The document provides definitions for various psychiatric and psychological terminology. It includes terms related to abnormal behaviors, personality, defense mechanisms, neurotransmitters, and alternative therapeutic modalities. Specifically, it defines terms like akathesia, amnesia, delusion, euphoria, repression, projection, acetylcholine, family therapy, and more. It also categorizes abnormal behaviors into disorders of consciousness, thought, affect, perception, memory, and others.

1. Glossary of common terminologies
Terminology Meaning
Akathesia Motor restlessness, inability to sit still
Amnesia Inability to experience pleasure in any activity
Apathy Lack of emotional feelings
Anorexia nervosa Characterized by extreme concern with body weight, an intense
fear of becoming fat and maintenance of body weight below
expected level
Blunt effect A reduction in emotional experience
Circumstantiality A pattern of communication that is demonstrated by the speakers
inclusion of many irreverent and unnecessary detailed in his
speech before he is able to come to the point
Idea of reference Is an incorrect belief that the statement or action of others are
related to oneself
Déjà vu A subjective feeling that an event which is occurring for the first
time has been experienced before

2. Terminology Meaning
Delusion A false unshakable fixed belief which is not amenable to reasoning and is
not in keeping with the patients socio cultural and educational background
Dystonia Muscle rigidity that effect posture, gait, eye movement
Echolalia Pathological repetition by imitation of the speech of another
Echoprexia Pathological repetition by imitation of the behavior of another
Encopresis Involuntary passage of faeces in inappropriate place after age of voluntary
control has been established
Euphoria Excessive feeling of happiness
Grandiose Unrealistic or exaggerated sense of self worth importance wealth or ability
Hallucinations A false sensory perception in the absence of an actual external stimulus
Illusion Misinterpretation of real external sensory experience
Insight Insight means the capacity to appreciate that ones disturbance of thought
and feelings are subjective and invalid
Jamais vu Failure to recognize events that have been encountered before
Stress Condition that result when a threat or challenge to ones wellbeing
requires a person to adjust or adapt to the environment

3. Terminology Meaning
Stupor A state in which the individual does not reach to his
surroundings and appears to be unaware of them
Tangentially A form of thinking or speech in which the clients tend to
wonder away from the intended point, and never returning
to the original idea
Thought block A sudden interruption in the thought process before the
thought is completed. After a pause, the subject cannot recall
what he had mean to say
Tic disorder Sudden, repetitive, arrhythmic, stereotyped motor movement
Waxy flexibility A condition by which the individual with schizophrenia
passively yields all movable parts of the body to any effort
made at placing them in certain position

4. Classification of abnormal
behavior

5. 1. Disorders of Consciousness
2. Disorders of Motor activity
3. Disorders of Thought
4. Disorders of Affect
5. Disorders of Perception
6. Disorders of Memory
7. Disorders of Orientation

6. Disorders of consciousness
Stupor In stupor patient remains motionless and mute. Patient
activity level reduced to a minimum
Clouding of
consciousness
In this there is absence of clear mindedness, there is disturbed
patient capacity to think, perceive, respond and remember
Confusion Disturbance of orientation of place, person and time
Delirium It consists of certain features such as clouding of
consciousness, illusion, disorientation, restlessness and
hallucination
Fuge and dissociation Dissociation is a reversible and temporary attraction in the
integrative function of consciousness and identity

7. Disorders of Motor activity
Decreased
activity
It is also known as psychomotor activity. In this the patient either takes too
long time to start the activity or after starting the activity he takes too much
time to complete it
Increased
activity
It is also called as hyperactivity. In this the patient either tries to do the
activity very fast or tries to do a lot of activity at a time
Waxy flexibility It is also known as stereotype position or catalepsy. In this the patient
constantly maintain a position for a long time without any movement
Mannerism It is also known as stereotype movement. When a person repeats any
movement without any purpose. Eg. Touching the nose while talking
Verbieration It is also known as stereotype speech. In this patient repeats a word or
sentence without any purpose
Compulsion It is usually follows obsession. Repeatedly performing any activity which is
unreasonable to other persons and patient himself
Negativism The patient is aware to external stimuli but he tries to oppose the stimulus
actively or passively
Echolalia Repetition of speech by imitation by the patient
Echoprexia The patient imitates the activities done by any other person
Suicide Act of killing oneself

