Glossary

Reproduced with the permission of Otsuka America Pharmaceutical, Inc. and/or Bristol-Myers Squibb Company

 

Acute episode (also known as crisis)
A period of out-of-control behavior that occurs after a first episode or relapse of symptoms of mental illness. These episodes usually require immediate medical attention. During this time, a person often needs to be admitted to a hospital to find the medicines and counseling needed to bring symptoms under control.

Advocacy organization (also called “support organization”)
A group that works to support those with mental illness through education, service, and lobbying efforts. These national associations are often divided into local chapters. Some examples of such organizations include The National Alliance on Mental Illness (NAMI) and the National Mental Health Association (NMHA).

Aftercare day treatment
After an acute episode, many people with schizophrenia benefit from having a place to go. Frequently this is a day-treatment program, in which someone with schizophrenia will receive services and a sense of being connected to others with the illness. In this setting, a person with schizophrenia will spend the day in the program but return home at night.

Antipsychotic medicines
Antipsychotics are the most common treatment used to treat schizophrenia; also called neuroleptics, antipsychotic medicines include the dopamine receptor antagonists fluphenazine and clozapine.

Assertive community treatment (ACT)
A type of program that delivers consistent, comprehensive follow-up treatment to people with serious mental illness. With this program, people with mental illness can receive around-the-clock treatment and social services in their own homes from a team of highly trained support professionals.

Atypical antipsychotic
Second-generation antipsychotic medicines that are effective in treating positive and negative symptoms of schizophrenia.

Caregiver
A person who contributes to maintaining the health, well-being, and daily life of someone with a mental illness. The responsibilities of this role vary greatly, from assisting in basic activities such as dressing and grooming to maintaining regular social contact. Family members and friends typically serve in this role, but the term can also refer to members of the treatment team.

Case manager (also called “personal service coordinator”)
Member of the healthcare team who oversees all aspects of patient care by coordinating service delivery and ensuring the continuity and integration of services.

Clubhouse
One type of organization that offers rehabilitation services. A clubhouse offers people with mental illness training, counseling, and support in a safe, friendly social setting. Besides rehabilitation services, people with schizophrenia also find a sense of belonging at these centers.

Cognitive symptoms
Signs and effects that result from schizophrenia’s impairment of mental functioning, including the ability to perceive, reason, and make judgments. Symptoms of impaired cognitive ability include difficulty concentrating and an inability to pay attention.

Community mental health center
An outpatient clinic in which a person with mental illness can receive a range of services, including the management of medicines, follow-up psychosocial therapy, and social services.

Complementary therapies
Nonmedical, stress-reducing therapies, such as yoga, massage, and exercise, that may help maintain emotional well-being, and may complement but not replace the consensus treatment guideline of medicine.

Counselors
Professionals trained in interview and social management techniques who act on behalf of the treatment team to work with patients on specific problems.

Crisis (see acute episode)

Diagnosis
A healthcare professional’s determination that a person is suffering from a certain illness. For a mental illness such as schizophrenia, this determination is usually made after a thorough review of both a patient’s current symptoms and his or her past history of symptoms, as well as through lab tests and a physical examination to rule out other medical problems.

Dopamine
A neurotransmitter of the nervous system; levels of activity in certain areas of the brain are associated with schizophrenia.

Dopamine and serotonin
Dopamine and serotonin are neurotransmitters — chemicals that transmit messages in the brain. Dopamine is involved in several brain functions and plays a role in emotion, motor activity and cognition. Dopamine also helps regulate the release of prolactin, a hormone that controls breast milk production. Serotonin is involved in several brain functions and plays a role in the control of mood and anxiety.
 
It is believed that schizophrenia is a result of an imbalance of dopamine and serotonin, with too much of these chemicals in certain areas of the brain and too little in others. Pharmacological treatments for schizophrenia aim to balance the levels of one or both of these neurotransmitters.

