Thought disorder - Knowledge

53: 1127:) as key symptoms of psychosis. Schizophrenia-spectrum disorders such as schizoaffective disorder and schizophreniform disorder typically consist of prominent hallucinations, delusions and FTD; the latter presents as severely disorganized, bizarre, and catatonic behavior. Psychotic disorders due to medical conditions and substance use typically consist of delusions and hallucinations. The rarer delusional disorder and shared psychotic disorder typically present with persistent delusions. FTDs are commonly found in schizophrenia and mood disorders, with poverty of speech content more common in schizophrenia. 797:): An inability to answer a question without excessive, unnecessary detail. This differs from tangential thinking in that the person does eventually return to the original point. A patient may answer the question "How have you been sleeping lately?" with "Oh, I go to bed early, so I can get plenty of rest. I like to listen to music or read before bed. Right now I'm reading a good mystery. Maybe I'll write a mystery someday. But it isn't helping, reading I mean. I have been getting only 2 or 3 hours of sleep at night." 1012:"Thought disorder" here refers to disorganization of the form of thought and not content. An older use of the term "thought disorder" included the phenomena of delusions and sometimes hallucinations, but this is confusing and ignores the clear differences in the relationships between symptoms that have become apparent over the past 30 years. Delusions and hallucinations should be identified as psychotic symptoms, and thought disorder should be taken to mean formal thought disorders or a disorder of verbal cognition. 4975:, THE SYMPTOMS OF SCHIZOPHRENIA, Negative Symptoms. "The two-syndrome concept as formulated by T. J. Crow was especially important in spurring research into the nature of negative symptoms ... but this does not diminish the creative efforts that led to these scales or importance of these scales for research. In fact, it was only through careful analysis of the structure of symptoms in these scales that a more accurate characterization of the phenomenology of schizophrenia was possible." 1142:

display language disturbances like those found in schizophrenia; a 2008 study found that children and adolescents with ASD showed significantly more illogical thinking and loose associations than control subjects. The illogical thinking was related to cognitive functioning and executive control; the loose associations were related to communication symptoms and parent reports of stress and anxiety.

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months and sometimes worsen; positive TDs somewhat improve. A negative TD is a good predictor of some outcomes; patients with prominent negative TDs are worse in social functioning six months later. More prominent negative symptoms generally suggest a worse outcome; however, some people may do well, respond to medication, and have normal brain function. Positive symptoms vary similarly.

896:: Persistent repetition of words or ideas, even when another person tries to change the subject. ("It's great to be here in Nevada, Nevada, Nevada, Nevada, Nevada.") It may also involve repeatedly giving the same answer to different questions ("Is your name Mary?" "Yes." "Are you in the hospital?" "Yes." "Are you a table?" "Yes"). Perseveration can include 876:): Speech which is unintelligible because the individual words are real, but the manner in which they are strung together results in gibberish. The question "Why do people comb their hair?" elicits a response like "Because it makes a twirl in life, my box is broken help me blue elephant. Isn't lettuce brave? I like electrons, hello please!" 584:. Other studies did not find an association between FTD and structural aberrations of the language network, however, and regions not included in the language network have been associated with FTD. Future research is needed to clarify whether there is an association with FTD in schizophrenia and neural abnormalities in the language network. 803:: An instance where ideas are related only by similar or rhyming sounds rather than actual meaning. This may be heard as excessive rhyming or alliteration ("Many moldy mushrooms merge out of the mildewy mud on Mondays", or "I heard the bell. Well, hell, then I fell"). It is most commonly seen in the manic phase of 4147:: ... The main symptoms are various forms of delusions such as those of persecution (which are typical of paranoid schizophrenia); hallucinations, which are usually auditory (hearing voices), but which may also be visual or tactile; and thought disorder, leading to impaired concentration and thought processes. ... 1082:

schizophrenia. People with depression have relatively-fewer TDs; the most prominent are poverty of speech, poverty of content of speech, and circumstantiality. Andreasen noted the diagnostic usefulness of dividing the symptoms into subtypes; negative TDs without full affective symptoms suggest schizophrenia.

291:, delusions are the most common thought content disorder. A delusion is a firm, fixed belief based on inadequate grounds, not amenable to rational argument or evidence to the contrary, which is out of sync with a person's regional, cultural, or educational background. Delusions are common in people with 989:(disturbances of thought content and form), and suggested the more-specific terms content thought disorder (CTD) and formal thought disorder (FTD). CTD was defined as a TD characterized by multiple fragmented delusions, and FTD was defined as a disturbance in the form or structure of thinking. The 2013 3583:, "Chapter 6 Psychiatric Rating Scales", OTHER SCALES, Table 6–6 Scale for the Assessment of Positive Symptoms (SAPS), Positive formal thought disorder, p. 45 includes and defines Derailment, Tangentiality, Incoherence, Illogicality, Circumstantiality, Pressure of speech, Distractible speech, Clanging. 3394:"Thought Process. ... Disorders of thought process include flight of ideas, thought blocking, impaired attention, poverty of thought content, poor abstraction abilities, perseveration, idiosyncratic associations (e.g., identical predicates and clang associations), overinclusion, and circumstantiality." 1173:

TD has been criticized as being based on circular or incoherent definitions. Symptoms of TD are inferred from disordered speech, based on the assumption that disordered speech arises from disordered thought. Although TD is typically associated with psychosis, similar phenomena can appear in different

