PIIMIC Glossary

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Capgra’s syndrome - The delusion that a close friend or relative has been replaced by an impostor. Can occur in paranoid schizophrenia, affective (mood) disorders, and organic brain syndrome.

Catalepsy - Muscles seem to freeze, holding the body, face and limbs in a semi-rigid pose, sometimes for many hours. The subject either resists attempts to change the posture or adopts a new unyielding position. Can be a symptom of schizophrenia, epilepsy, conversion disorder, brain disease, or some drugs.

Cataplexy - A brief but sudden and complete loss of muscle tone - without loss of consciousness - causing the subject to collapse. Associated with narcolepsy and other sleep disorders.

Catatonia - Stiff or rigid movement and posture.  Such cases stop communicating and may not speak for weeks or even months, but can suddenly lose control and explode in a rush of aggressive or disorganized behaviour. Similar to Catalepsy but poses are held more rigidly. A rare symptom of schizophrenia and some brain diseases.

CBT (Cognitive behaviour therapy) - A talk therapy that suggests more positive ways of thinking about the subject’s relationship to the environment. Helps patients concentrate their thinking and behaviour on improving their functioning.

Children and teens (prevalence) – For legal issues, see Juveniles and Minors in Glossary. Also see Glossary for Prevalence - Juveniles in detention. Serious mental disorders are being diagnosed at younger ages, and more often than previously identified, including anxiety and mood disorders, psychotic disorders (schizophrenia), disruptive behavior disorders, and substance dependency. Other disorders always show symptoms at an early age, for example Autism (rare), Attention Deficit Hyperactivity Disorder (ADHD).

Clinical Depression - See Depression in Glossary.

Cognitive impairment - Defective thinking process, interfering with normal relations to others or to the environment. A common symptom of psychiatric disorders. See CBT in the Glossary.

Cognitive therapy - is aimed at relieving symptoms rather than resolving underlying conflicts. It is used for the treatment of depression, anxiety disorders (mainly panic and phobias), anger management, personality disorders, and marital therapy. Therapeutic efforts aim to decrease faulty perceptions and negative attitudes. This is done by identifying how the patient reacts to life situations and helping the patient test the validity of these reactions. For example, someone who assumes that bad things never happen to good people might feel intensely unworthy in the face of an adverse event. The therapist attempts to modify this tendency by persuading the patient that adverse events occur for many reasons, most of which have nothing to do with the worth of the person.

Committal Criteria - In civil cases, committal to hospital of persons of any age (see Glossary entry on Juveniles & Minors) is a decision made not by police or the judicial system, but by the examining physician(s) at hospital – based on meeting criteria under sec.22 of the BC Mental Health Act. Physicians must find:
1)         Seriously impaired behaviour needing psychiatric treatment; and,
2)         The subject is not suitable for admission as a voluntary patient. (This means that, without committal, the person would likely refuse admission to hospital).
Physicians must also find either that:
3)         The person needs care in order to prevent the person’s substantial mental or physical deterioration. (This means that without treatment, the person would likely deteriorate to the point that they would need the protection of an in-patient setting); or,
4)         The person needs care for the protection of the person or the protection of others. (The term protection has been clarified by the BC Supreme Court. In addition to physical dangerousness, it can include physical, social, family, vocational or financial harms caused by a mental disorder. Protection of self can include any of the above and also suicidal threats or gestures. Making threats, or acting under delusions can be evidence of a need for protection. Unlike police apprehension criteria, physicians do not need to find likely endangerment of the subject or others.)

The Act makes it clear that the purpose of detaining someone through involuntary admission is to enable treatment of the person’s mental disorder. The Act provides for appropriate psychiatric treatment of all involuntary patients, including those who are incapable of appreciating the nature of the treatment and/or the need for treatment, and are therefore unable to give consent, or refuse to give it. In respect of civil rights, the Act provides various information and review procedures. (For police intervention criteria, see Apprehension Criteria in Glossary.)

Community release orders (probation, conditional sentence, bail, recognizance) Various types of conditional releases from court charges or from jail sentences as ordered by judges. See Parole in the Glossary for releases by parole boards.

Probation - A sentence imposed by a judge either in lieu of, or in addition to a term of imprisonment, fine, or conditional sentence. The probation term can be up to three years and is supervised by a probation officer. Various conditions can apply. In cases of mental illness, the offender is often required to attend for treatment or counselling and to take medication as prescribed by a treatment provider. Actual wording as to degree or frequency of treatment is determined by the judge at the time of sentencing. There are case law limitations on the extent to which an individual can be forced to accept treatment. Jurisdiction for probation is Canada wide.

Conditional sentence - Similar to probation. A sentence of imprisonment to be served in the community. Can be applied only to sentences of less than two years. Various conditions can apply, as in probation, and are supervised by probation officers. Breaches can result in the offender having to serve all or part of the remaining sentence in jail. In a variation of conditional sentences, electronic monitoring of curfew conditions can be imposed. In cases of mental disorder, an offender may be required to attend for treatment and/or counseling and to take medications as prescribed by a treatment provider.