8. Disorders of thought
Autistic thinking It is manifested by withdrawal of a patient into the self
Flight of ideas In this the thinking process appears too rapid
Thought retardation In this when any question is asked to the patent he speaks slowly in a low tone and
takes a very long time to complete the answer
Circumstantiality When any question is asked to a patient he begins to respond, follow series of related
topics and reaches his answer but only after many unnecessary details
Tangentiality In this when any question is asked to patient he begins to respond, tells many
unnecessary details but never reaches to correct answer
Perseveration It is a persistent repetition of same ideas or thought
E.g. when a patient is asked different question, he gives same answer
Thought blocking Sudden cessation of thought in the process of thinking
Incoherence Means disconnect thinking. In this one idea is mixed up with another without any
connection
Hypochondriasis In tis patient feels himself ill without any medical basis or pathology
Delusion In this patient has false fixed belief
Obsession An idea or impulse which arrives into the conscious mind of a patient
Phobia An irrational fear of a specific object, situation or activity

9. Disorders of Affect
Euphoria In this the patient has a constant sense of pleasant feelings
Elation It is a joyful affect and in this motor activity level of patient increase
Exhaltation In this patient has delusion of grandiosity
Ecstasy There is a very sever elevation of mood. Intense sense of rapture
present. Highest level of happiness
Depression Patient has a feeling of hopelessness , helplessness and
worthlessness
Grief Depressive symptoms due to actual loss of money, family members
Anxiety It is defined as unpleasurable reaction to an imagined or unreal
danger
Apathy Lack of emotion. The patient shows inadequate response to those
stimulus that normally gives sense of happiness or pain
Ambivalence In this the patient has two opposite ideas or feelings towards a
same person or same situtustion at the same time
Inappropriate affect There is inappropriate response to any stimulus

10. Disorder of perception
Hallucination Perception of a stimulus by the person in the absence of
actual stimulus
Illusion It is also known as wrong perception. In this perception
disorder the clear stimulus is improperly recognized by the
patient

11. Disorders of Memory
Hyper amnesia An excessive retention of sleep
Amnesia Absence of memory
Paramnesia False recollection of memory
Hyperamnesia An extreme degree of retention and recall of memory
Deja-vu Unfamiliar or new situation, person or object is
treated as familiar one

12. Personality
Personality is the total quality of an behavior as
it is shown in the habits, thinking, attitudes,
interest, and the manner of acting and personal
philosophy of life
Definition:
Personality is the dynamic organization within
the individual of those psycho-physical systems
that determine is unique adjustment of life

13. Meaning:
P- perception capacity
E- emotional maturity
R- responsiveness to the situation
S- sociability
O- Originality
N- Neutrality
A- Appearance
L- Leadership
I- Integrated
T- Tendency
Y- Young (in thinking)

14. Types of personality
Hippocrait Kretchmers Sheldon Jungs allports
Sanguin
Phlegmatic
Melancholic
Choleric
Pyknic
Athletic
Leptosomatic
Endomorphic
Mesomorphic
Ectomorphic
Extroverts
Introverts
Cardinal traits
Central traits
Secondary traits

15. Body type Body characteristics Personality characteristics
Choleric Bodily strong Emotionally weak and easily
tempted
Melecholic Bodily weak Emotionally weak
Phlegmatic Bodily weak lazy type always
happy
Emotionally strong, able to
control his or her emotions
Senguine Bodily strong- energetic Control type
Pyknic Fat types Social and helping other
Athletic Healthy, balance between muscle
and bone development
Energetic, optimist can
adjust to any situation
Asthetic Thin, and lean tall, no muscle, only
bone
unsociable, shy, pessimist
and always alone
Endomorphy No muscle development,
prominent stomach
Takes everything easy,
sociable and affectionable
Mesomorphy Balance between development of
stomach and bones
Likes to work, interested in
adventurous activities
Ectomorphy Weak, tall and thin Unsociable and alone

16. Theories of personality Development
Freud’s stages of personality Development
Stages of
development
Main characteristics Examples of unsuccessful
task completion
Oral
(Birth to 18 month)
Use mouth and tongue to deal with anxiety
E.g. Sucking, feedings)
Smoking, alcoholism,
obesity, drug addiction,
difficulty trusting
Anal
(18 moths to 3 years)
Muscle control in bladder, rectum, anus
provides sensual pleasure; toilet training can
be a crisis
Constipation,
perfectionism, OCD
Phallic
(3-6 years)
Learn sexual identity and awareness of
genital areas as source of pleasure.
The development of Electra complex
(female) and Oedipus complex (male) occurs
during this stage of development
Homosexuality, Tran
sexuality, sexual identity
problem
Latency
(6-9 years)
Quite stage in sexual development, learn to
socialize
Inability to conceptualize;
lack of motivation in
school or job
Genital
12 year to adulthood
Sexual maturity and satisfactory
relationships with opposite sex
Frigidity, impotence,
premature ejaculation,
unsatisfactory relationship