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found that different subtypes of TD occur at different frequencies in those with mania, depression, and schizophrenia. People with mania have pressured speech as the most prominent symptom, and have rates of derailment, tangentiality, and incoherence as prominent as in those with schizophrenia. They

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Language abnormalities exist in the general population, and do not necessarily indicate a condition. They can occur in schizophrenia and other disorders (such as mania or depression), or in anyone who may be tired or stressed. To distinguish thought disorder, patterns of speech, severity of symptoms,

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impairment in people with schizophrenia—measured by the difference between fluency (e.g. the number of animals' names produced in 60 seconds) and phonological fluency (e.g. the number of words beginning with "F" produced in 60 seconds)—predicts the severity of formal thought disorder, suggesting that

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and poverty of content. The two groups were posited to be at either end of a spectrum of normal speech, but later studies showed them to be poorly correlated. A comprehensive measure of FTD is the Thought and Language Disorder (TALD) Scale. The Kiddie Formal Thought Disorder Rating Scale (K-FTDS) can

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As possibly something else: "Dissociative Disorders", Differential Diagnosis, Psychotic disorders, p. 296 "... Dissociative experiences of identity fragmentation or possession, and of perceived loss of control over thoughts, feelings, impulses, and acts, may be confused with signs of formal thought

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She also cited the prognostic value of negative-positive-symptom divisions. In manic patients, most TDs resolve six months after evaluation; this suggests that TDs in mania, although as severe as in schizophrenia, tend to improve. In people with schizophrenia, however, negative TDs remain after six

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Unfortunately, "thought disorder" is often involved rather loosely to refer to both FTD and delusional content. For the sake of clarity, the unqualified use of the phrase "thought disorder" should be discarded from psychiatric communication. Even the designation "formal thought disorder" covers too

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Autism spectrum disorders (ASD) whose diagnosis requires the onset of symptoms before three years of age can be distinguished from early-onset schizophrenia; schizophrenia under age 10 is extremely rare, and ASD patients do not display FTDs. However, it has been suggested that individuals with ASD

1138:, when an individual fakes illness for other gains, by clinical presentations; malingerers feign thought content with no irregularities in form such as derailment or looseness of association. Negative symptoms, including alogia, may be absent, and chronic thought disorder is typically distressing. 527:

course of FTD. The most comprehensive longitudinal study of FTD by 2023 found a distinction in the longitudinal course of thought-disorder symptoms between schizophrenia and other psychotic disorders. The study also found an association between pre-index assessments of social, work and educational

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Any disturbance of thinking that affects language, communication, or thought content; the hallmark feature of schizophrenia. Manifestations range from simple blocking and mild circumstantiality to profound loosening of associations, incoherence, and delusions; characterized by a failure to follow

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Houghtalen, Rory P; McIntyre, John S (2017). "7.1 Psychiatric Interview, History, and Mental Status Examination of the Adult Patient". In Sadock, Virginia A; Sadock, Benjamin J; Ruiz, Pedro (eds.). Kaplan & Sadock's Comprehensive Textbook of Psychiatry (10th ed.). Wolters Kluwer. HISTORY AND

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has found that negative symptoms tend to correlate with one another, but positive symptoms tend to separate into two groups. The three clusters became known as negative symptoms, psychotic symptoms, and disorganization symptoms. Alogia, a TD traditionally classified as a negative symptom, can be

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Neurotypical thought—consisting of awareness, concerns, beliefs, preoccupations, wishes, fantasies, imagination, and concepts—can be illogical, and can contain contradictory beliefs and prejudices or biases. Individuals vary considerably, and a person's thinking may also shift from time to time.

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Formal thought disorder affects the form (rather than the content) of thought. Unlike hallucinations and delusions, it is an observable, objective sign of psychosis. FTD is a common core symptom of a psychotic disorder, and may be seen as a marker of severity and as an indicator of prognosis. It

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n. a symptom of thought disorder, often occurring in individuals with schizophrenia, marked by frequent interruptions in thought and jumping from one idea to another unrelated or indirectly related idea. It is usually manifested in speech (speech derailment) but can also be observed in writing.

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Thought content: Delusions— persecutory (paranoid), grandiose, infidelity, somatic, sensory, thought broadcasting, thought insertion, ideas of reference, ideas of unreality, phobias, obsessions, compulsions, ambivalence, autism, dereism, blocking, suicidal or homicidal preoccupation, conflicts,

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The Thought Disorder Index (TDI), also known as the Delta Index, was developed to help further determine the severity of TD in verbal responses. TDI scores are primarily derived from verbally-expressed interpretations of the Rorschach test, but TDI can also be used with other verbal samples

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medication is often used to treat FTD. Although the vast majority of studies of the efficacy of antipsychotic treatment do not report effects on syndromes or symptoms, six older studies report the effects of antipsychotic treatment on FTD. These studies and clinical experience indicate that

3391:"Form of Thought. Disorders of the form of thought are objectively observable in patients' spoken and written language. The disorders include looseness of associations, derailment, incoherence, tangentiality, circumstantiality, neologisms, echolalia, verbigeration, word salad, and mutism." 1148:

have been useful for assessing TD in disturbed patients. A series of inkblots are shown, and patient responses are analyzed to determine disturbances of thought. The nature of the assessment offers insight into the cognitive processes of another, and how they respond to equivocal stimuli.