Bail - A release from court that allows an alleged offender to remain in the community. The offender may be released on recognizance, with or without surety, or on bail. Conditions of the bail orders often require the alleged offender to report at specific times to a bail supervisor, remain within the jurisdiction of the court, and not change employment or residence without notifying the court or bail supervisor. In cases of mental disorder, conditions might include abstaining from drugs or alcohol, or taking medication as directed by a treatment provider.

Recognizance - Similar to bail. Commonly used in domestic disputes under provisions for violence in sec. 810 of the Criminal Code. A recognizance order is imposed when there has not been a formal charge laid, but there is sufficient evidence that another person has fear of personal injury (for self, spouse or child), serious personal harm or sexual harm, or that personal property will be damaged. Such orders can be imposed for up to 12 months and require the defendant to adhere to conditions imposed to secure good conduct. Jail for up to 12 months is the alternative for refusing to enter the recognizance.

Co-morbid – A generic medical term for co-occurring illnesses that typically tend to occur together, such as Autism and Deafness; Diabetes and Heart Disease; HIV and Hepatitis (etc.). Can also include co-occurring psychiatric disorders. See Concurrent Disorders and Dual Diagnosis in Glossary.

Compensate and decompensate - Refers to subject’s own efforts, and external supports, intended to adjust behaviour and lifestyle to the symptoms of a mental illness. During a recovery phase, a subject may go off medication, or be exposed to stress, or treatment will start to fail, and symptoms may start to return. Subject will be showing "signs of decompensating."

Compliance, non compliance - Cooperation or non-cooperation with treatment. Usually refers to medication but can also cover terms or conditions related to involuntary hospitalization and leave, probation or parole, attending outpatient counseling, etc. Some health professionals prefer to use "adherence" or non-adherence to medical treatment, especially when subject is a voluntary patient. See Glossary entry on Treatment Compliance Issues.

Concurrent Disorder – According to current regional health usage in BC in early 2003, concurrent disorder means a psychiatric disorder co-occurring with addiction (substance abuse) The condition was previously called dual disorder. Often used interchangeably with “co-morbid” conditions. See Glossary entry on Dual Disorder.

Conduct disorder - "Delinquent or Anti-social" behaviour. Repetitive and persistent pattern of violating rights of others, norms or rules. Prone to criminal activity, difficulty at home, in school and in the community is common, along with very early sexual activity. A teenage subject may project an image of toughness, but self-esteem is usually low. Sometimes accompanied by other disorders (ADHD, depression, alcohol and drug abuse).  See Personality Disorders in Glossary.

Confusion - Reduced awareness of surroundings, impaired focus on topics or relationships. Preoccupied with events or thoughts inappropriate to surroundings, for example, turns on gas stove and forgets to light it. Various causes including alcohol or drug intoxication, diabetic coma, stroke, mental disorder or brain trauma.

Consumer and Consumer Survivor - Either term means: a user of mental health services. The term consumer was originally adopted by the mental health community as a politically correct way to convey that de-institutionalized patients now had choices of services. It has become a short convenient label often used by people in the mental health system including consumers themselves. More recently it became politically correct in some circles to use the term "person with a mental disorder," however this term becomes awkward when used repeatedly in written form. Some consumers, advocating reform of mental health services, call themselves "consumer survivors," to signify they have survived the defects of the system. Terms like patient, sufferer, victim or survivor are in general use but each has a specific shade of meaning. This website project was developed mainly for police and for practical convenience, so in many cases it uses the simple and neutral term "subject." It is well appreciated that "subjects" are people.

Conversion disorder - Painful emotions or memories are suppressed and subconsciously converted into physical symptoms. Example: a paralyzed arm expresses guilt and relieves anxiety over some kind of injury the subject caused with the arm. Can be linked with psychiatric or organic disorders. Treated by psychotherapy.

Cost of mental disorders to Canadian public purse - The annual cost of mental illness in Canada is much higher than previously thought, and is now rated as the single most costly category of disease affecting Canadians. A recent Health Canada study gives a "very conservative" estimate of $14.4 billion annually in treatment, medication, premature death and lost productivity (as surveyed in 1998). Lost work time accounted for $6 billion of the total, and was found to be badly under-estimated in previous studies.

Crisis – In the broad mental health environment, crisis can take many forms, ranging from emotional anguish at the loss of housing or other supports, to a disabling psychotic break with unpredictable and unsafe behaviour. Some emotional crisis situations are well within the range that can be handled by supportive family or friends, without an immediate call on police for mental health emergency response. In a severe crisis, however, with mental illness known or suspected, and potential serious harm to the subject or others, there should be no hesitation in calling police for help. In such a crisis, the subject’s usual coping strategies are suddenly overwhelmed by real and/or perceived threats to safety, well-being or stability. To stop potential harm (including violence and suicide) the subject needs reassurances of help, and emergency medical attention leading to treatment and stabilization. Police have the authority, in their role as peace officers even if no crime is involved, to apprehend and transport the subject safely to medical attention. Hospital settings can provide links to services and supports in the community, and assist with discharge planning and ongoing treatment and guidance.     

Criteria – See Glossary entries: Apprehension Criteria for police; and Committal Criteria for physicians (involuntary).