17. Erikson's stages of psychosocial development
Stages and age
(approx.)
Virtue Task Consequences of unsuccessful task
completion
Infants (birth to 18
months)
Trust vs mistrust
Hope Viewing the world as safe and reliable,
relationships as nurturing, stable and
dependable
Suspiciousness, trouble with personal
relationship
Toddler 1 to 3 years)
Autonomy vs shame
Will Achieving a sense of control and free will Low self esteem , self dependency
Pre school (3 to 6)
Initiative vs guilt
Purpose Beginning development of conscious
learning to mange conflict and anxiety
Passive personality, strong feeling of
guilt
School age (6 to 12)
Industry vs inferior
Competence Emerging confidence in own ability,
taking pleasure in accomplishments
Unmotivated, unreliable
Adolescence (12 to18)
Identity vs role
confusion
Fidelity Formulate a sense of self and
belongingness
Substance abuse, difficulty in keeping
personal relation relationship
Young adult (18 to 25)
Intimacy vs isolation
Love Formulating adult, loving relationship
and meaningful attachment to other
Emotional immaturity,
Middle adult(26 to45)
Generativity vs
stagnation
Care Being creative and productive, focus is an
establishment of family and guiding to
the next generation
Inability to show concern for anyone
but self
Maturity (45 to death)
Ego integrity vs
despair
Wisdom Accepting the responsibility for one’s self
and life
Has difficulty dealing with issues of
aging and death, may have feeling of
hopelessness

18. Defence mechanism
are methods of attempting to promote self and cope with basic dries are
emotionally painful thoughts, feelings or events
Defence mechanism Example
Repression
Unconscious and involuntary forgetting of painful
ideas, events and conflicts
Forgetting a loved ones birthday after
a fight
Denial
Unconscious refusal to admit an unacceptable idea or
behavior, usually the first defence learned and use
The mother of child who is fatally ill
may refuse to admit that there is
anything wrong
Displacement
Unconsciously discharging pent up feelings to a less
threating object
A husband comes home after a bad day
at work and yells at his wife
Reaction formation
Replacing unacceptable feeling with their exact
opposite
A jealous boy who hates his elder
brother may his exaggerated respect
and affection towards him
Rationalization
It is a process in which an individual justifies his
failures and socially unacceptable behavior by giving
A student who fails in examination may
complain that the teacher not given
good notes and has resulted in failure

19. Sublimation
Consciously or unconsciously channelling instinctual drives
Aggressive might be transformed into
competitiveness in business and sports
Compensation
Consciously covering up for a weakness by over
emphasizing or making up a desirable trait
A student who fails in his studies may
compensate by becoming the college
champion in athletic
Projection
Unconsciously or consciously blaming someone else for
one’s difficulties
A person who blames another for his own
mistake is using the projection mechanism
Intellectualization
Separation of the emotions of a painful event or situation
from the facts involved in acknowledging the facts but not
the emotions
Person shows no emotional expression when
discussing serious car accident
Undoing
Consciously doing something to counteract or make up for a
transgression or wrong doing
Giving a treat to child who is being punished
fro wrong doing
Regression
Unconscious return to an earlier and more comfortable
development level
An adult throws a temper tantrum when he
does not get his own way
Dissociation
Unconscious separation of painful feelings and emotions
from an unacceptable idea
Amnesia
Conversion
The unconscious expression of intrapsychic conflict
symbolic through physical symptoms
A student awakens with the migraine
headache in the morning of final
examination and feels too ill to take the test

20. Therapeutic communication
It is an interpersonal interaction between the nurse
and the patient that focuses on the patients specific
needs for prompting an effective exchange of
information
Process: sender, Message, Receiver, feedback
Phases:
• Pre interaction,
• Orientation,
• Working ,
• Termination phase