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People with schizophrenia have more negative TD, including poverty of speech and poverty of content of speech, but also have relatively high rates of some positive TD. Derailment, loss of goal, poverty of content of speech, tangentiality and illogicality are particularly characteristic of

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TD which is unresponsive to treatment predicts a worse illness course. In schizophrenia, TD severity tends to be more stable than hallucinations and delusions. Prominent TDs are more unlikely to diminish in middle age, compared with positive symptoms. Less-severe TD may occur during the

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perspective. Singer and Wynne said that familial communication patterns play a key role in shaping the development of FTD; dysfunctional social interactions undermine a child's development of cohesive, stable mental representations of the world, increasing their risk of developing FTD.

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and is an observable sign of psychosis. As a common, core symptom of psychosis, it may be seen as a marker of severity and a predictor of prognosis. FTD reflects a cluster of cognitive, linguistic, and affective disturbances which has generated research interest from the fields of

468:(TLC disorders). Up to seven domains of FTD have been described on the Thought, Language, Communication (TLC) Scale, with most of the variance accounted for by two or three domains. Some TLC disorders are more suggestive of severe disorder, and are listed with the first 11 items. 2820:

Wang, X; Savage, R; Borisov, A; Rosenberg, J; Woolwine, B; Tucker, M; May, R; Feldman, J; Nemeroff, C; Miller, A (October 2006). "Efficacy of risperidone versus olanzapine in patients with schizophrenia previously on chronic conventional antipsychotic therapy: A switch study".

3895:"Thought disorder is the most studied form of the disorganization symptoms. It is referred to as "formal thought disorder," or "conceptual disorganization," or as the "disorganization factor" in various studies that examine cognition or subsyndromes in schizophrenia. ..." 1183:

separated into two types: poverty of speech content (a disorganization symptom) and poverty of speech, response latency, and thought blocking (negative symptoms). Positive-negative-symptom diametrics, however, may enable a more accurate characterization of schizophrenia.

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As the proper FTD: "Schizophrenia Spectrum and Other Psychotic Disorders", Key Features That Define the Psychotic Disorders, Disorganized Thinking (Speech), p. 88 "Disorganized thinking (formal thought disorder) is typically inferred from the individual's speech.

3117:"... The paucity of meaningful content in the presence of a normal amount of speech that is sometimes included in alogia is actually a disorganization of thought and not a negative symptom and is properly included in the disorganization cluster of symptoms. ..." 122:—all disturbances of thought content and form. Two specific terms have been suggested—content thought disorder (CTD) and formal thought disorder (FTD). CTD has been defined as a thought disturbance characterized by multiple fragmented delusions, and the term 769:: A poverty of speech in amount or content, it is classified as a negative symptom of schizophrenia. When further classifying symptoms, poverty of speech content (little meaningful content with a normal amount of speech) is a disorganization symptom. Under 1065:

It was believed that TD occurred only in schizophrenia, but later findings indicate that it may occur in other psychiatric conditions (including mania) and in people without mental illness. Not all people with schizophrenia have a TD; the condition is not

825:): Thought frequently moves from one idea to another which is obliquely related or unrelated, often appearing in speech but also in writing ("The next day when I'd be going out you know, I took control, like uh, I put bleach on my hair in California"), 3956:, THINKING DISTURBANCES, Continuity. "Word salad describes the stringing together of words that seem to have no logical association, and verbigeration describes the disappearance of understandable speech, replaced by strings of incoherent utterances." 3984:

Disturbance in the form of thought rather than the content of thought; thinking characterized by loosened associations, neologisms, and illogical constructs; thought process is disordered, and the person is defined as psychotic. Characteristic of

204:. A clinical difference exists between these two groups. Patients with psychoses are less likely to show awareness or concern about disordered thinking, and those with other disorders are aware and concerned about not being able to think clearly. 515:

is marked by irrelevant intrusions and pronounced combinatory thinking, usually with a playfulness and flippancy absent from patients with schizophrenia. The FTD present in patients with schizophrenia was characterized by disorganization,

3033:Çokal, Derya; Sevilla, Gabriel; Jones, William Stephen; Zimmerer, Vitor; Deamer, Felicity; Douglas, Maggie; Spencer, Helen; Turkington, Douglas; Ferrier, Nicol; Varley, Rosemary; Watson, Stuart; Hinzen, Wolfram (19 September 2018). 2429: 659:

required by the therapy. However, provisional evidence suggests that FTD may not preclude the effectiveness of CBT. Kircher and colleagues have suggested that the following methods should be used in CBT for patients with FTD:

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de Bruin, Esther I.; Verheij, Fop; Wiegman, Tamar; Ferdinand, Robert F. (January 2007). "Assessment of formal thought disorder: The relation between the Kiddie Formal Thought Disorder Rating Scale and clinical judgment".

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of two words which are similar in meaning or sound. Although neologisms may refer to words formed incorrectly whose origins are understandable (such as "headshoe" for "hat"), these can be more clearly referred to as word

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categorizes FTD as "a psychotic symptom, manifested as bizarre speech and communication." FTD may include incoherence, peculiar words, disconnected ideas, or a lack of unprompted content expected from normal speech.

