UKOM Sp.KJ key terms

The theory that positive psychotic symptoms arise from excessive mesolimbic dopamine transmission, while negative and cognitive symptoms relate to prefrontal dopamine deficit; it underpins the mechanism of antipsychotic D2 blockade.

Drug-induced movement disorders caused by nigrostriatal dopamine D2 blockade, including acute dystonia, parkinsonism, akathisia, and tardive dyskinesia. They are common with high-potency first-generation antipsychotics and require dose reduction, switching, or anticholinergic treatment.

A rare, life-threatening reaction to dopamine-blocking drugs marked by hyperthermia, severe rigidity, autonomic instability, and raised creatine kinase. Management is immediate drug withdrawal, supportive cooling, and sometimes dantrolene or bromocriptine.

A toxic state from serotonergic excess, often after combining SSRIs with MAOIs or other serotonergic agents, producing agitation, hyperreflexia, clonus, tremor, diarrhoea, and fever. It is distinguished from neuroleptic malignant syndrome by clonus and hyperreflexia.

A withdrawal-like syndrome after abrupt reduction of selective serotonin reuptake inhibitors, with dizziness, paraesthesia, flu-like symptoms, irritability, and insomnia. It is managed by tapering gradually and is most marked with short half-life agents such as paroxetine.

A first-generation dopamine D2 antagonist such as haloperidol or chlorpromazine, effective against positive psychotic symptoms but prone to extrapyramidal effects and hyperprolactinaemia. It remains widely used in Indonesian services because of low cost and availability.

Involuntary choreoathetoid movements, especially of the tongue, lips, and jaw, appearing after months or years of dopamine antagonist exposure. It may persist after drug withdrawal and is treated by stopping or switching the offending agent, sometimes with VMAT2 inhibitors.

An atypical antipsychotic reserved for treatment-resistant schizophrenia because of superior efficacy, but requiring regular blood monitoring for agranulocytosis, plus vigilance for myocarditis, seizures, and severe constipation.

Schizophrenia that persists with significant symptoms despite adequate trials of at least two different antipsychotics at therapeutic doses for sufficient duration, with adherence confirmed. Clozapine is the evidence-based next step.

Schneiderian phenomena considered strongly suggestive of schizophrenia, including audible thoughts, voices arguing or commenting, thought insertion or withdrawal, thought broadcasting, made feelings, made impulses, and delusional perception. Modern classifications treat them as important but not pathognomonic.

Symptoms that add to normal experience, chiefly hallucinations and delusions, and which usually respond to dopamine-blocking antipsychotics. They are contrasted with negative symptoms, which reflect loss of normal function.

Deficits such as blunted affect, alogia, avolition, anhedonia, and social withdrawal that predict poor functional outcome and respond poorly to antipsychotics. They must be distinguished from depression, medication effects, and environmental understimulation.

Disturbance in the form or flow of thinking inferred from speech, such as loosening of associations, derailment, neologisms, and word salad. It is assessed by the structure rather than the content of speech.

A fixed false belief held with strong conviction despite contradictory evidence and not shared by the person's culture. It is distinguished from overvalued ideas by its incorrigibility and its disruption of ordinary reasoning.

A perception experienced without an external stimulus, in any sensory modality, and perceived as real by the person. Auditory hallucinations are commonest in psychosis and must be separated from illusions and pseudohallucinations.

A person's awareness of having an illness, its nature, and the need for treatment. Poor insight is common in psychosis, predicts non-adherence, and is a key consideration in decisions about involuntary care.

A structured clinical assessment of appearance, behaviour, speech, mood and affect, thought form and content, perception, cognition, insight, and judgement. It complements history taking and forms the basis of the psychiatric formulation.

A period of at least two weeks with depressed mood or anhedonia plus other symptoms such as sleep, appetite, energy, concentration, and psychomotor change, causing distress or impairment. It is a building block for depressive and bipolar diagnoses.

