CAQ-Psychiatry key terms

The collaborative, trusting relationship between clinician and patient, including agreed goals and tasks. It predicts treatment engagement and outcome across psychotherapy and pharmacotherapy and is assessed early and monitored over time.

A structured bedside assessment of appearance, behavior, speech, mood, affect, thought process and content, perception, cognition, insight, and judgment. It documents current functioning and provides the baseline against which later change is measured.

Systematic evaluation of ideation, intent, plan, means access, prior attempts, protective factors, and substance use to estimate acute and chronic risk. It guides level of care, safety planning, and documentation rather than predicting events with certainty.

A written, collaboratively built list of personal warning signs, coping strategies, people to contact, and professional resources used when suicidal urges escalate. It is a brief intervention distinct from no-suicide contracts, which lack evidence.

Legal detention and treatment of a person over objection, justified by mental illness plus danger to self or others or grave disability, depending on jurisdiction. Criteria, duration, and review rights are set by statute and require careful documentation.

A clinical determination that a patient can understand relevant information, appreciate consequences, reason about options, and communicate a choice. It is task-specific and distinct from legal competence, which courts decide.

Obtaining permission for evaluation or treatment after disclosing purpose, risks, benefits, alternatives, and the right to refuse. It requires capacity and voluntariness and applies to medication, psychotherapy, and research participation.

The duty to protect patient information, subject to exceptions such as imminent danger to identifiable others, suspected abuse of children or vulnerable adults, and court order. Limits should be explained at the outset of care.

A legal obligation, arising from Tarasoff-type rulings in many jurisdictions, to take reasonable steps when a patient poses serious threat to an identifiable person. Steps may include warning, notifying police, or hospitalization.

The patient's displacement onto the clinician of feelings, expectations, and relational patterns originating in earlier relationships. Recognizing it informs formulation and, in psychodynamic therapy, becomes a focus of interpretive work.

The clinician's emotional reactions to the patient, including responses shaped by the clinician's own history. Used reflectively, it signals interpersonal dynamics and risk of acting out; unexamined, it can distort care.

The capacity to understand behavior in terms of underlying mental states such as beliefs, feelings, and intentions, in oneself and others. It falters under stress and is a target of mentalization-based treatment for borderline pathology.

Largely unconscious mental operations that manage anxiety and conflict, such as denial, projection, splitting, and sublimation. Mature defenses are adaptive; immature or rigid ones correlate with personality pathology and impaired functioning.

A structured, present-focused psychotherapy targeting maladaptive thoughts and behaviors through psychoeducation, cognitive restructuring, and behavioral experiments or exposure. It is first-line for many anxiety, depressive, and obsessive-compulsive presentations.

A therapy for depression that schedules meaningful activity and reduces avoidance, on the premise that mood improves when patients re-engage with rewarding contingencies. It is as effective as full cognitive therapy and simpler to deliver.

Repeated, prolonged contact with feared stimuli without escape, allowing fear to extinguish and predictions to be disconfirmed. It is central to treating phobias, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.

A comprehensive treatment combining individual therapy, skills groups, phone coaching, and consultation, developed for chronic suicidality and borderline personality disorder. It balances acceptance with change and targets skills in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

A directive, person-centered style using open questions, affirmation, reflective listening, and summary to evoke the patient's own reasons for change. It reduces ambivalence about substance use and treatment adherence.

A transtheoretical model describing progression through precontemplation, contemplation, preparation, action, and maintenance, with relapse as a normal stage. Interventions are matched to stage, so action-oriented advice fails in precontemplation.

Induction of a generalized seizure under anesthesia and muscle relaxation to treat severe depression, catatonia, and some psychotic or bipolar states. It is highly effective, with transient memory effects as the main adverse outcome.

Depression that fails to remit after adequate trials of at least two antidepressants at therapeutic dose and duration, with adherence verified. Options include switching, augmentation, psychotherapy, and neuromodulation.

A potentially life-threatening toxidrome of agitation, autonomic instability, hyperreflexia, clonus, and hyperthermia caused by serotonergic excess, often from drug combinations. Management is stopping agents, supportive care, and sometimes cyproheptadine.

A rare, severe reaction to dopamine antagonists marked by rigidity, hyperthermia, autonomic instability, and altered consciousness with elevated creatine kinase. Treatment is stopping the agent plus supportive care, and sometimes dantrolene or bromocriptine.

Involuntary, often orofacial movements appearing after prolonged dopamine-blocking treatment, sometimes persisting after the drug stops. Risk rises with age, duration, and typical antipsychotics; vesicular monoamine transporter 2 inhibitors are used for treatment.

A cluster of central obesity, dyslipidemia, hypertension, and hyperglycemia that raises cardiovascular and diabetes risk. Antipsychotics, especially olanzapine and clozapine, contribute, so baseline and periodic monitoring is required.

An atypical antipsychotic reserved for treatment-resistant schizophrenia and for reducing suicide risk, requiring monitoring for agranulocytosis and myocarditis. It also risks seizures, constipation, and sialorrhea and must not be combined with other marrow-suppressing agents.

A mood stabilizer with anti-manic and suicide-preventive properties, monitored by serum level and renal and thyroid function. Toxicity presents with tremor, ataxia, vomiting, and confusion and is precipitated by dehydration or interacting drugs.

An acute, fluctuating disturbance of attention and awareness due to a medical or toxic cause, often with perceptual disturbance. It is a medical emergency distinguished from dementia by acuity and reversibility, and treated by addressing the underlying cause.

A syndrome of psychomotor abnormality including stupor, mutism, posturing, negativism, and waxy flexibility, occurring with mood, psychotic, or medical illness. Benzodiazepines and electroconvulsive therapy are the main treatments.

A progressive, acquired decline in two or more cognitive domains sufficient to impair independence, distinct from normal aging. Reversible contributors and behavioral symptoms should be assessed, and caregiver burden addressed.

A syndrome of signs and symptoms following reduction or cessation of a substance after heavy or prolonged use. Alcohol and benzodiazepine withdrawal can be life-threatening, requiring medically supervised tapering or substitution.

A trauma-related disorder with intrusion, avoidance, negative cognition and mood, and hyperarousal lasting over a month and causing impairment. First-line treatments are trauma-focused psychotherapy and selective serotonin reuptake inhibitors.

Marked adverse reaction to antipsychotics, including severe rigidity or sedation, reported in dementia with Lewy bodies. It supports avoiding typical antipsychotics and using cautious, low-dose alternatives when pharmacotherapy is unavoidable.

Insight is awareness of illness and its implications; judgment is the capacity to make sound decisions about one's situation. Both are documented in the mental status examination and inform risk, adherence, and capacity discussions.

Occupational exhaustion, detachment, and reduced efficacy resulting from chronic workplace stress, distinct from depression though overlapping. It affects clinicians and patients alike and is addressed through workload, support, and boundary work.

A behavioral technique pairing progressive relaxation with a graded hierarchy of feared stimuli, introduced by Wolpe. It is a historical precursor to modern exposure-based treatments and illustrates graded habituation principles.