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Yalincetin, Berna; Bora, Emre; Binbay, Tolga; Ulas, Halis; Akdede, Berna Binnur; Alptekin, Koksal (July 2017). "Formal thought disorder in schizophrenia and bipolar disorder: A systematic review and meta-analysis".

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use the term "formal thought disorder" broadly, referring to abnormalities in thought form with psychotic cognitive signs or symptoms, and studies of cognition and subsyndromes in schizophrenia may refer to FTD as

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A criticism related to the separation of symptoms of schizophrenia into negative or positive symptoms, including TD, is that it oversimplifies the complexity of TD and its relationship to other positive symptoms.

174:. One of the first known cases of thought disorders, or specifically OCD as it is known today, was in 1691. John Moore, who was a bishop, had a speech in front of Queen Mary II, about "religious melancholy." 2540:

Nestor, Paul G.; Shenton, Martha E.; Wible, Cindy; Hokama, Hiroto; O'Donnell, Brian F.; Law, Susan; McCarley, Robert W. (February 1998). "A neuropsychological analysis of schizophrenic thought disorder".

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Although formal thought disorder typically refers to marked abnormalities in the form and flow or connectivity of thought, some clinicians use the term broadly to include any psychotic cognitive sign or

942:: Wandering from the topic and never returning to it, or providing requested information ("Where are you from?" "My dog is from England. They have good fish and chips there. Fish breathe through gills"). 621:, however; environmental influences, such as allusive thinking in parents during childhood, and environmental risk factors for schizophrenia (including childhood abuse, migration, social isolation, and 126:

is often used to refer to an FTD: a disruption of the form (or structure) of thought. Also known as disorganized thinking, FTD results in disorganized speech and is recognized as a major feature of

2249:(4th ed.). New York: Springer Science+Business Media. 6.6. Clinical Findings, 6.6.2. Mental Status Examination in a Subject with Schizophrenia, 6.6.2.5. Thought Form and Content, p. 103. 869:: Conclusions are reached which do not follow logically (non sequiturs or faulty inferences). "Do you think this will fit in the box?" is answered with, "Well of course; it's brown, isn't it?" 3202:. indicates and briefly defines the follow types: Clanging, Circumstantial, Derailment (loose associations), Flight of ideas, Incoherence (word salad), Neologism, Tangential, Thought blocking 1165:). TDI has a twenty-three-category scoring index; each category scores the level of severity on a scale from 0 to 1, with .25 being mild and 1.00 being most severe (0.25, 0.50, 0.75, 1.00). 458:

be used to assess the presence of formal thought disorder in children and their childhood. Although it is very extensive and time-consuming, its results are in great detail and reliable.

4090:, p. 81: ... In addition, disturbances of affect and volition, and thought disorder are usually prominent. Hallucinations and delusions may be present but are not usually prominent. ... 2999:

Palmier-Claus, Jasper; Griffiths, Robert; Murphy, Elizabeth; Parker, Sophie; Longden, Eleanor; Bowe, Samantha; Steele, Ann; French, Paul; Morrison, Anthony; Tai, Sara (2 October 2017).

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reflects a cluster of cognitive, linguistic, and affective disturbances that have generated research interest in the fields of cognitive neuroscience, neurolinguistics, and psychiatry.

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de Sousa, Paulo; Spray, Amy; Sellwood, William; Bentall, Richard P. (December 2015). "'No man is an island'. Testing the specific role of social isolation in formal thought disorder".

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Spohn, H. E.; Coyne, L.; Larson, J.; Mittleman, F.; Spray, J.; Hayes, K. (January 1986). "Episodic and Residual Thought Pathology in Chronic Schizophrenics: Effect of Neuroleptics".

882:: Completely new words (or phrases) whose origins and meanings are usually unrecognizable ("I got so angry I picked up a dish and threw it at the geshinker"). They may also involve 3406:

Ganos, Christos; Ogrzal, Timo; Schnitzler, Alfons; Münchau, Alexander (September 2012). "The pathophysiology of echopraxia/echolalia: Relevance to Gilles De La Tourette syndrome".

859:: A form of FTD marked by abrupt leaps from one topic to another, possibly with discernible links between successive ideas, perhaps governed by similarities between subjects or by 4001:

disruptions in the form or structure of thinking. Examples include derailment and tangentiality. It is distinct from TD, in which the disturbance relates to thought content."

834:: Echoing of another's speech, once or in repetition. It may involve repeating only the last few words (or the last word) of another person's sentences, and is common on the 430: 828:

Distractible speech: In mid-speech, the subject is changed in response to a nearby stimulus ("Then I left San Francisco and moved to ... Where did you get that tie?")

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Remberk, Barbara; Namysłowska, Irena; Rybakowski, Filip (December 2012). "Cognition and communication dysfunctions in early-onset schizophrenia: Effect of risperidone".

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and residual periods of schizophrenia. Treatment for thought disorder may include psychotherapy, such as cognitive behavior therapy (CBT), and psychotropic medications.

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FTD in schizophrenia has been found to be associated with structural and functional abnormalities in the language network, where structural studies have found bilateral

3571:... consists of suppressing an idea that is next in a thought series and replacing it with another idea closely related to it. Also called paralogia; perverted logic." 2189:"This form of thought is most characteristic of mania and tends to be overinclusive, with difficulty in excluding irrelevant, extraneous details from the association." 1778:

Bora E, Yalincetin B, Akdede BB, Alptekin K (July 2019). "Neurocognitive and linguistic correlates of positive and negative formal thought disorder: A meta-analysis".