Dual-diagnosis program
To help break the habit of abusing drugs and alcohol, your friend or relative may need counseling services from a dual-diagnosis program. These structured programs, sometimes referred to as mental illness chemical abuse programs (MICA), help people with schizophrenia cope simultaneously with the challenges of the illness and of sobriety.

Employment counselor (see “vocational specialists”)

Extrapyramidal symptoms (EPS)
Extrapyramidal symptoms include abnormal involuntary movements, alterations in muscle tone, and postural disturbances; may also include features of Parkinsonism (tremor, rigidity, and slow movements), akathisia (restlessness), and choreiform (dancing) or athetoid (writhing) movements.

Hospitalization/intensive partial hospitalization
During or just after an acute episode, people with schizophrenia might need help in the more structured setting of a hospital. Partial hospitalization programs provide intensive services during the day but allow people to return home at night.

Lack of insight
The inability of a person with mental illness to acknowledge that he or she has an illness. This occurs because the positive symptoms of schizophrenia sometimes distort a person’s ability to perceive his or her own condition.

Life-skills training
An aspect of rehabilitation training in which a person develops basic abilities that are required to independently perform daily activities. This training includes learning how to dress and groom oneself, balance a checkbook, and manage one’s emotions during stressful situations.

Negative symptoms
Symptoms experienced by people with schizophrenia that involve deficits in normal behavior, such as a lack of motivation, and social withdrawal.

Neurotransmitters
Neurotransmitters (neuro = pertaining to nerves) are chemical substances in the brain that transmit nerve impulses across a synapse.

Nurse practitioner
Nursing professional with additional training in delivering services normally reserved for physicians. In some states nurse practitioners may also be able to prescribe medicines.

Occupational therapist
Counseling professional who helps train people with disabilities, such as those with mental illness, to learn basic skills needed to be productive.

Outpatient medicine management
Follow-up appointments in which the treatment team oversees how a patient is responding to medicines. During these regularly scheduled visits, usually to a mental health clinic or private office, the treatment team members discuss the symptoms or side effects a patient might be experiencing and then decide together whether or not to change a prescribed regimen.

Outpatient supportive therapy
Appointments in which a person with mental illness receives psychosocial counseling, vocational training, and other services. These services are meant to supplement the medical management of the disease and are focused on the rehabilitation of a person with mental illness.

Peer educators
People with the same mental illness, or their family members, who conduct group discussions or educational sessions to help others who are ill or living with the condition.

Peer support (see “self-help groups”)

Physician assistant
Licensed healthcare professional who may perform many of the roles normally performed by physicians. In certain states, these professionals are also able to prescribe medicines. Sometimes a member of the support staff serves as a helper for the physician and is called an “assistant.” This is not to be confused with a licensed physician assistant.

Positive symptoms
In patients with schizophrenia, positive symptoms involve excesses or distortions of normal functions, including delusions, hallucinations, disorganized speech, paranoia, and grossly disorganized or catatonic behavior. Catatonic behavior is a marked decrease in reactivity to the environment and may include maintaining rigid or inappropriate postures.

Psychiatric social worker (see “social worker”)

Psychiatrist
Licensed physician with additional training in the study and treatment of mental disorders and with the ability to prescribe medicines.

Psychologist
Mental healthcare professional who often has an advanced degree in clinical training with respect to mental disorders but who is not a licensed physician.

Psychosocial counseling
Therapy that focuses on a person’s ability to develop skills needed to cope with the psychological and emotional challenges of living with mental illness. Often intended as a complement to the medical management of mental illness, this therapy can help a person learn to solve problems, manage stress and maintain relationships.

Recovery
A process through which a person with mental illness learns a new way of living a satisfying, hopeful, and contributing life within the limitations of his or her condition.

Rehabilitation
The process by which a person learns to cope with the psychological, physical, social, and emotional aspects of living with a mental illness and learns to prevent relapses. This process can take many forms, from structured sessions with a therapist or vocational specialist to less-formal meetings with peers. This aspect of treatment is intended to complement the management of symptoms with medicine.

