This document provides an overview of psychiatric nursing and defines key terms used in diagnosing and treating mental health issues. It begins with a definition of psychiatric nursing from the American Nurses Association emphasizing the use of human behavior theories and self-care. It then lists and defines 68 terms related to mental health diagnoses, symptoms, and treatment approaches. Finally, it discusses the history and development of international classification systems for mental disorders from ICD-8 to ICD-10 and how they have been modified for use in India.

1. Prepared by,
Vipin Chandran

2. Psychiatric Nursing:
“It is a specialized area of nursing
practice, employing theories of human
behavior as it is a science, and the
purposeful use of self as it is an art, in
the diagnosis and treatment of human
responses to actual or potential mental
health problems”
(American Nurses Association, 1994)

3. 1. Abreaction- It is a emotional release or
discharge of recalling a painful experience.
2. Abstinence- Voluntary refraining from
behavior or the use of a substance that has
caused problems in psychosocial, biologic,
cognitive/perceptual or spiritual belief of life
especially with regard to food, alcohol or
drugs.
3. Addiction- Addiction is a term used to define
a state of dependence or recurrent drug
intoxication, characterized by psychological
and physical dependence as well as tolerance.

4. 4. Aggression- An action, verbal or physical, for
dealing with frustration and anxiety caused
by not achieving a desired goal.
5. Agoraphobia- Defined an anxiety about
being in place or situations from which
escape may be difficult
6. Akathisia- Motor restlessness, inability to sit
still.

5. 7. Akinesia- Lack of physical movement.
8. Ambivalence- Co-existence of two opposing
impulses toward the same thing in the same
person at the same time.
9. Amnesia- Partial or total inability to recall
past experiences, may be organic or
emotional in origin.
10. Anergia- Lack of energy for day to day
activities.
11. Anhedonia- Loss of interest in and
withdrawal from all regular and pleasurable
activities.

6. 12. Anorexia Nervosa- An eating disorder,
characterized by self starvation, weight loss
below minimum normal weight, intense fear
of being fat.
13. Apathy- lack of emotional feeling.
14. Aphasia- Difficulty in formulation of words
or loss of language ability or it is the
disturbances in language output.
15. Abstract thinking- Ability to appreciate
nuances of meaning, multidimensional
thinking with ability to use metaphors &
hypotheses appropriately.

7. 16. Autistic thinking- Preoccupations totally
removing a person from reality.
17. Avolition- Lack of motivation or inabilities to
initiate tasks.
18. Blackout- Sudden loss of consciousness; an
episode of forgetting all or part of what
occurred during or following a period of
alcohol intake.
19. Blunted Affect- A reduction in emotional
experience.

8. 20.Bulimia Nervosa- The uncontrolled ingestion of
large amount of food followed by inappropriate
compensatory methods to prevent weight gain
and for maintaining body shape.
21. Catatonia- A state of psychologically induced
immobilization at times interrupted by episodes
of extreme agitation.
22. Circumstantiality- A disorder of thinking
process, determining tendency is maintained
but the patient can reach the goal only after
having exhaustively explored all unnecessary
associations arising in his mind.

9. 23. Clang Association- Meaningless rhyming of
words often in a forceful manner. In this,
rhyming is more important than the context of
the word.
24.Compulsion- An irrational and repetitive
impulse to perform an act.
25. Confabulation- Unconscious filling of memory
gaps by imagined or untrue experiences due to
memory impairment.
26.Conversion- Process by which a psychological
thought, event or memory is transferred to a
physical or sensory symptoms.

10. 27. Crisis- A situation in which customary problem
solving or decision- making methods are not
adequate.
28. Cyclothymic- Swings of mood of elation and
depression.
29. Defense Mechanism- Unconscious mental processes
that the ego uses to resolve conflicts, which will
abolish anxiety and depression.
30. Delirium- An etiologically non- specific syndrome
characterized by concurrent disturbances of
consciousness and attention, perception, thinking,
memory, psychomotor behavior, emotion and sleep-
wake cycle.
31. Dejavu- A subjective feeling that an experience,
which is occurring for the first time, has been
experienced before.