4084:, p. 80: ... Thought disorder may be obvious in acute states, but if so it does not prevent the typical delusions or hallucinations from being described clearly. ... 2100:

Houghtalen RP, Mcintyre JS (2017). "7.1 Psychiatric Interview, History, and Mental Status Examination of the Adult Patient". In Sadock VA, Sadock BJ, Ruiz P (eds.).

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to fixed delusions. These beliefs and delusions are typically non-specific diagnostically, even if some delusions are more prevalent in one disorder than another.

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Andreasen NC (November 1979). "Thought, language, and communication disorders. I. Clinical assessment, definition of terms, and evaluation of their reliability".

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Andreasen NC (November 1979). "Thought, language, and communication disorders. I. Clinical assessment, definition of terms, and evaluation of their reliability".

232:. At the core of thought content disorder are abnormal beliefs and convictions (after taking the person's culture and background into consideration) ranging from 863:, puns, wordplay, or innocuous environmental stimuli (such as the sound of birds chirping). It is most characteristic of the manic phase of bipolar disorder. 1157:

inkblots from others whose thought processes were considered normal, and it has become one of the most widely used assessment tools for diagnosing TDs.

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Miller DD, Arndt S, Andreasen NC (2004). "Alogia, attentional impairment, and inappropriate affect: their status in the dimensions of schizophrenia".

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Evasion: The next logical idea in a sequence is replaced with another idea closely (but not accurately or appropriately) related to it; also known as

4444:, Schizophrenia Spectrum and Other Psychotic Disorders, Key Features That Define the Psychotic Disorders, Disorganized Thinking (Speech), p. 88. 1046:

wide a territory. It should always be made clear whether one is referring to derailment or loose associations, flight of ideas, or circumstantiality.

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includes delusions, hallucinations, disorganized thought process (formal thought disorder), and disorganized or abnormal motor behavior (including

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Kircher, Tilo; Bröhl, Henrike; Meier, Felicitas; Engelen, Jennifer (June 2018). "Formal thought disorders: from phenomenology to neurobiology".

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Arndt S, Alliger RJ, Andreasen NC (March 1991). "The distinction of positive and negative symptoms. The failure of a two-dimensional model".

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Singer, Margaret Thaler; WYNNE, LC (February 1965). "Thought Disorder and Family Relations of Schizophrenics: IV. Results and Implications".

770: 496:, 27 to 80 percent of patients with schizophrenia present with FTD. A hallmark feature of schizophrenia, it is also widespread amongst other 1153:

developed this test to diagnose schizophrenia after realizing that people with schizophrenia gave drastically different interpretations of

2090:, HISTORY AND EXAMINATION, Risk Assessment "Suicidal, violent, and homicidal ideation fall under the category of thought content ..." 4539:(10th ed.). Wolters Kluwer. CLINICAL PRESENTATIONS OF MALINGERING, Psychological Symptomatology: Clinical Presentations, Psychosis. 890:

Overinclusion: The failure to eliminate ineffective, inappropriate, irrelevant, extraneous details associated with a particular stimulus.

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demonstrate FTD, suggesting that it is not exclusive to schizophrenia. About six percent of healthy subjects exhibit a mild form of FTD.

352:: belief that insignificant remarks, coincidental events, or innocuous objects in one's environment have personal meaning or significance 111: 1005:

which generally defined thought disorders similarly to the psychiatric glossaries and used the word in other entries as the ICD-10 did.

4074:, p.59: Features suggestive of schizophrenia, such as bizarre delusions, hallucinations, or thought disorder, may also be present. ... 268:: the need to perform an act persistently and repetitively (without it necessarily leading to a reward or pleasure) to reduce distress 2650:

Marengo, J. T.; Harrow, M. (January 1997). "Longitudinal Courses of Thought Disorder in Schizophrenia and Schizoaffective Disorder".

2015:, "Chapter 1 Psychiatric History and Mental Status Examination", MENTAL STATUS EXAMINATION, Thought Disorder, Thought Content., p. 7. 936:: Speech characterized by words or phrases which are flowery, excessive, and pompous ("The attorney comported himself indecorously"). 617:

linked to glutamatergic transmission contribute to functional aberrations in typical language-related brain areas. FTD is not solely

274:: belief that one's thoughts alone can bring about effects in the world, or that thinking something corresponds with doing that thing 4061: 4482:

Ivleva EI, Tamminga CA (2017). "12.16 Psychosis as a Defining Dimension in Schizophrenia". In Sadock VA, Sadock BJ, Ruiz P (eds.).

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Formal thought disorder (FTD) is also known as disorganized speech. Evidence of disorganized thinking, it is a hallmark feature of

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Matorin AA, Shah AA, Ruiz P (2017). "8 Clinical Manifestations of Psychiatric Disorders". In Sadock VA, Sadock BJ, Ruiz P (eds.).

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antipsychotics are often an effective treatment for patients with positive or negative FTD, but not all patients respond to them.

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Cuesta, Manuel J.; Peralta, Victor; De Leon, Jose (January 1994). "Schizophrenic syndromes associated with treatment response".