21. Technique of therapeutic communication
Technique Explanation
Using silence Allows client to take control of the discussion
Acceptance Convey positive regard
Giving recognition Acknowledging indicating awareness
Offering self Making oneself available
Broad opening Allow clients to select the topic
Offering general leads Encourage clients to continue
Placing the event in sequence
or time
Clarifies the relationships of events in time
Making observation Verbalizing what is observed or perceived
Encouraging description of
perception
Asking client to verbalize what is being perceived
Encouraging comparison Asking client to compare similarities and differences in
ideas, experience, or interpersonal relationship
Restating Lets client know whether an expressed statement has or has
not been understand

22. Reflecting Directs questions or feelings back to client so that they
may be recognized and accepted
Focusing Taking notice of a single idea or even a single word
Exploring Delving further into a subject, idea, experience or
relationship
Seeking clarification and
validation
Striving to explain what is vague and searching for mutual
understanding
Presenting reality Clarifying misconceptions that client may be experiencing
Voicing doubt Expressing uncertainty as to the reality of clients
perception
Verbalizing the implied Putting into words what client has only implied
Attempting to translate words
into feelings
Putting directly into words the feeling that the client has
expressed only indirectly
Formulating plan of action Striving to prevent anger or anxiety escalating to
unmanageable level when stressor recurs

23. Neurotransmitters
Neurotransmitter Imbalance
Acetylcholine Decreased level - Alzheimer's disease
Increased level- Depression
Norepinephrine Decreased level- Depression
Increased level- Mania, anxiety schizophrenia
Dopamine Decreased level- Parkinson's disease and
depression
Increased level- Mania and schizophrenia
Serotonin Decreased level- Depression
Increased level- Anxiety
Histamine Decreased level- Depression
GABA Decreased level- Anxiety disorder
Somatostatin Decreased level - Alzheimer's disease
Increased level - Huntington disease

24. Alternative therapeutic modalities
Various therapies are used to relieve patient’s
symptoms and helping him to understand and
modify his conduct and to lead a well adjusted life

25. Psychoanalytical therapy:
In this focus is on the cause of problem, which is
buried somewhere in the unconscious. The therapist
tries to take the patient into the past in an effort to
determine to determine where the problem began.
Techniques used are free association, ream analysis,
hypnosis, catharsis and abreaction therapy

26. Individual psychotherapy:
It is a method bringing about change in a person
by exploring his or her feelings, attitudes,
thinking and behavior
Indication- stress related disorder
alcohol and drug dependence
sexual disorder
marital disharmony

27. Cognitive therapy:
it focuses on how patents think about themselves
and their world, make change in current ways of
thinking and behaviour
Indications:
anxiety, eating disorder
personality disorder
suicidal thoughts or attempts
sexual disorders

28. Family therapy:
It is used when individuals psychiatric symptoms are
inseparably related with the family in which he live.
Thus the focus of the treatment is not the individual,
but the family
Indication: family problems or marital maladjustment

29. Behavior therapy:
It is a form of treatment for problems in which a trained
person deliberately establishes a professional relationship
with the patient, with objective of removing or modifying
existing symptoms and promoting positive personality,
growth and development
Indications-
Specific phobias
alcohol abuse
paraphilia
homosexuality
transvestism
obsession
compulsion

30. Etiological factors of mental illness
Biological factors Psychological factors Social factors
• Hereditary
• Disturbances in
neurotransmitters
• Brain damage
• Physiological changes
• Strained interpersonal
relationships
• Stress and frustration
• Pathological personality
• Childhood insecurities
• Poverty
• Alcoholism
• Urbanization
• Family instability
• Unemployment

31. Organic mental disorder
these are behavioral or psychological disorders associated with transient or permanent
brain dysfunction
Dementia: It is an acquired global impairment of intellect,
memory and personality but without impairment of
consciousness. Sundown phenomena is also common in
dementia
Stage I- early stage (2 to 4 years)
Forgetfulness, declining interest in environment, poor
performance at work
Stage II- middle stage (2 to 12 years )
Progressive memory loss, irritable, anxious, wandering
Neglect personal hygiene, social isolation
Stage III- final Stage (up to 9 years)
Unable to communicate, does not recognise family,
incontinence of urine and faeces, looses the ability to stand and
walk

32. Delirium:
It is an acute organic mental disorder characterised
by impairment of consciousness, disorientation
and disturbances in perception, and restlessness
Signs and symptoms-
Impairment of consciousness and attention
Perceptual disturbances, disturbances of cognition,
psychomotor disturbances, disturbances of sleep
wake cycle