11. 31. Delusion- False, unshakeable belief, which is
not amenable to reasoning( Control, Grandeur,
guilt, infidelity, persecution, reference,
Erotomania, Nihilism, Somatic).
32. Dementia- Diffuse brain dysfunction
characterized by a gradual, progressive and
chronic deterioration of intellectual function,
judgment, orientation, memory, affect or
emotional stability, cognition and attention.
33. Denial- Unconscious refusal to face thoughts,
feelings, wishes, needs or reality factors that are
consciously intolerable.

12. 34.Depersonalization- A person subjective sense
of being unreal, strange or unfamiliar.
35.Derealization- A subjective sense that the
environment is strange or unreal.
36.Dyslexia- Learning disorder in the reading
domain.
37.Dissociation- The act of separating and
detaching a strong emotionally charged
conflict from one’s consciousness.

13. 38. Dysthymia- A state of chronic low-level depression
lasting for more than two years.
39. Echolalia- Pathological repetition by imitation of the
speech of another.
40. Echopraxia- Pathological repetition by imitation of
the behavior of another.
41. Flight of ideas- Rapid shift between topic that are
unrelated to each other.
42. Fugue- Dissociative fugue is characterized by
episodes of wandering away (usually from home).
43. Grandiosity- A person exaggerated conception of his
or her importance, power of identity.
44. Grief- Appropriate emotional response to an external
and consciously recognized loss.

14. 45.Hallucination- A false perception, which is
not a sensory distortion or misinterpretation,
but which occurs at the same time as real
perceptions.
46.Hyperkinetic Attention Deficit Disorder-
Disorder common in children, onset before
the age of 7 years and males more commonly
affected (6-8 times more).
47.Hypochondriasis- Disorder characterized by
preoccupation with the fear of developing a
serious disease or the belief that one has a
serious disease.

15. 48.Hypomania- Distinct period of at least a few
days of mild elevation of mood, sharpened
and positive thinking and increased energy
and activity level.
49.Hysteria- Characterized by many somatic
symptoms that cannot be explained
adequately on the basis of physical and
laboratory examination.
50.Ideas of Reference- Belief that some events
have a special personal meaning.

16. 51. Illusion- Misinterpretation of external stimuli.
52. Impulsiveness- Emotional instability and lack of
impulse control.
53. Insight- The capacity to appreciate that one’s
disturbance of thought and feeling are
subjective and invalid.
54. Labile Affect- Rapidly shifting emotions,
unrelated to external stimuli.
55. Libido- Forces by which sexual instinct is
represented in the mind.
56. Malingering- Internal productivity of false or
grossly exaggerated psychological symptoms,
motivated by extend incentives such as avoiding
military duty, avoiding work etc.

17. 57. Mania- Characterized by elevated expansive or
irritable mood.
 Euphoria (Mild elevation of mood)
 Elation (Moderate elevation of mood)
 Exaltation (Severe elevation of mood)
 Ecstasy (Very severe elevation of mood)
 Echolalia- Repetition, echo or mimicking of
phrases or words heard.
 Echopraxia- Repetition, echo, or mimicking of
action observed even when asked not to do so.
 Euthymia- Normal range of mood.

18. 58.Neologism- New word created by patient
often combining syllables of other words, for
idiosyncratic psychological reasons.
59.Neuroleptic Malignant Syndrome-
Potentially life threatening characterized by
muscular rigidity, fever, autonomic
instability and an altered level of
consciousness.
60.Oedipus complex- Attachment of the child
to the parent of the opposite sex,
accompanied by envious feelings towards the
parent of the same sex.