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Several theories have been developed to explain the causes of formal thought disorder. It has been proposed that FTD relates to

2694:(10th ed.). Wolters Kluwer. RELATIONSHIP OF NEUROCOGNITIVE IMPAIRMENT TO SCHIZOPHRENIA SYMPTOMS, Formal Thought Disorder. 927:: Viewing innocuous stimuli as having a specific meaning for the self ("What's the time?" "It's 7 o'clock. That's my problem"). 5096: 5077: 5031: 5012: 4569: 4544: 4516: 4491: 4411: 4386: 4168: 4024: 3883: 3483: 3450: 3199: 2699: 2262: 2180: 2148:

nihilistic ideas, hypochondriasis, depersonalization, derealization, flight of ideas, idé fixe, magical thinking, neologisms.

2140: 2135:(10th ed.). Wolters Kluwer. MENTAL STATUS, Table 7.2–1. Common Questions for the Psychiatric History and Mental Status. 2116:

Thought content: obsession, delusion, magical thinking, overvalued ideas, ideas of reference or influence, persecutory ideas.

2109: 1893: 1355: 610: 2104:(10th ed.). Wolters Kluwer. Table 7.1-5. Elements of the Mental Status Examination with Examples of Abnormal Findings. 655:

evaluating the effectiveness of CBT for treating psychosis often exclude individuals with severe FTD because it reduces the

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typically assess FTD by initiating an exploratory conversation with patients and observing the patient's verbal responses.

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Semantic paraphasia: Substitution of inappropriate words ("I slipped on the coat, on the ice I mean, and broke my book").

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It can be subdivided into clusters of positive and negative symptoms and objective (rather than subjective) symptoms. On

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Harvey PD, Keefe RS, Eesley CE (2017). "12.10 Neurocognition in Schizophrenia". In Sadock VA, Sadock BJ, Ruiz P (eds.).

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Holzman, P. S.; Shenton, M. E.; Solovay, M. R. (January 1986). "Quality of Thought Disorder in Differential Diagnosis".

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Liddle PF (August 1987). "The symptoms of chronic schizophrenia. A re-examination of the positive-negative dichotomy".

4406:(5th ed.). Saunders Elsevier. Schizophrenic Language Disorder, CLINICAL DESCRIPTION AND THOUGHT DISORDER, p. 167. 4051:"The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines (CDDG)" 3915: 3743: 3529: 3341: 3149: 1974: 1652: 1433: 1386: 1302: 4688:

Diagnostic Psychological Testing: The Theory, Statistical Evaluation, and Diagnostic Application of a Battery of Tests

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Lewis SF, Escalona R, Keith SJ (2017). "12.2 Phenomenology of Schizophrenia". In Sadock VA, Sadock BJ, Ruiz P (eds.).

3781:"Unpleasant and pleasant referential thinking: Relations with self-processing, paranoia, and other schizotypal traits" 3676:

n. failure of an individual to eliminate ineffective or inappropriate responses associated with a particular stimulus.

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semantic and syntactic rules that is inconsistent with the person's education, intelligence, or cultural background."

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A 2017 psychiatric text describing thought disorder as a "disorganization syndrome" in the context of schizophrenia:

948:: Meaningless, stereotyped repetition of words or phrases which replace understandable speech; seen in schizophrenia. 225: 2891:

Namyslowska, Irena (January 1975). "Thought disorders in schizophrenia before and after pharmacological treatment".

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Kircher T, Bröhl H, Meier F, Engelen J (June 2018). "Formal thought disorders: from phenomenology to neurobiology".

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Abnormalities in the structure or content of thought, as reflected in a person's speech, writing, or behaviour. ...

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Barrera A, McKenna PJ, Berrios GE (2009). "Formal thought disorder, neuropsychology and insight in schizophrenia".

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Derailment is essentially equivalent to loosening of associations. See cognitive derailment; thought derailment."

1001:(which only used the word "thought disorder", always accompanied with "delusion" and "hallucination") and a 2002 364:: belief that one's thoughts are not one's own, but belong to someone else and have been inserted into one's mind 4560:

Sikich L, Chandrasekhar T (2017). "53 Early-Onset Psychotic Disorders". In Sadock VA, Sadock BJ, Ruiz P (eds.).

4140:: ... Symptoms include delusions, hallucinations, thought disorders, loss of affect, mania, and depression. ... 4590:"Formal thought disorder and the autism spectrum: relationship with symptoms, executive control, and anxiety" 4300:

Andreasen NC (November 1979). "Thought, language, and communication disorders. II. Diagnostic significance".

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Disturbance in thinking in which a person exhibits delusions that may be multiple, fragmented, and bizarre."

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2280:"A rating scale for the assessment of objective and subjective formal Thought and Language Disorder (TALD)" 1197: 648: 591: 346:: belief that the person, or someone to whom the person is close, is being malevolently treated in some way 4760:"Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report" 4373:(4th ed.). New York: Springer Science+Business Media. 4.7. Clinical Picture, 4.7.2. Symptoms, p. 59. 60:

Cloth embroidered by a person diagnosed with schizophrenia; non-linear text has multiple colors of thread.

1067: 978: 652: 102:. Psychiatric and psychological glossaries in 2015 and 2017 identified thought disorders as encompassing 5121: 4991: 3931: 3759: 3545: 3357: 3165: 3131:, "6 Psychiatric Rating Scales", Table 6–5 Scale for the Assessment of Negative Symptoms (SANS), p. 44. 2131:

Sadock BJ (2017). "7.2 Outline for a Psychiatric Examination". In Sadock VA, Sadock BJ, Ruiz P (eds.).

