Chapter 31
Reduced motivation, interest, or emotional involvement in activities and surroundings.
Medication-related movement disorders, especially associated with dopamine-blocking drugs, including akathisia, dystonia, parkinsonism, and tardive dyskinesia.
Extrapyramidal side effects (EPSEs)
Reductions in usual functioning, such as diminished emotional expression, motivation, speech, pleasure, or social engagement.
Negative symptoms
An involuntary, sustained or recurring deviation of the eyes, usually upward, caused by a dystonic muscle reaction.
Oculogyric crisis
Misinterpretations of actual sensory stimuli, such as mistaking a shadow for a person.
Illusions
Reduced amount, richness, or elaboration of thinking, often reflected in brief answers and limited spontaneous speech.
Poverty of thought
Difficulty recognizing familiar objects, people, or sounds despite adequate basic sensory functioning.
Agnosia
Interpreting unrelated events or remarks as having special personal meaning, without the fixed certainty of a delusion.
Ideas of reference
Absence or marked reduction of movement, including difficulty initiating voluntary movement.
Akinesia
Fixed beliefs maintained despite strong contradictory evidence and not explained by the person’s cultural or religious context.
Delusions
Involuntary spasms of the voice-box or throat muscles that can impair speaking, swallowing, or breathing; airway involvement is a medical emergency.
Laryngeal-pharyngeal dystonia
A state involving impaired reality testing, often with delusions, hallucinations, or markedly disorganized thinking.
Psychosis
Feeling that one’s surroundings are unreal, distant, dreamlike, or unfamiliar.
Derealization
Sensory experiences, such as hearing voices or seeing things, that occur without an external stimulus.
Hallucinations
Repeatedly continuing a word, idea, response, or action even after it is no longer appropriate or the subject has changed.
Perseveration
Difficulty identifying and describing one’s own emotions.
Alexithymia
Abnormally slow movement, often with reduced spontaneous movement.
Bradykinesia
A potentially persistent movement disorder associated with prolonged exposure to dopamine-blocking medications, often causing repetitive movements of the mouth, tongue, face, limbs, or trunk.
Tardive dyskinesia
Abnormal, involuntary movements, such as repetitive, twisting, or jerking motions.
Dyskinesia
Reduced ability to experience pleasure or interest in previously enjoyable activities.
Anhedonia
Involuntary muscle contractions that cause twisting movements or abnormal, sometimes painful postures.
Dystonia
A mental disorder involving disturbances in thinking, perception, emotional expression, motivation, and functioning, which may include episodes of psychosis.
Schizophrenia
Inner restlessness and a strong urge to move, often shown by pacing, rocking, or difficulty sitting still.
Akathisia
An abnormal twisting or tilting of the neck; in a medication-related dystonic reaction, it results from involuntary neck-muscle contractions.
Torticollis
Experiences or behaviors added to usual functioning, such as hallucinations, delusions, and disorganized speech or behavior.
Positive symptoms
A rare, life-threatening reaction usually associated with antipsychotics, involving high fever, severe muscle rigidity, altered mental status, and unstable autonomic functions.
Neuroleptic malignant syndrome (NMS)