diagnosis, and should be considered when presentation and context suggest secondary gain.

A severe alcohol withdrawal syndrome occurring roughly 48 to 96 hours after cessation, with confusion, agitation, hallucinations, tremor, and autonomic instability. It is life-threatening and requires benzodiazepines, supportive care, and treatment of complications.

A structured scale quantifying alcohol withdrawal severity across tremor, sweating, anxiety, agitation, perceptual disturbances, and autonomic signs. Scores guide symptom-triggered benzodiazepine dosing and help identify patients at risk for seizures or delirium tremens.

Calculation of an equivalent dose when switching opioids, using standard potency ratios to preserve analgesia while avoiding withdrawal or toxicity. Cross-tolerance is incomplete, so clinicians typically reduce the calculated dose and reassess.

An opioid antagonist that rapidly reverses respiratory depression and overdose. It is titrated to restore breathing without precipitating severe withdrawal, and repeated or continuous dosing may be needed because its duration is shorter than many opioids.

A partial mu-opioid agonist used for opioid use disorder and pain. It has high receptor affinity, a ceiling effect on respiratory depression, and can precipitate withdrawal in patients with full agonists on board; induction requires planning.

The use of sedating medications to relieve refractory distress at the end of life, with the goal of comfort rather than hastening death. It requires informed consent, careful titration, and attention to existential and family concerns.

A person authorized to make medical decisions for a patient who lacks capacity, using substituted judgment or best-interest standards. Surrogates may be named in advance directives or identified by state law, often in a hierarchical order.

A process of providing information about diagnosis, proposed treatment, alternatives, and risks and benefits, then confirming the patient's voluntary authorization. It requires decisional capacity and is distinct from merely obtaining a signature.

Emergency legal detention of a person with mental illness who poses danger to self or others or is gravely disabled, permitting evaluation and treatment without consent. Criteria, duration, and review procedures vary by jurisdiction.

A legal obligation, recognized in many jurisdictions, for mental health clinicians to protect identifiable third parties from serious threats made by a patient. Actions may include warning the intended victim, notifying police, or taking other protective steps.

New or worsening physical, cognitive, or psychiatric impairment persisting after critical illness and ICU stay. It may include weakness, executive dysfunction, depression, anxiety, and posttraumatic stress, and requires longitudinal rehabilitation and support.

A pretransplant assessment of psychiatric stability, substance use, adherence, social support, and coping capacity to identify modifiable risks. It informs selection and posttransplant planning rather than serving as a simple pass-fail gate.

A rare but severe psychiatric emergency beginning shortly after childbirth, with mania, confusion, delusions, hallucinations, and risk of suicide or infanticide. It requires urgent inpatient treatment and often involves mood stabilizers, antipsychotics, and electroconvulsive therapy.

The weight-adjusted amount of maternal medication an infant receives through breast milk, expressed as a percentage of the maternal dose. Values below roughly 10 percent are generally considered low risk, though infant factors matter.

The capacity of an exposure to cause structural or functional harm to a developing fetus. Risk depends on timing, dose, and agent; valproate, lithium, and some anticonvulsants require particular caution in reproductive planning.

A stress-related syndrome of emotional or behavioral symptoms developing within months of an identifiable stressor and causing marked distress or impairment. It is not better explained by another mental disorder and typically resolves when the stressor remits.

Grief is a normative response to loss, with waves of sadness, yearning, and preoccupation that usually preserve self-esteem and function. Major depression is more persistent, pervasive, and functionally impairing, with anhedonia, worthlessness, and suicidality that may warrant treatment.

Occurrence of acute delirium in a patient with preexisting cognitive impairment. Because baseline deficits mask new changes, it is often missed and is associated with accelerated decline, longer hospitalization, and higher mortality.

Drug-induced movement abnormalities such as tremor, rigidity, bradykinesia, dystonia, and akathisia, usually from dopamine-blocking agents. They can mimic psychiatric or neurologic illness and may require dose reduction, anticholinergics, or a switch in medication.