19. 61. Obsession- Pathological persistent of an
irresistible thoughts or feeling that cannot be
eliminated from consciousness by logical
effort, associated with anxiety.
62.Paranoia- Chronic well- systematized
delusional state without hallucination.
63.Perseveration- Persistent and inappropriate
repetition of the same thoughts, as judged by
the patient’s words or actions.
64.Phobia- Refers to the persistent, irrational,
exaggerated and invariably pathological
dread of a specific stimulus or situation.

20. Specific phobia
Social phobia
Acrophobia
Agoraphobia
Algophobia
Ailurophobia
Erythrophobia
Panphobia
Claustrophobia
Xenophobia
Zoophobia
Trypanophobia/ Tomophobia

21. 65. Pica- Persistent eating of non- nutritive
substances for at least one month.
66.Stupor- A state in which the individual does not
react to his surroundings & appear to be
unaware.
67.Tangentiality- Refers to inability to have goal
directed associations of thought, speaker never
gets from desired point to desired goal.
68.Waxy Flexibility (Cereaflexibilities)- Condition
of a person who can be molded into a position
that is then maintained, when an examiner
moves the person’s limb, the limb feels as if it
were made of wax.

23. • In the 1960’s the World Health Organization
(WHO) drafted the eighth revision of the
International Classification of Diseases(ICD-
8).
• In 1979 this was further revised as (ICD-9).
• In 1987, the ICD-9 was further refined to (ICD-
10)
• Numeric codes (001-009) were used in ICD-9.
• Whereas alpha numeric- coding scheme,
based on codes with single letter followed by
two numbers at the three- character level
(A00-299) has been adopted in ICD-10.

24. • Chapters on mental disorders in ICD-9 had
only 30 character categories (290-319).
• Chapter V (F) of ICD-10 has 100 such
categories with decimal numeric subdivision
at the four- character level.

25. F00-F09 Organic, including symptomatic, mental
disorders
F00 Dementia in Alzheimer’s disease
F01 Vascular Dementia
F02 Dementia in other disease classified elsewhere
F03 Unspecified Dementia
F04 Organic Amnestic Syndrome
F05 Delirium
F06 Other Mental Disorders due to brain damage and
dysfunction and to physical disease
F07 Personality and behavioral disorders due to brain
disease
F09 Unspecified organic or symptomatic mental
disorder

26. F10- F19 Mental and Behavioral Disorders due to
psychoactive substance use
F10- Mental & Behavioral disorders due to use of alcohol
F11- Mental & Behavioral disorders due to use of opiods
F12- Mental & Behavioral disorders due to use of cannabiniods
F13- Mental & Behavioral disorders due to use of sedatives or
hypnotics
F14- Mental & Behavioral disorders due to use of cocaine
F15- Mental & Behavioral disorders due to use of other stimulants,
including caffeine
F16- Mental & Behavioural disorders due to use of hallucinogen
F17- Mental & Behavioral disorders due to use of tobacco
F18- Mental & Behavioral disorders due to use of volatile solvents
F19- Mental & Behavioral disorders due to multiple drug use and
use of other psychoactive substances

27. F20-F29 Schizophrenia, Schizotypal and
Delusional disorders
F20- Schizophrenia
F20.0 Paranoid Schizophrenia
F20.1 Hebephrenic Schizophrenia
F20.2 Catatonic Schizophrenia
F20.3 Undifferentiated Schizophrenia
F20.4 Post- Schizophrenic Depression
F20.5 Residual Schizophrenia
F20.6 Simple Schizophrenia
F20.8 Other Schizophrenia
F20.9 Schizophrenia, unspecified

28. F21 Schizotypal Disorders
F22 Persistent Delusional Disorders
F23 Acute & Transient Psychotic Disorders
F24 Induced Delusional Disorder
F25 Schizoaffective Disorders
F28 Other nonorganic Psychotic Disorders
F29 Unspecified nonorganic Psychosis