33. Substance use disorders
Disorders due to psychoactive substance use refer to
condition arising from the abuse of alcohol,
psychoactive drugs and other chemicals such as
volatile solvents
Types of substance used-
• Alcohol
• Opioids
• Cocaine
• Amphetamine
• Nicotine
• Caffeine

34. Alcohol dependence syndrome:
It refers to the use of alcohol beverages to the point of
causing damage to the individual, society or both
Symptoms:
Malaise, dyspepsia, mood swings or depression,
increased incidence of infection, poor personal hygiene,
denial of problem, consumption of alcohol containing
products and nutritional deficiency
Withdrawal symptoms
Wernicke's korsakoff syndrome- due to thiamine
deficiency that is caused by chronic alcohol abuse
Wernicke syndrome- characterized by prominent
cerebellar ataxia, palsy of the 6th cranial nerve
Korsakoff’s syndrome- gross memory disturbances

35. Management:
Detoxification- it is the treatment for alcohol
withdrawal symptoms. The drug of choice are
benzodiazepines
Disulfirum is used to ensure abstinence in the
treatment of alcohol dependence.
Dose is 500 mg/day orally for the first two weeks,
followed by a maintenance dose of 250 mg/day. It
should not exceeds 500 mg/day

36. Opioid dependence:
commonly used opioids are heroin and synthetic
preparation like pethadine
Symptoms- apathy, bradycardia, hypotension,
respiratory depression
Withdrawal symptoms- constricted pupil watery eyes,
running nose, irritability, tremors, sweating, cramp,
nausea, diarrhea, insomnia, anorexia
Treatment-
Overdose- naloxine
Detoxification- methodine, clonidine

37. Schizophrenia
It is psychotic condition characterized by disturbance
in thinking, emotions, volitions and faculties in the
presence of clear consciousness, which usually leads
to social withdrawal
Types- paranoid, hebephrenic, catatonic, residual,
undifferentiated, simple, post schizophrenic
depression
Symptoms:
Affective disturbances, autistic thinking, ambivalence,
associative looseness

38. Thought and speech disorders- autistic thinking,
looseness of association, thought block,
neologism, poverty of speech, poverty of
ideation, echolalia, preservation, verbigeration,
delusion of various kinds
Disorder of perception- auditory hallucination,
visual hallucination
Disorders of affact- apathy, emotional blunting,
emotional shallowness, anhedonia and
inappropriate emotional response

39. Treatment- pharmacotherapy includes
antipsychotics, antidepressants, mood stabilizers
ECT
Extra pyramidal syndrome-
These are serious neurological symptoms and
major side effects of antipsychotic drugs it
includes parkinsonism, acute dystonia,
akathesia,

40. Personality disorders
Personality disorders result when personality
traits become abnormal i.e. become inflexible
and maladaptive and cause significant social or
occupational impairment or significant
subjective data

41. Paranoid personality: long standing suspiciousness
and mistrust of persons in general. They refuse
responsibility for their own feelings and assign
responsibility to other
Schizoid personality disorder:
They seems to be cold and aloof; they display
remote reserve and show no involvement with
everyday events
Antisocial personality disorder:
They seems to be normal and even charming and
ingratiating. Lying, truancy, run away from home,
thefts, fights, illegal activities

42. Borderline personality disorder:
Patients are stand on the border between neurosis
and psychosis and are characterized by
extraordinarily unstable affect, mood, behavior,
object relations and self images
Histrionic personality disorder:
They are excitable and emotional and behave in a
colorful, dramatic.
Narcissistic personality disorder:
Heightened sense of self importance and grandiose
feelings of uniqueness

43. Avoidant personality disorder:
Extremely sensitive to rejection and may lead a
socially withdraw in life
Dependent personality disorder:
Lack of self confidence, and may experience intense
discomfort when alone
Obsessive compulsive personality disorder:
Emotional constriction, orderliness, perseverance,
stubbornness and indecisiveness

44. Depression
An alteration in mood that is expressed by feelings
of sadness, despair, and pessimism. There is a loss
of interest in usual activities and somatic
symptoms may be evident
Clinical features
depressed mood
depressed cognition
suicidal thought
psychomotor activity

