Egyptian Board Psychiatry key terms

A structured clinical assessment of appearance, behaviour, speech, mood and affect, thought form and content, perception, cognition, insight and judgement, used to describe a patient's current psychiatric state and to track change over time.

Disturbance in the flow and organisation of thinking inferred from speech, including derailment, tangentiality, incoherence, neologisms and loosening of associations; historically rated with instruments such as the Thought and Language Index.

A patient's awareness of having an illness, of its nature and cause, and of the need for treatment. Poor insight is common in psychosis and predicts non-adherence, and is rated in scales such as the Schedule for Assessment of Insight.

A brief 30-point cognitive screening test covering orientation, registration, attention and calculation, recall, language and visuospatial construction. Scores are adjusted for education and age; it is insensitive to mild impairment and frontal dysfunction.

A 30-point screening instrument designed to detect mild cognitive impairment, with heavier weighting than the MMSE on executive function, attention, abstraction and delayed recall. A score below 26 is usually considered abnormal, adjusted for education.

An acute, fluctuating disturbance of attention and awareness with altered cognition, developing over hours to days, usually caused by a medical condition, drug intoxication or withdrawal. It is a medical emergency with high mortality and is frequently missed.

A group of psychotic phenomena described by Schneider, including audible thoughts, voices arguing or commenting, thought insertion, withdrawal and broadcasting, made feelings and impulses, and delusional perception, once regarded as strongly suggestive of schizophrenia.

A 30-item clinician-rated instrument with positive, negative and general psychopathology subscales, scored from 1 to 7 per item, widely used to measure symptom severity and treatment response in schizophrenia trials.

A late-onset, persistent hyperkinetic movement disorder of the mouth, tongue, face and sometimes limbs, associated with prolonged dopamine-blocking antipsychotic exposure. It may be irreversible and is assessed with the Abnormal Involuntary Movement Scale.

A rare, life-threatening reaction to dopamine antagonists marked by severe rigidity, hyperthermia, autonomic instability and altered consciousness, with raised creatine kinase. Management is drug withdrawal, supportive care, and agents such as dantrolene or bromocriptine.

A toxidrome caused by serotonergic excess, with clonus, hyperreflexia, agitation, tremor, diarrhoea and hyperthermia, usually of rapid onset after combining serotonergic drugs. Withdrawal of the offending agent and supportive care are the mainstays.

An atypical antipsychotic reserved for treatment-resistant schizophrenia, effective where other agents fail and reducing suicidality, but requiring regular blood monitoring because of agranulocytosis; it also risks myocarditis, seizures and severe constipation.

Schizophrenia that has not responded adequately to at least two different antipsychotics given at appropriate dose and duration with confirmed adherence. Clozapine is the evidence-based next step and should not be delayed by repeated trials of other drugs.

The extent to which a patient takes medication and follows agreed treatment as prescribed. It is assessed by history, pill counts, pharmacy records or plasma levels, and is improved by simplifying regimens and addressing side-effects and beliefs.

A depot or sustained-release antipsychotic formulation given intramuscularly every one to several weeks. It secures delivery of medication, removes covert non-adherence and reduces relapse, and is best offered rather than imposed.

An antidepressant that inhibits monoamine oxidase, raising noradrenaline, dopamine and serotonin. Irreversible forms require a low-tyramine diet and avoidance of serotonergic drugs because of hypertensive crisis and serotonin syndrome.

The induction of a controlled generalised seizure under anaesthesia and muscle relaxation to treat severe or psychotic depression, catatonia and life-threatening mania. It is the most effective acute treatment for severe depression.

A syndrome of abnormal psychomotor activity including stupor, mutism, posturing, waxy flexibility, negativism and excitement, occurring in psychotic, mood and medical disorders. Benzodiazepines and electroconvulsive therapy are the main treatments.

A mood stabiliser with antimanic and prophylactic action and evidence of anti-suicidal effect, requiring monitoring of renal function, thyroid function and plasma levels because of its narrow therapeutic index and toxicity risk.

A mood disorder defined by at least one manic episode, usually with depressive episodes that are often more frequent and disabling. It is distinguished from bipolar II disorder, which requires hypomania and never full mania.

A course specifier in bipolar disorder denoting at least four mood episodes in twelve months, with episodes separated by remission or a switch. It is more common in women and is often treatment-refractory.

A severe psychiatric emergency, usually beginning within two weeks of childbirth, with mania, confusion, delusions and hallucinations, and high risk of suicide and infanticide. It requires urgent admission and usually antipsychotic and mood-stabiliser treatment.

A patient's functional ability to make a specific decision, judged by understanding, retention, appreciation and reasoning. Capacity is decision-specific and time-specific, is presumed present, and is a legal rather than a clinical status.

Voluntary agreement to an intervention after receiving and understanding information about its nature, purpose, risks, benefits and alternatives. Valid consent requires capacity, adequate disclosure and absence of coercion.

The ethical and legal duty not to disclose information obtained in a clinical relationship without the patient's permission. It may be overridden where the law requires, such as risk of serious harm or statutory notification.

A legal determination that a defendant can understand the nature of the proceedings and participate in their defence, including instructing counsel. It is distinct from criminal responsibility and may be restored with treatment.

The legal test of whether a defendant's mental disorder at the time of the act removed the ability to know the wrongfulness of the conduct or to control it, depending on the jurisdiction's test, such as M'Naghten.

A disorder of recurrent intrusive thoughts, urges or images that cause anxiety, and repetitive behaviours or mental acts performed to neutralise them, consuming at least an hour a day or causing impairment.

The psychological treatment of choice for obsessive-compulsive disorder, in which the patient is exposed to feared triggers while refraining from the compulsive ritual, allowing anxiety to habituate and beliefs to be disconfirmed.

A trauma-related disorder with intrusive re-experiencing, avoidance, negative alterations in mood and cognition, and hyperarousal persisting beyond a month after exposure to actual or threatened death, serious injury or violence.

A trauma response occurring within days of the event and lasting up to a month, with dissociation, intrusion, avoidance and arousal. It may predict later post-traumatic stress disorder and is a target for early intervention.

A structured, time-limited psychological treatment that identifies and modifies unhelpful thoughts and behaviours through collaborative empiricism, behavioural experiments and homework, with strong evidence across anxiety, mood and trauma disorders.

A syndrome beginning hours after cessation or reduction of heavy drinking, with tremor, sweating, anxiety, nausea and possible seizures, progressing to delirium tremens with confusion and autonomic instability; benzodiazepines are the treatment.

A directive, client-centred counselling style that explores and strengthens a person's own reasons for change by expressing empathy, developing discrepancy, rolling with resistance and supporting self-efficacy, used widely in substance use treatment.

A public health approach that aims to reduce the adverse consequences of substance use without requiring abstinence, through measures such as needle exchange, supervised consumption and opioid substitution therapy.

A multidisciplinary team providing assessment, treatment and care coordination for people with severe mental illness in their own setting, aiming to reduce hospital admission and support recovery within the local population.

A high-intensity, team-based model of community care with low caseloads, shared responsibility and outreach, providing flexible long-term support to people with severe mental illness who struggle to engage with conventional services.

The proportion of a population that has a condition at a given point (point prevalence) or during a defined period (period prevalence). It reflects both incidence and duration and is used to plan services.

The number of new cases of a condition arising in a population over a defined period, expressed as a rate per person-time. It measures risk of onset and, unlike prevalence, is not inflated by long illness duration.