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Lexicon of Psychiatric and Mental Health Terms

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Lexicon of Psychiatric and Mental Health Terms Lexicon of psychiatric and mental health terms SECOND EDITION World Health Organization Geneva 1994 WHO Library Cataloguing in Publication Data Lexicon of psychiatric and mental health terms.-2nd ed. 1.Mental disorders-terminology 2.Psychiatry-terminology ISBN 92 4 154466 X (NLM Classification: WM 15) The World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. Applications and enquiries should be addressed to the Office of Publications, World Health Organization, Geneva, Switzerland, which will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available. © World Health Organization 1994 Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. Typeset in India Printed in England 93/9727 - Macmillan/Ciays- 6500 Contents Introduction 1 Acknowledgements 3 Definitions of terms 4 Introduction Far from being a pastime of retired academics, psychiatric lexicography today is a necessary counterpart of the standardization of diagnosis and the refinement of classification in the mental health field. The past hvo decades have witnessed the introduction of explicit (or "operational") diagnostic criteria in a fieldthat was formerly considered open to subjective interpretation, with clinical judgement as the final arbiter. Recent classifications of mental and behavioural disorders, such as DSM-IIIR1 and Chapter V(F) of ICD-102, have been developed with the ambitious goal of serving as clinical, research, and teaching tools rather than merely as conventions for statistical reporting of psychiatric diagnoses. Clinical descriptions and diagnostic guidelines for some 380 disorders are incorporated in The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic g11idelines,3 which represents a major step towards the attainment of a "common language" among mental health professionals and other workers worldwide. However, agreement and mutual understanding in the mental health field will remain incomplete or spurious unless the syntax provided by the classification and diagnostic criteria is complemented by an equally explicit and acceptable lexis. Clinical descriptions and diagnostic guidelines, explicit as they are, use terms that are not themselves defined. Many of these terms have a long history and evolved in contexts different from the one provided by current classifications. Some of them have changed their meanings repeatedly. In addition, modem psychiatry is increasingly permeated by concepts and by related terms originating in other scientific and clinical fields with which psychiatry is interacting: biology, genetics, physiology, neurology, psychology, and the social sciences. There is a practical need in clinical work teaching, and research for reference to an authoritative lexicon of terms. In 1989 the World Health Organization published the Lexicon of psychiatric and mental health terms, Volume 1 (Lexicon 1), which contained definitions of over 300 terms that appeared in Chapter V of ICD-9.4 This was the result of a joint project between the WHO Division of Mental Health and the US Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA), which had sponsored much of the work leading to a better congruence between ICD and other national classifications in the mental health field, and to the development of international diagnostic instruments for field and clinical research. 1 Diagnostic and staiisticalmmuu<! cf mm!al disorders, 3rd ed. (revised). Washington, DC. American Psychiatric Assodation, 1987. 2 International Statistical Classification o.f Diseases and Rdated Health Problems. Tenth Revision. Vol. I: Tabular list. Geneva, World Health Organization. 1992 (Chapter V(F) Mental and behavioural disorders). 3 The ICD-IO Class(licaiion of 1\1wial m'd Beirav:oHraZ Disorders: Clinical descriptions and diagnostic guidelines. Geneva, World Health Organization, 1992. 4 International Classifiwtion of Diseases. :\;'inth R£C:isiotc. Vol. I. Geneva, World Health Organization, 1977. 1 ---------- ------ -- --------- - ----------- Lexicon of psychiatric and mental health terms Following the finalization of the ICD-10 Classification of Mental and Behavi­ oural Disorders, it became apparent that the lexicographic work initiated in connection with ICD-9 was in need of continuation to account for the many new terms that had been incorporated in ICD-10. It was under the aegis of the joint WHO/ADAMHA project that this new version of the Lexicon was conceived and prepared. The second edition of the Lexicon of psychiatric and mental health terms is designed as a companion volume to the ICD-IO Classification of Mental and Behavioural Disorders. It contains some 700 terms that appear in the text of ICD-IO and that, in the judgement of experts, require definitions. Some of these, common to both ICD-9 and ICD-IO, have been reproduced, with minor modifications, from Lexicon I. The majority of terms, however, had to be defined de novo, except for the names of disorders that have a descriptive definition in ICD-IO. As in Lexicon I, most of the terms incorporated in this second edition fall into three broad categories: (i) names of diseases, syndromes, and other conditions that appear as diagnoses in psychiatry; (ii) names of symptoms or signs and other psychopathological terms used in the descriptions or definitions of psychiatric disorders; and (iii) terms for abstract constructs reflecting relationships or rules and principles used in the conceptual construction of psychiatric diagnosis and classifica­ tion. However, this second edition of the Lexicon includes a fourth category of terms, namely those originating in disciplines and fields outside psychiatry, which have gained a firm position within the mental health area. In contrast to the tripartite structure of Lexicon I, corresponding to categories (i)-(iii), the arrangement of terms in the second edition follows the alphabetical principle throughout. Where appropriate, the code number of the ICD-IO category in which the term appears is given in parentheses for each entry. Alternative names of certain disorders are given in square brackets, e.g. acquired aphasia with epilepsy [Landau-Kleffner syndrome]. For most of the terms, existing synonyms (or near synonyms) have been listed; where it is recommended that the user consult a related term in the Lexicon, the suggestion "See also" is given. The use of bold type for any term within a definition indicates the existence of a lexicon entry for that term. The definitions were drafted and edited by a small editorial group consisting of Professor Michael Shepherd, Professor Assen Jablensky, and Dr Robert Campbell. In the final stages of the project the group was assisted by Dr Aleksandar Janca of the Division of Mental Health, WHO. Dr Norman Sartorius, then Director, Division of Mental Health, WHO, provided overall support and advice throughout this pro­ longed, and often laborious, project. 2 Acknowledgements As was the case for the first edition of the Lexicon of psychiatric and mental health terms, the preparation of this edition was supported by funds provided through the World Health Organization/National Institutes of Health (formerly ADAMHA) Joint Project on the Diagnosis and Classification of Mental Disorders, Alcohol- and Drug-Related Problems. 3 Definitions of terms abreaction The process of discharge or release of emotional tension associated with a repressed conflict, memory, or idea and often accompanied by the recall of a painful experience. As a technique it was introduced originally by Breuer (1842-1925) in a psychoanalytical context, but the term has since been broadened and has entered general parlance. abuse 1. Excessive or improper use of substances, e.g. alcohol or other drugs, which may result in damage to health or increased risk of such damage. See also: abuse of non-dependence-producing substances; caffeine use disorder; harmful use; substance use disorder 2. Mistreatment; harming or injuring another. See also: child abuse; deprivation; maltreatment syndrome; victimology abuse of non-dependence-producing substances Excessive or inappropriate use of any of a wide variety of medicinals, proprietary drugs, and herbal and folk remedies. Particularly important groups are: 1. psychotropic drugs that do not produce dependence, such as antidepres- sants; 2. laxatives (abuse of which is termed laxative habit); and 3. analgesics such as aspirin and paracetamol. Also within this group are antacid abuse, vitamin abuse, and abuse of steroids or hormones. acculturation difficulty Slowness or inadequacy in adapting to the demands of a new environment
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