Iraqi Board Psychiatry key terms

The progressive sensitisation in which repeated, initially subthreshold stressors or mood episodes trigger later episodes with less provocation, a model used to explain episode acceleration in bipolar and recurrent depressive disorders.

A bipolar course specifier applied when a person has at least four distinct mood episodes within twelve months, each separated by remission or a switch to the opposite polarity.

A specifier for mood episodes in which subsyndromal symptoms of the opposite polarity coexist with the predominant mood, for example elevated activity during depression or depressed mood during mania.

A mood disorder defined by at least one lifetime manic episode, which may be followed or preceded by hypomanic or major depressive episodes and usually causes marked functional impairment.

A distinct period of abnormally elevated or irritable mood and increased energy lasting at least four consecutive days, noticeable to others but without marked impairment, psychosis, or hospitalisation.

A thought disorder in which speech moves rapidly between ideas linked by understandable associations, rhymes, or puns, typically seen in mania and distinguishable from loosening of associations.

Observable disturbance in the form or flow of thinking, inferred from speech, including derailment, neologisms, tangentiality, and incoherence, with derailment being prominent in schizophrenia.

Schneiderian experiences once considered pathognomonic of schizophrenia, including thought insertion, withdrawal and broadcasting, made feelings and impulses, and voices discussing or commenting on the patient.

The experience that one's thoughts, feelings, actions, or bodily sensations are controlled or replaced by an external agency, a core psychotic symptom often grouped with made experiences.

A fixed false belief held with firm conviction despite contradictory evidence and outside the person's cultural or religious context, not explained by ordinary reasoning differences.

A delusional misidentification in which the patient believes a familiar person has been replaced by an identical-looking impostor, associated with schizophrenia, dementia, and right hemisphere lesions.

A misidentification delusion in which a place, person, or object is believed to exist in duplicate, often after right frontal or parietal injury and frequently seen in neurodegenerative disease.

An acute, fluctuating disturbance of attention and awareness with altered cognition, usually caused by a medical condition, medication, or substance, and requiring prompt identification of the underlying cause.

A nihilistic delusional state in which the person denies the existence of body parts, organs, or the self, or believes they are dead, seen in severe depression and some organic disorders.

A rare, life-threatening reaction to dopamine-blocking drugs characterised by rigidity, hyperthermia, autonomic instability, and raised creatine kinase, managed by stopping the drug and supportive care.

A drug-induced toxidrome of altered mental state, autonomic hyperactivity, and neuromuscular excitation such as clonus and hyperreflexia, caused by serotonergic excess and ranging from mild to fatal.

Movement adverse effects of dopamine blockade, including acute dystonia, parkinsonism, akathisia, and tardive dyskinesia, which differ in timing and management.

Involuntary, repetitive orofacial and limb movements appearing after months or years of dopamine antagonist exposure, often persistent and requiring dose review or switching strategy.

A self-limited cluster of dizziness, nausea, flu-like symptoms, insomnia, and sensory disturbances after abrupt reduction of antidepressants, most typical of short half-life serotonergic agents.

Measurement of plasma drug concentration to guide dosing for agents with narrow therapeutic ranges, such as lithium, clozapine, and tricyclics, interpreted with timing and clinical state.

An atypical antipsychotic reserved for treatment-resistant psychosis because of agranulocytosis risk, requiring regular blood counts and vigilance for myocarditis, seizures, and constipation.

Schizophrenia that persists with significant symptoms despite adequate trials of at least two different antipsychotics at appropriate dose and duration, with adherence confirmed.

Clinical poisoning from lithium, with tremor, vomiting, diarrhoea, ataxia, confusion, and seizures, precipitated by dehydration, renal impairment, or interacting drugs and requiring urgent level measurement.

A structured clinical assessment of appearance, behaviour, speech, mood, thought, perception, cognition, insight, and risk, recorded to describe the patient's current psychiatric functioning.

The patient's awareness of having an illness, of its nature and cause, and of the need for treatment, graded from complete denial to full understanding and used in risk and capacity assessment.

A brief scored cognitive screen covering orientation, registration, attention, recall, language, and construction, useful for tracking change but influenced by education and sensory impairment.

