Glossary

Fixed false belief based on incorrect inference about external reality. The delusions are not consistent with patient's intelligence and cultural background and cannot be corrected by reasoning. Occurs in some psychotic states and firmly sustained despite clear evidence to the contrary. The belief is not part of a cultural tradition such as an article of religious faith. Can range from being quite bizarre and fragmented to being plausible and organised.

Types of delusions include: bizarre, jealous, erotomanic, grandiose, control, reference, persecution, somatic, thought broadcasting and thought insertion.

Systematised delusions are a stable set of delusions in which various psychotic features tend to interrelate, and the person is able to discuss most things in terms of his/her delusional system. Documented in thought content section of MSE.

Non-systematised delusions are those that change rapidly in content; their organisation is difficult to elucidate and the psychotic elements are not particularly interrelated. Non-systematised delusions usually extend into many areas of life, and new data - new people and situations - are constantly incorporated to further support the presence of the delusion. The patient usually has concurrent mental confusion, hallucinations, and some affective lability.

Dimensions of Delusions:

• Conviction - How convinced person is of belief.

• Extent - Do delusions involve many areas of person's life?

• Bizarreness - A delusion that involves a phenomenon that the person's culture would regard as physically impossible. Bizarre delusions suggest schizophrenia.

• Disorganization - Are beliefs internally consistent, logical, and systematised?

• Pressure - How preoccupied person is with belief.

Types of delusions:

• Passivity experiences/delusions of control - False belief that a person's will, thoughts, or feelings are being controlled by external forces. These include thought broadcasting, thought insertion or thought withdrawal.

• Grandiose/ delusions of grandeur - False belief that the behaviour of others refers to oneself or that events, objects, or other people have a particular and unusual significance, usually of a negative nature. Derived from idea of reference in which persons falsely feel that others are talking about them. For example, a belief that a television program or newspaper article has special meaning for him/her or that a person on the television or radio are talking about/or to them.

Sensation of unreality concerning oneself, parts of oneself, or ones environment that occurs under extreme stress or fatigue. Seen in schizophrenia, depersonalisation disorder and schizotypal personality disorder.

When used to describe a mood, depression refers to feelings of sadness, despair, and discouragement. As such, depression may be a normal feeling state. The overt manifestations are highly variable and may be culture specific. Depression may be a symptom seen in a variety of mental or physical conditions, a syndrome of associated symptoms secondary to an underlying illness, or a specific mental illness. Slowed thinking, decreased pleasure, decreased purposeful physical activity, guilt and hopelessness, and disorders of eating and sleeping may be seen in the depressive syndrome.

Pattern of speech in which a person's ideas slip off one track onto another that is completely unrelated or only obliquely related. Thoughts are disconnected or illogically connected. In its worst form, derailment develops into loosening of associations and then further deteriorates into word salad. Documented in thought form and flow section of MSE.

Feeling dejected. Without or almost without hope.

Acting according to one's inner drives or feelings, without regard for restraints imposed by cultural norms or superego. Removal of an inhibitory, constraining, or limiting influence.

The loss of awareness of the position of the self in relation to space, time, or other person; confusion.

Unconscious defence mechanism involving the segregation of any group of mental or behavioural processes from the rest of the person's psychic activity. May entail the separation of an idea form its accompanying emotional tone.

Inability to maintain attention; shifting from one area or topic to another with minimal stimulus.

Unusual rhythms found in a person's speech.