OMSB Psychiatry (OEPSY) key terms

An acute, fluctuating disturbance of attention and awareness caused by an underlying medical condition, substance, or medication, developing over hours to days and typically reversible when the cause is treated.

A chronic, progressive decline in two or more cognitive domains severe enough to impair daily functioning, occurring in clear consciousness and usually irreversible, with Alzheimer disease as the commonest cause.

A brief structured bedside tool for detecting delirium, requiring acute onset with fluctuation plus inattention, and either disorganised thinking or altered level of consciousness.

A 30-point clinician-administered screen of orientation, registration, attention, recall, and language, used to quantify cognitive impairment and track change over time; scores are adjusted for education.

A 30-point cognitive screen with greater emphasis on executive function and visuospatial ability than the MMSE, making it more sensitive to mild cognitive impairment and early vascular or frontotemporal disease.

A structured cross-sectional assessment of appearance, behaviour, speech, mood and affect, thought form and content, perception, cognition, insight, and judgement, forming the core descriptive record of a psychiatric interview.

Abnormalities in the form or flow of thinking, such as derailment, tangentiality, loosening of associations, thought blocking, or flight of ideas, observed through speech rather than reported by the patient.

A patient's awareness of having an illness, its nature and cause, and the need for treatment; poor insight predicts non-adherence and is common in psychosis, mania, and some personality disorders.

A clinical state of impaired reality testing marked by hallucinations, delusions, disorganised thinking, or grossly abnormal behaviour, arising in schizophrenia, mood disorders, substance use, and organic brain disease.

A fixed false belief held with strong conviction despite contradictory evidence and outside the person's cultural or religious context, classified as bizarre or non-bizarre and by theme such as persecutory or grandiose.

A perception experienced without an external stimulus, in any sensory modality; auditory hallucinations are typical of schizophrenia, whereas visual hallucinations more often suggest delirium, dementia, or substance effects.

A chronic psychotic disorder defined by positive, negative, and cognitive symptoms lasting at least six months with significant functional decline, typically emerging in late adolescence or early adulthood.

Deficits reflecting loss of normal function in schizophrenia, including blunted affect, alogia, avolition, anhedonia, and asociality; they respond poorly to dopamine-blocking antipsychotics and strongly predict poor outcome.

Excesses or distortions of normal mental activity in psychotic illness, chiefly hallucinations, delusions, disorganised speech, and grossly disorganised or catatonic behaviour, usually responsive to antipsychotic medication.

The initial presentation of psychotic symptoms, a critical window for prompt assessment, exclusion of organic and substance causes, and early initiation of treatment to limit long-term disability.

The interval between onset of frank psychotic symptoms and initiation of adequate treatment; longer duration is associated with poorer symptomatic and functional outcomes, supporting early intervention services.

A mood disorder requiring at least two weeks of depressed mood or anhedonia plus additional symptoms such as sleep, appetite, energy, concentration, and psychomotor changes, causing distress or impairment.

Loss of interest or pleasure in activities that were previously enjoyable; a core criterion symptom of depression and also a negative symptom in schizophrenia, where it may reflect a distinct mechanism.

A mood disorder characterised by episodes of mania or hypomania with or without depression; type I requires a full manic episode, while type II involves hypomania and recurrent depression without mania.

A distinct period of abnormally elevated, expansive, or irritable mood with increased energy lasting at least one week, accompanied by decreased need for sleep, pressured speech, and impulsive risk-taking.

A potentially fatal toxidrome from serotonergic excess, presenting with mental status change, autonomic instability, and neuromuscular hyperactivity such as clonus, hyperreflexia, and tremor, requiring drug cessation and supportive care.

A rare life-threatening reaction to dopamine antagonists marked by rigidity, hyperthermia, autonomic instability, and altered consciousness with raised creatine kinase, managed by stopping the agent and giving supportive care.

A medication class acting mainly on dopamine D2 receptors, used for schizophrenia and other psychoses; second-generation agents add serotonin blockade and carry greater metabolic risk than first-generation drugs.