A mood disorder defined by at least one manic episode, which may be followed or preceded by hypomanic or depressive episodes. Mania causes marked impairment, may include psychosis, and often requires mood stabilisers and hospital care.

A drug that prevents or reduces recurrence of manic and depressive episodes, chiefly lithium, valproate, and lamotrigine. Lithium remains the reference standard but needs monitoring of renal, thyroid, and serum levels.

Therapeutic induction of a controlled generalised seizure under anaesthesia, used for severe depression, catatonia, and dangerous mania. It is highly effective in treatment-resistant and life-threatening cases and is not a punishment or last resort.

A psychomotor syndrome with stupor, mutism, posturing, waxy flexibility, negativism, or excitement, occurring in mood disorders, psychosis, and medical illness. Benzodiazepines and electroconvulsive therapy are the main treatments.

A disorder of recurrent intrusive thoughts and repetitive behaviours performed to reduce distress, consuming significant time and causing impairment. First-line treatment is exposure and response prevention plus SSRIs at adequate dose and duration.

A cognitive-behavioural therapy for obsessive-compulsive disorder in which the person deliberately confronts feared triggers while refraining from rituals, allowing anxiety to habituate. It is the psychological treatment with the strongest evidence base.

A trauma-related disorder with intrusion, avoidance, negative mood and cognition, and hyperarousal lasting more than one month after a traumatic event. It is distinguished from acute stress disorder by duration and from adjustment disorder by the severity criterion.

Trauma-related symptoms of intrusion, avoidance, dissociation, and arousal beginning within days of a traumatic event and lasting up to one month. Persistence beyond that period indicates possible post-traumatic stress disorder.

Emotional or behavioural symptoms arising within three months of an identifiable stressor and disproportionate to it, without meeting criteria for another disorder. It resolves when the stressor ends or adaptation occurs.

An acute, fluctuating disturbance of attention and awareness caused by an underlying medical condition, medication, or substance. It is a medical emergency requiring identification and treatment of the cause rather than sedation alone.

A progressive decline in two or more cognitive domains sufficient to impair independence, in the absence of delirium. Alzheimer disease is the commonest cause, followed by vascular dementia, and treatable contributors must be excluded.

A brief 30-point screening instrument for orientation, memory, attention, language, and visuospatial function. It supports but does not replace clinical diagnosis and is influenced by education and sensory impairment.

A severe withdrawal state with confusion, agitation, hallucinations, tremor, and autonomic overactivity, typically beginning two to four days after heavy drinking stops. It is treated with benzodiazepines, thiamine, and supportive care.

A person's functional ability to make a specific decision, assessed by understanding, retaining, weighing, and communicating relevant information. Capacity is decision-specific and time-specific, and its absence justifies substituted or involuntary approaches.

Detention and treatment of a person with a mental disorder without consent, permitted only when statutory criteria such as risk to self or others and lack of capacity are met. Indonesian mental health law requires respect for rights and due process.

Structured clinical evaluation of suicidal ideation, intent, plan, means, previous attempts, protective factors, and mental state, used to plan safety and follow-up. It informs management but cannot predict individual suicide with certainty.

A developmental disorder of inattention, hyperactivity, and impulsivity beginning in childhood and causing impairment across settings. Diagnosis requires symptoms in more than one setting, and stimulants or behavioural approaches are mainstays of care.

A developmental condition of persistent deficits in social communication with restricted, repetitive behaviours and interests, present from early childhood. It is highly variable in severity and frequently co-occurs with intellectual disability and ADHD.

A disorder of general cognitive and adaptive functioning with onset in the developmental period, defined by standardised testing and everyday functioning. Care emphasises support, skills training, and management of co-occurring psychiatric and medical conditions.

A structured, time-limited psychotherapy that identifies and modifies unhelpful thoughts and behaviours maintaining distress. It is first-line or adjunctive for depression, anxiety, obsessive-compulsive disorder, and many other conditions.