45. Mania
It is characterized by pressure of speech, increased
psychomotor activity and elevated
Hypomania is a lesser degree of mania. There is
persistent mild elevation of mood and increased
sense of psychological well being
Clinical feature:
Euthymia
Euphoria
Elation
Exaltation
Ecstasy

46. Psychomotor activity-increased from activeness
and restlessness to manic excitement
Speech and thought- flight of ideas, pressure of
speech, delusion of grandeur, delusion of
persecution, distractibility
Treatment:
Lithium carbonate 900 to 2100mg/day
ECT

47. Bipolar effective disorder
Recurrent episodes of mania and depression in
the same patient at different times
Treatment:
Lithium carbonate
Valproic acid
Carbamazepine
Antidepressant
Antipsychotics

48. Somatoform disorder
Characterized by repeated presentation with physical
symptoms which do not have any physical basis and
persistent request for investigation and treatment
Somatization disorder: chronic multiple somatic
complaints, unexplained by the medical findings
Hypochondriasis: A persistent preoccupation with a fear
or belief of having a serious disease
Somatoform autonomic dysfunction: in this disorder the
symptoms are in the predominantly under autonomic
control
Persistent somatoform pain disorder: the main feature of
this disorder is persistent and sever pain without any
physical basis

49. Acute stress disorder
Acute stress disorder develops within one month
after an individual experiences or sees an event
involving a threat or actual death, serious injury or
physical violation to the individual or others and
responds to this event with strong feelings of fear,
helplessness or horror
Pharmacological treatment includes nxiolytics,
selective serotonin reuptake inhibitors and anti
depressants
Cognitive therapy may be speed up recovery and
may prevent acute stress disorder from turning into
PTSD

50. Post traumatic stress disorder
Hyper arousal, re experiencing of image of the
stressful events and avoidance of reminders
It is a reaction to extreme stressor such as floods,
earthquakes, war and rape
The symptoms develop after the latency, within 6
months after the stress or may be delayed
Anxiolytics, SSRI and anti depressants to relieve
secondary symptoms
Psychotherapy includes cognitive therapy, exposure
therapy and eye movement desensitization and
reprocessing

51. Phobia
A phobia is an irrational fear of specific object, activity
or situation or to anything
Types:
Acrophobia
Hematophobia
Claustrophobia
Gamophobia
Zoophobia
Algophobia
Micro phobia
Insecto phobia

52. Obsessive compulsive disorder
OCD is repetitive, irresistative and unwanted thoughts and
ritualistic action
It is characterised by intrusive thoughts that produce
uneasiness, apprehension, fear or worry (obsession),
repetitive behaviors aimed at reducing the associated anxiety
(compulsion), or a combination
Various types of obsession includes obsessional thoughts,
obsessional images, obsessional rumination, obsessional
doubts, obsessional impulses, obsessional rituals, obsessional
slowness
Pharmacological treatment includes clomipramine,
fluvoxamine, fluoxetine, sertraline
Exposure and response prevention is the most effective
treatment

53. Adjustment disorder
Adjustment disorder is a short term condition that
occurs when a person has difficulty coping with, or
adjusting to a particular source of stress
Duration of the disorder is usually less than one
month
It is characterized by predominant disturbance of
emotions
Treatment is like anxiolytics and antidepressants

54. Eating disorder
Eating disorders are psychological illness defined as
abnormal eating habits that may involve either
insufficient or excessive food intake to the
determent of an individuals physical and mental
health
Anorexia Nervosa: Inadequate food intake leading
to a weight that is clearly too low
Intense fear of weight gain, obsession with weight
and persistent behavior to prevent weight gain
Clinical features includes amenorrhea, excessive
weight loss, lanugo, abdominal distension, and
electrolyte disturbances

55. Bulimia nervosa: frequent episodes of consuming
very large amount of food followed by behaviors
to prevent weight gain such as self induced
vomiting
Binge eating disorder: Frequent episodes of
consuming very large amount of food but
without behavior to prevent weight gain, such as
self induced vomiting
A feel of being out of control during the binge
eating episodes
A feeling of strong shame or guilt regarding the
binge eating

56. Seasonal effective disorder
It is also known as winter depression, winter blue,
summer depression, summer blue, or seasonal
depression is a mood disorder in which people who
have normal mental health throughout most of the
year experience depressive symptoms in the winter
or summer