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Content thought disorder is a thought disturbance in which a person experiences multiple, fragmented

4350: 3239:, Chapter 16 Schizophrenia, APPLICATION OF THE NURSING PROCESS, Thought Process and Content, p. 446. 277:

Overvalued ideas: false or exaggerated belief held with conviction, but without delusional intensity

3937: 3878:(10th ed.). Wolters Kluwer. THE SYMPTOMS OF SCHIZOPHRENIA, Disorganization, Thought Disorder. 3765: 3551: 3363: 3171: 1996: 1674: 1455: 1408: 1324: 808: 573: 561:

deficit (being confused about what has already been said in a conversation) and attentional focus.

501: 340:: belief that one is the greatest, strongest, fastest, richest, or the most intelligent person ever 300: 4814:, 25.6. Relationship Between Thought Disorders and Other Symptoms of Schizophrenia., pp. 503–504. 4432:, 25.6. Relationship Between Thought Disorders and Other Symptoms of Schizophrenia., pp. 503–504. 4202:"Neural correlates of formal thought disorder: An activation likelihood estimation meta-analysis" 4050: 2167:(4th ed.). New York: Springer Science+Business Media. 1.5.5. Speech and Thought., pp. 8–10. 602:

in the superior temporal gyrus in patients with schizophrenia, is a major cause of positive FTD.

577: 376:

Outside control: belief that outside forces are controlling one's thoughts, feelings, and actions

373:

Influence: belief that other people (or external agents) are covertly exerting power over oneself

3216:(7th ed.). Wolters Kluwer. CONTENT OF THE ASSESSMENT, Thought Process and Content, p. 232. 1918: 388:

Nihilistic: belief that the mind, the body, the world at large, or parts thereof no longer exist

150:). Disorganized speech leads to an inference of disorganized thought. Thought disorders include 52: 5040: 3965: 3657: 3580: 3385: 3128: 2994: 2992: 2278:

Kircher T, Krug A, Stratmann M, Ghazi S, Schales C, Frauenheim M, et al. (December 2014).

2012: 1545:"The Epidemiology and Associated Phenomenology of Formal Thought Disorder: A Systematic Review" 1484: 1478: 1073:

When defining thought-disorder subtypes and classifying them as positive or negative symptoms,

905: 629: 618: 569: 411: 312: 5021: 3977: 3564: 1944: 1512: 667:

Repeat and clarify the core issues and main emotions that the patient is trying to communicate

3194:

EXAMINATION, Thought Process/Form, Table 7.1–6. Examples of Disordered Thought Process/Form.

790: 735: 497: 493: 379: 188:, said that TD was its defining characteristic. Disturbances of thinking and speech, such as 147: 2989: 2231:, HISTORY AND EXAMINATION, Thought Content & Table 7.1–7. Examples of Delusional Thought 787:): An abrupt stop in the middle of a train of thought which may not be able to be continued. 511:

The characteristics of FTD vary amongst disorders. A number of studies indicate that FTD in

255:

Preoccupation: centering thought on a particular idea in association with a strong affection

773:, thought blocking is considered a part of alogia, and so is increased latency in response. 656: 651:(CBT) is another treatment for FTD, but its effectiveness has not been well-studied. Large 355: 343: 243:

Content thought disorder is not limited to delusions. Other possible abnormalities include

370:: belief that thoughts have been "taken out" of one's mind, and one has no power over this 8: 4313: 4284: 4078:... Hallucinations, thought disorder, or isolated catatonic phenomena may be present. ... 2939: 2763: 2592: 2383: 2229:

Psychiatric Interview, History, and Mental Status Examination of the Adult Patient (2017)

2088:

Psychiatric Interview, History, and Mental Status Examination of the Adult Patient (2017)

915:: Mispronunciation; syllables out of sequence ("I slipped on the lice and broke my arm"). 482: 337: 320: 265: 74: 114:(a reasoning disorder characterized by expression of illogical or delusional thoughts), 5116: 4918: 4846: 4786: 4759: 4663: 4638: 4614: 4589: 4338: 4226: 4201: 4013: 3805: 3780: 3712: 3687: 3635: 3610: 3501: 3059: 3034: 2487: 2163:

Akiskal HS (2016). "1 The Mental Status Examination". In Fatemi SH, Clayton PJ (eds.).

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may also reflect TD, and can be observed and assessed with mental-status tests such as

524: 438: 367: 248: 3688:"Phonetic basis of phonemic paraphasias in aphasia: Evidence for cascading activation" 2926:

Hurt, Stephen W. (December 1983). "Thought Disorder: The Measurement of Its Changes".

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Roche, Eric; Creed, Lisa; MacMahon, Donagh; Brennan, Daria; Clarke, Mary (July 2015).

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The heritability of FTD has been demonstrated in a number of family and twin studies.