The functional ability to make a specific decision, assessed by understanding, retaining, weighing, and communicating information, presumed present unless proven otherwise.

Detention and treatment in hospital without consent, permitted by mental health law only when mental disorder, risk to self or others, and necessity criteria are met with procedural safeguards.

A defendant's present ability to understand charges, instruct counsel, and follow proceedings; if lacking, the court may divert to treatment rather than continue to trial.

A verdict in which the accused admits the act but is excused because severe mental disorder at the time impaired understanding of wrongfulness or the ability to control conduct.

The intentional production or exaggeration of symptoms for an identifiable external gain such as compensation, avoiding duties, or obtaining drugs, distinguished from factitious disorder and conversion symptoms.

The intentional feigning or induction of illness with the primary aim of assuming the sick role, without external reward, and often accompanied by repeated hospital presentations.

Distressing physical symptoms with excessive thoughts, anxiety, or time devoted to health concerns, persisting typically beyond six months and impairing daily life regardless of medical explanation.

Preoccupation with having or acquiring a serious illness in the absence of significant somatic symptoms, with high health anxiety persisting at least six months and often driven by reassurance seeking.

A disorder of recurrent intrusive thoughts and repetitive behaviours or mental acts performed to reduce distress, which are time-consuming and not realistically connected to what they aim to neutralise.

A cognitive behavioural treatment in which the patient confronts feared triggers while refraining from the compulsive ritual, allowing anxiety to habituate and beliefs about harm to be tested.

A therapeutic technique that identifies, examines, and modifies distorted automatic thoughts and underlying beliefs by testing evidence and generating balanced alternatives.

The patient's unconscious displacement onto the therapist of feelings, expectations, and relational patterns originating in earlier significant relationships, used as therapeutic material in psychodynamic work.

The clinician's emotional reactions to the patient, which may reflect the patient's interpersonal impact or the clinician's own unresolved issues and can inform or distort treatment.

A trauma- and stressor-related disorder with intrusion, avoidance, negative mood and cognition, and hyperarousal lasting over one month after exposure to actual or threatened death, injury, or violence.

Trauma-related symptoms of intrusion, avoidance, arousal, and negative mood arising within three days to one month of a traumatic event, with duration distinguishing it from post-traumatic stress disorder.

Disruption of normally integrated consciousness, memory, identity, emotion, or perception, ranging from depersonalisation and derealisation to amnesia and identity fragmentation.

A severe withdrawal state with confusion, agitation, hallucinations, tremor, and autonomic instability, typically beginning two to four days after cessation and carrying significant mortality if untreated.

A thiamine deficiency syndrome of acute confusion, ophthalmoplegia, and ataxia, common in alcohol misuse and an emergency requiring immediate parenteral thiamine to prevent permanent damage.

A persistent amnestic disorder with impaired new learning and confabulation following untreated thiamine deficiency, often emerging after Wernicke encephalopathy and frequently irreversible.

A neurodevelopmental disorder of persistent inattention and/or hyperactivity and impulsivity, present before age twelve and impairing functioning across more than one setting.

A neurodevelopmental condition characterised by persistent deficits in social communication and interaction plus restricted, repetitive behaviours or interests, with onset in the early developmental period.

A developmental disorder with deficits in general mental abilities and adaptive functioning, beginning in childhood and classified by severity based on everyday functioning rather than IQ alone.

Significant acquired decline in one or more cognitive domains that interferes with independence in daily activities, corresponding to dementia and distinguished from milder cognitive impairment.

Non-cognitive features of dementia such as agitation, psychosis, depression, apathy, and sleep disturbance, often the main driver of distress and care burden and managed first non-pharmacologically.

The presence of altered voluntary motor or sensory function, such as weakness, blindness, or non-epileptic seizures, incompatible with recognised neurological disease and often shaped by psychological factors.

The proposal that reduced serotonergic neurotransmission underlies depression, which shaped antidepressant development but is now regarded as an oversimplified account of a heterogeneous disorder.

The model linking positive psychotic symptoms to excessive mesolimbic dopamine activity, supported by antipsychotic potency and drug-induced psychosis, with glutamate and other systems also implicated.

The proportion of variance in a trait within a population attributable to genetic differences, estimated from twin and family studies and not a statement about an individual's risk.