57. Sexual disorder
Disorders of preference:
Transvestism- sexual arousal occurs by wearing clothes of the
opposite sex
Sexual sadism- the person is sexually aroused by physical and
psychological humiliation, suffering, or suffering of the sexual
partner
Exhibitionism - here the person is sexually aroused by the exposure
of ones genitalia to an unsuspecting stranger
Sexual masochism- here the person is sexually aroused by physical
or psychological humiliation or injury inflected to self by other
Voyeurism- this is a persistent or recurrent tendency to observe
unsuspecting person naked and engaged in sexual activity
Paedophilia - it is characterized by persistent or recurrent
involvement of an adult in sexual activity with prepubertal children
Zoophilia - involving in sexual activity with animals

58. Sexual dysfunction:
Frigidity- absence of desire for sexual activity
Impotence – this disorder is characterized by an
inability to have or sustain penile erection till the
completion of satisfactory sexual activity of both
partners
Premature ejaculation- Ejaculation before the
completion of satisfactory sexual activity of both
partner
Non organic vaginism- an involuntary spasm of lower
1/3rd of vagina, interfering with coitus
Non organic dyspareunia- pain in the genital area of
either male or female during coitus

59. Electro convulsive therapy
ECT was first introduced by Bini and cerletti in April 1938. From 1980
onwards ECT is being considered as a unique psychiatric treatment
Voltage- 70 to 120 volts
Duration- 0.7 to 1.5 seconds
Frequency- 3 times per week
Total number- 6 to 10 up to 25 may be preferred as indicated
Indications: major depression, severe catatonia, severe psychosis,
organic mental disorder
Contra indication: Raised ICP, CHF, cerebral haemorrage, retinal
detachment, pneumona, brain tumour, cerebral aneurysm
Drugs used:
inj. Succinyl choline mg/kg (muscle relaxants)
Inj. Thiopentine sodium 3 mg/kg (anaesthetic)
Inj. Atropine 3 mg/kg (to reduce respiratory secretion and prevent
aspiration)

60. Attention deficit hyperactive disorder
Also known as hyperkinetic disorder, is persistent
pattern of inattention and or hyper activity.
Characterized by neurological disorder,
developmentally inappropriate inattention,
impulsiveness and in some cases, hyper activity
Treatment:
Methylphenidate, amphotamine
Behavioral modification technique
Cognitive behavior therapy
Social skill training
Family education

61. Mental Retardation
Significantly subaverge general intellectual
functioning resulting in or associated with concurrent
impairments in adaptive behavior and manifested
during the developmental period
Types
Mild 50 to 70
Moderate 35 to 50
Severe 20 to 35
Profound < 20

62. Psychiatric Emergencies
• Psychiatric emergency is a condition wherein the patient has
disturbance of thought, affect and psychomotor activity leading
to a threat to his existence
• Types:
– Suicide
– Violent or aggressive behavior or excitement
– Panic attacks
– Catatonic stupor
– Hysterical attacks
– Transient situational disturbances
– Delirium tremens
– Epilepsy
– Acute drug induced or extra pyramidal syndrome
– Drug toxicity
– Victims of disaster rape victim
– Stress

63. Suicide: suicide is type of deliberate self harm and is
defined as an intentional human act of killing oneself
Violent or aggressive behavior: this is a severe form of
aggressiveness. During this stage, patient will be
irrational, uncooperative, delusional and assaultive.
Panic attack: episodes of acute anxiety and panic can
occur as a part of psychotic or neurotic illness
Catatonic stupor: stupor is a clinical syndrome akinesis
and mutism but with relative preservation of
consciousness awareness
Transient situational disturbances: these are
characterized by disturbed feelings and behavior
occurring due to overwhelming external stimuli

64. Delirium tremens: delirium tremens is an acute
condition resulting from withdrawal of alcohol
Extra pyramidal syndrome: antipsychotics can cause a
variety of movement- related side effects, collectively
known as extra pyramidal syndrome
Drug toxicity: drug overdose may be an accidental or
suicidal
Victims of disaster: victims of disaster are people, who
have survived a sudden, unexpected stress
Rape victim: rape is perpetuation of an act of sexual
intercourse with a female against her will and consent
Stress: stress is the non specific response of the body to
any kind of demand made upon it

65. Methods of assessment in psychiatry
• History collection
• Mental status examination
• Mini mental status examination
• Neurological examination
• Investigation
• Psychological tests

66. Mental status examination
The mental status examination is used to
determine whether a patient is experiencing
abnormalities in thinking and reasoning ability,
feelings or behavior
• General appearance
• Speech
• Thought
• Mood and affect
• Perception
• Cognitive function