Drug-induced movement disturbances from dopamine blockade, including acute dystonia, parkinsonism, akathisia, and tardive syndromes, ranging from distressing to disabling and requiring dose reduction or anticholinergic treatment.

A late-onset involuntary movement disorder of the tongue, face, and limbs appearing after months or years of dopamine-blocking treatment, often persistent after drug withdrawal and managed with VMAT2 inhibitors.

A first-line antidepressant class that blocks presynaptic serotonin reuptake, used for depression, anxiety disorders, and obsessive-compulsive disorder, with gastrointestinal and sexual side effects and a discontinuation syndrome.

A medication that prevents recurrence of manic or depressive episodes, principally lithium and certain anticonvulsants; lithium remains the reference standard and uniquely reduces suicide risk in bipolar disorder.

Arising when serum lithium exceeds the narrow therapeutic range, producing tremor, ataxia, vomiting, confusion, and seizures; risk rises with dehydration, renal impairment, and interacting drugs such as diuretics and NSAIDs.

A controlled general-anaesthetic procedure delivering brief electrical stimulation to induce a seizure, highly effective for severe or psychotic depression, catatonia, and treatment-resistant illness.

Depression that fails to respond adequately to two or more antidepressant trials of sufficient dose and duration, prompting review of diagnosis, adherence, and options such as augmentation or ECT.

A syndrome of abnormal motor behaviour including stupor, mutism, rigidity, posturing, waxy flexibility, and excitement, occurring in psychotic, mood, and medical disorders and responding dramatically to benzodiazepines or ECT.

A disorder of recurrent intrusive thoughts and repetitive behaviours or mental acts performed to reduce distress, causing significant time loss or impairment and treated with SSRIs and exposure-based psychotherapy.

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

Trauma-related symptoms of intrusion, dissociation, avoidance, and arousal occurring within one month of a traumatic event and lasting up to a month; if symptoms persist beyond that, PTSD is diagnosed.

A structured, time-limited psychotherapy identifying and modifying maladaptive thoughts and behaviours, with strong evidence across depression, anxiety disorders, OCD, and PTSD, delivered individually or in groups.

A problematic pattern of substance use causing impairment or distress, defined by criteria such as craving, tolerance, withdrawal, loss of control, and continued use despite harm, graded by severity.

A syndrome beginning hours after cessation of heavy drinking, with tremor, anxiety, sweating, nausea, and tachycardia; it can progress to seizures and delirium tremens and is managed with benzodiazepines and thiamine.

Severe alcohol withdrawal marked by confusion, hallucinations, marked autonomic hyperactivity, and fever, typically 48 to 96 hours after the last drink and carrying significant mortality without prompt benzodiazepine treatment.

Thiamine deficiency causing the triad of ophthalmoplegia, ataxia, and confusion, seen in chronic alcohol use and malnutrition; untreated it can progress to Korsakoff syndrome with persistent amnesia.

A persistent amnestic disorder from thiamine deficiency, characterised by impaired anterograde memory and confabulation with relatively preserved other cognition, often following untreated Wernicke encephalopathy.

A structured clinical enquiry into suicidal ideation, intent, plan, means access, prior attempts, and protective factors, informing risk formulation, safety planning, and level of observation or care.

A patient's functional ability to make a specific decision, assessed by understanding, appreciation, reasoning, and expressing a choice; it is decision-specific and distinct from the legal status of competence.

Detention and treatment of a person without consent under mental health legislation, justified by mental disorder plus risk to self or others or need for treatment, subject to periodic review and appeal.

The extent to which a person takes medication and follows agreed treatment as prescribed; poor adherence in psychiatry is driven by side effects, poor insight, stigma, and complex regimens and predicts relapse.

A depot formulation given intramuscularly at intervals of weeks to months to maintain stable plasma levels, used where adherence is unreliable or oral therapy is poorly tolerated, reducing relapse risk.