Rehospitalization
The need to reenter a hospital for treatment after a relapse of symptoms. If relapse leads to a full-blown acute episode, it is sometimes necessary to return to the safety of a hospital to adjust medicines and bring symptoms under control.

Relapse
Signs of a disease or illness after a period of time during which symptoms are not present. If not addressed, this worsening of symptoms may progress either slowly or abruptly into an acute episode.

Schizophrenia
Schizophrenia is a complex and serious mental disorder thought to be caused by imbalances in brain chemistry that lead to abnormal thinking and behavior, including positive symptoms (e.g., hallucinations, delusions) and negative symptoms (e.g., blunted emotions, poverty of speech).

Self-help groups (also called “peer support” or “support groups”)
A group of people — either people with the same mental illness or family members of those who have the same illness — that comes together to provide mutual support. These associations of consumers and family members provide education, support, and a sense of belonging. Recently these associations have also begun to offer some mental health services, such as peer counseling.

Serotonin
A neurotransmitter that is believed to be involved in causing schizophrenia.

Sheltered employment
Structured settings in which individuals disabled by mental illness are able to perform work. Those who work in this setting are not necessarily working toward competitive employment.

Side effects
A response to a drug. Most side effects are undesirable yet cause only minor disturbances, while others may cause serious problems.

Social Security Disability Insurance (SSDI) benefits
Benefits offered by the U.S. government for people who are unable to work for long periods of time. Supplemental Security Income (SSI) benefits are available for anyone who is unable to work because of an illness. If your relative had worked before becoming ill, then he or she might also be able to receive Social Security Disability Insurance (SSDI) benefits.

Social skills training
An aspect of psychosocial counseling or vocational rehabilitation in which people with mental illness learn the skills of social interaction. During this training a person with mental illness may learn how to be more aware of social cues and facial expressions and to improve his or her ability to communicate.

Social worker (also called “psychiatric social worker”)
This core mental healthcare professional, who has earned an MSW degree, is trained to appreciate and emphasize the impact of environmental factors on mental disorders. A social worker helps patients form relationships, acting as a link among the patient, family members, and community resources.

Supplemental Security Income (SSI)
A federal income supplement program funded by general tax revenues; designed to help aged, blind, and disabled people who have little or no income and provide financial support to meet basic needs for food, clothing, and shelter.

Support groups (see “self-help groups”)

Support organization (also called “advocacy organization”)

Supported employment
This is a model of vocational rehabilitation in which a person with mental illness is trained intensively before beginning a job. Once the job begins, the person receives on-site training from a job coach and extensive support throughout the first months.

Symptoms
A specific sign of an illness. With schizophrenia, symptoms are often classified as being “positive,” “negative,” or “cognitive.”

Transitional employment
A model of vocational training by which a person with mental illness is accompanied to a job by a rehabilitation specialist.

Treatment
A process that uses medicines and follow-up services to help a person with mental illness to manage the symptoms of the illness and learn to live with its limitations. This program of therapies is usually directed by a psychiatrist and overseen by a broad team of professionals, family members, and friends.

Treatment team
The broad team of healthcare professionals, including psychiatrists, psychologists, nurse practitioners, social workers, vocational specialists, caseworkers and other caregivers who, along with family members and friends, work together to assist the treatment of a person with mental illness.

Typical antipsychotic
First-generation antipsychotics that are often effective in controlling the positive symptoms of schizophrenia (e.g., hallucinations and delusions).

Vocational specialist (also called “employment counselors”)
Training and counseling professional involved in helping people with mental illness to develop the range of skills needed to be productive. Sometimes a vocational specialist will assist people in the transition to full-time or part-time employment.

Vocational training
The process by which a person with mental illness learns the skills needed to be productive. Sometimes this therapy focuses on learning basic skills of concentration and reasoning; at other times the therapy is designed to train people for specific job skills needed for competitive employment.

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