67. Neurological examination
Aspects of neurological examination
1. Level of consciousness
2. Mental status examination
3. Special cerebral functions
4. Cranial nerve function
5. Motor function
6. Sensory function
7. Cerebellar function
8. Reflexes

68. 1. Level of consciousness
Alertness: patient is awake, responds immediately
and appropriately to all verbal stimuli
Lethargic: patient is drowsy and inattentive but
arouses easily, frequently off to sleep
Stupors: He arouses with great difficulty and co
operates minimally when stimulated
Semi comatose: The patient has lost his ability to
respond to verbal stimuli. There is some response
to painful stimuli
Comatose: When the patient is stimulated there is
no response to verbal or painful stimuli, no motor
activity is seen

69. Glasgow coma scale
Best eye opening Spontaneously
To speech
To pain
No response
4
3
2
1
Best motor response Obeys verbal command
Localizes pain
Flexion- withdrawal
Flexion- abnormal
Extension
No response
6
5
4
3
2
1
Best verbal response Oriented to time, place, person
Conversation confused
Speech inappropriate
Sounds incomprehensive
No response
5
4
3
2
1
Total score 15

70. 2. Mental Status Examination
The component of the assessment of MSE is should
be examined
3. Special cerebral functions:
Assess for agnosia, apraxia and aphasia
Agnosia - inability to recognize common object
through the senses
Apraxia - Patient cannot carry out skilled act in the
absence of paralysis.
Aphasia - inability to communicate

71. Cranial nerve function

72. Motor function
Assessment of motor function involves assessing for
• Muscle size
• Muscle strength
• Muscle tone
• Muscle coordination
• Gait and movement

73. Sensory function
Sensory assessment involves testing for touch, pain,
vibration, position and discrimination
Abnormalities of sensation:
Dystherasia- well localized, irritating sensation, such as
warmth, cold, itching, tickling
Parasthesia- distortion of sensory stimuli
Anaesthesia- absence of sense of touch
Hypoesthesia- reduced sense of touch
Hyperesthesia- pathological over perception of touch
Analgesia- absence of sense of pain
Hypalgesia- reduced sense of pain
Hyperalgesia- increased sense of pain

74. Assessment of cerebellar function
(for evaluation of balance coordination)
Finger to finger test: place the index finger on the
nurse finger
Finger to nose test: tell to patient to extend his index
finger and then touch the tip of his nose several times
in rapid succession
Romberg test: nurse instruct the patient to stand with
his feet together with arm positioned one side by
closing the eyes
Tandom walking test: this is tested by having the
patient assumes a normal standing position. He is then
instructed to walk over hell on a straight line

75. Reflex activity
Reflex testing evaluates the integrity of specific
sensory and motor pathways.
Reflex activity assessment, always a part of
neurologic assessment, provides information about
the nature, location, and progression of neurological
disorder
Plantar reflex
Corneal reflex
Deep tendon reflex

76. Nursing process
Nursing process is an orderly, systematic manner of
determining the patents problems, making plans to
solve them, initiating the plan or assigning others to
implement it and evaluating the extent to which the
plan was effective in resolving the problems
identified

77. Steps in nursing process:
1. Assessing or gathering data
2. Diagnosis or identifying a problem
3. Planning or creating a plan to achieve desired
outcomes
4. Implementation
5. Evaluation

78. Nursing assessment:
Assessment involves the collection, organization, and analysis of
information, about the patients health
Sources of assessment:
1. Clinical interview
2. History taking-
1. Identification and demographic details
2. Presenting complaints/chief complaints
3. History of present illness
4. Past psychiatric history
5. Family history
6. Personal history
7. Premorbid personality
3. MSE
4. Physical examination
5. Psychological test

79. Nursing diagnosis:
It defined as clinical judgement about individual,
family or community responses to actual and
potential health problems
Planning:
Planning involves setting and prioritizing goals,
formulating nursing interventions and developing a
care plan in conjunction with patient based on the
nursing diagnosis chosen

80. Implementation:
Nursing interventions are the most powerful piece
of nursing process. Interventions are selected to
achieve patient outcome and to prevent or reduce
problems. Implementation serves as a blue print of
plan
Evaluation:
Evaluation is the process of determining the value
of an intervention. Nurse determine the
effectiveness of interventions with particular
patients