29. F30-F39 Mood Affective Disorders
F30- Manic Episode
F30.0- Hypomania
F30.1- Mania Without Psychotic Symptoms
F30.2- Mania With Psychotic Symptoms
F30.8- Other Manic Episodes
F30.9- Manic Episode Unspecified

30. F31- Bipolar Affective Disorder
F32- Depressive Episode
F33- Recurrent Depressive Disorder
F34- Persistent Mood Affective Disorders
F38- Other Mood Affective Disorders
F39- Unspecified Mood Affective Disorders

31. F40-F48 Neurotic, Stress Related &
Somatoform Disorders
F40- Phobic Anxiety Disorders
F41- Other Anxiety Disorders
F42- Obsessive Compulsive Disorder
F43- Reaction to Severe Stress and Adjustment
Disorders
F44- Dissociative Conversion Disorders
F45- Somatoform Disorders
F48- Other Neurotic Disorders

32. F50-F59 Behavioral Syndromes Associated with
Physiological Disturbances & Physical Factors
F50- Eating Disorders
F51- Nonorganic Sleep Disorders
F52- Sexual Dysfunction, not caused by Organic
Disorder or Disease
F53- Mental & Behavioral disorders associated with
puerperium, not elsewhere classified
F54- Psychological & Behavioral Factors associated with
disorder or diseases classified elsewhere
F55- Abuse of non-dependence producing substances
F59- Unspecified Behavioral Syndromes associated with
physiological disturbance

33. F60-F69 Disorders of Adult Personality &
Behavior
F60- Specific Personality Disorders
F61- Mixed & Other Personality Disorders
F62- Enduring Personality Changes, not attributable
to brain damage and disease
F63- Habit and Impulse Disorders
F64- Gender Identity Disorders
F65- Disorders of Sexual Preference
F66- Psychological & Behavioral disorders
F68- Other Disorders of Adult personality & Behavior
F69- Unspecified Disorder of Adult Personality

34. F70-F79 Mental Retardation
F70- Mild Mental Retardation
F71- Moderate Mental Retardation
F72- Severe Mental Retardation
F73- Profound Mental Retardation
F78- Other Mental Retardation
F79- Unspecified Mental Retardation

35. F80-F89 Disorders of Psychological
Development
F80- Specific Developmental Disorders of speech &
language
F81- Specific Developmental Disorders of Scholastic
Skills
F82- Specific Developmental Disorder of Motor
Function
F83- Mixed Specific Developmental Disorder
F84- Pervasive Developmental Disorders
F88- Other Disorder of Psychological Development
F89- Unspecified Disorders of Psychological
Development

36. F90-F98 Behavioral & Emotional Disorders with
onset usually occurring in Childhood & Adolescence
F90- Hyperkinetic Disorder
F91- Conduct Disorders
F92- Mixed Disorders of Conduct & Emotions
F93- Emotional Disorders with onset specific to
childhood
F94- Disorders of social functioning with onset specific
to childhood & adolescence
F95- Tic Disorders
F98- Other Behavioral & Emotional disorders with onset
usually occurring in childhood & adolescence
F99- Unspecified Mental Disorder

37. Indian Classification:
In India Neki (1963), Wig and Singer (1967), Vahia
(1961) and Varma (1971) have attempted some
modification of ICD-8 to suit Indian Conditions.
1) PSYCHOSIS
2) NEUROSIS
3) SPECIAL DISORDERS

38. Classification of Mental Illness:
PSYCHOSIS
Functional
Schizophrenia
Affective
Mania Depression
Organic
Acute Chronic

39. NEUROSIS:
1. Anxiety Neurosis
2. Depressive Neurosis
3. Hysterical Neurosis
4. Obsessive Compulsive Neurosis
5. Phobic Neurosis

40. SPECIAL DISORDERS:
1) Childhood Disorders
2) Personality Disorders
3) Substance Abuses
4) Psychophysological Disorders
5) Mental Retardation

41. Thank You…!