5092: 5073: 5046: 5027: 5008: 4955: 4951: 4910: 4881: 4838: 4791: 4742: 4691: 4668: 4619: 4565: 4540: 4512: 4511:(10th ed.). Wolters Kluwer. BIPOLAR DISORDERS, Bipolar I Disorder, Acute Mania. 4487: 4407: 4382: 4317: 4288: 4231: 4164: 4106: 4020: 3968:, "Chapter 4 Signs and Symptoms in Psychiatry", GLOSSARY OF SIGNS AND SYMPTOMS, p. 32 3879: 3845: 3841: 3810: 3717: 3660:, "Chapter 4 Signs and Symptoms in Psychiatry", GLOSSARY OF SIGNS AND SYMPTOMS, p. 29 3640: 3489: 3479: 3456: 3446: 3423: 3217: 3195: 3064: 2978: 2943: 2908: 2904: 2873: 2838: 2834: 2802: 2798: 2767: 2732: 2695: 2667: 2632: 2596: 2558: 2522: 2479: 2409: 2387: 2347: 2311: 2258: 2176: 2136: 2105: 1922: 1889: 1858: 1825: 1807: 1795: 1741: 1623: 1574: 1488: 1378: 1351: 1273: 1150: 939: 839: 707: 454: 361: 259: 244: 197: 159: 65: 4922: 4850: 4564:(10th ed.). Wolters Kluwer. DIFFERENTIAL DIAGNOSIS, Autism Spectrum Disorders. 4369:

Coryell W, Clayton PJ (2016). "4 Bipolar Illness". In Fatemi SH, Clayton PJ (eds.).

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studies, using a semantic verbal-fluency task performed by the participants during

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Ninivaggi FJ (2017). "28.1 Malingering". In Sadock VA, Sadock BJ, Ruiz P (eds.).

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Schizophrenic Speech: Making Sense of Bathroots and Ponds that Fall in Doorways

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3114:"... In this way, alogia is conceived of as a 'negative thought disorder.' ..." 2457: 2455: 2453: 2451: 2449: 2447: 2445: 2443: 1145: 1078:

are likelier to have pressured speech, distractibility, and circumstantiality.

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Tufan, Ali Evren; Bilici, Rabia; Usta, Genco; Erdoğan, Ayten (December 2012).

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their frequency, and any resulting functional impairment can be considered.

401:. FTD, a disorder of the form (rather than content) of thought, encompasses 4795: 4776: 4672: 4623: 4235: 3814: 3721: 3644: 3427: 3068: 2877: 2842: 2771: 2736: 2636: 2483: 2351: 2315: 2030:, THINKING DISTURBANCES, Thought Content, Disturbances in Thought Contents. 1862: 1799: 1745: 1627: 1578: 1277: 1202: 866: 590:

which might cause FTD have also been investigated. Studies have found that

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Motor speech disorders: substrates, differential diagnosis, and management

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Gently encourage patients to clarify what they are trying to communicate

2408:(5th ed.). Arlington, VA: American Psychiatric Association. 2013. 982: 958: 912: 901: 873: 554: 419: 331: 115: 70: 5004: 4217: 4131: 4101: 3419: 3141: 2569: 2306: 1854: 1089:

A prominent TD at illness onset suggests a worse prognosis, including:

3521: 2018: 1124: 1113: 1026: 966: 897: 879: 831: 739: 517: 288: 193: 131: 107: 91: 4999:(2nd ed.). Washington, DC: American Psychological Association. 3099:, 25.4. What Are the Common Types of Thought Disorder?, pp. 498–499. 762:

Thirty symptoms (or features) of TD have been described, including:

676:

Ask patients to slow down and explain how one point leads to another

4404:

Sims' Symptoms in the Mind: Textbook of Descriptive Psychopathology

3102: 3087:, 25.3. What Are the Boundaries of Thought Disorder?., pp. 498–499. 1940: 1938: 997:

for disorganized thinking and speech. This contrasts with the 1992

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Kaplan and Sadock's Concise Textbook of Clinical Psychiatry (2008)

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Kaplan and Sadock's Concise Textbook of Clinical Psychiatry (2008)

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Kaplan and Sadock's Concise Textbook of Clinical Psychiatry (2008)

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Kaplan and Sadock's Concise Textbook of Clinical Psychiatry (2008)

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Kaplan and Sadock's Concise Textbook of Clinical Psychiatry (2008)

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Diagnostic and statistical manual of mental disorders : DSM-5

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Kaplan and Sadock's Concise Textbook of Clinical Psychiatry (2008)

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Diagnostic and statistical manual of mental disorders : DSM-5

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Kaplan & Sadock's Comprehensive Textbook of Psychiatry (2017)

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Kaplan & Sadock's Comprehensive Textbook of Psychiatry (2017)

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Kaplan & Sadock's Comprehensive Textbook of Psychiatry (2017)

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Kaplan & Sadock's Comprehensive Textbook of Psychiatry (2017)

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Roche E, Creed L, MacMahon D, Brennan D, Clarke M (July 2015).

998: 921:: Rapid speech without pauses, which is difficult to interrupt. 766: 743: 614: 280: 4972: 4103:

The British Medical Association Illustrated Medical Dictionary

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Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Fatemi SH, Folsom TD (2016). "6 Schizophrenia". In Fatemi SH,

2153: 358:: belief that others can hear (or are aware of) one's thoughts 4329:

Andreasen NC, Hoffrnann RE, Grove WM (1984). Alpert M (ed.).

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Kaplan and Sadock's Concise Textbook of Clinical Psychiatry

4588:

Solomon M, Ozonoff S, Carter C, Caplan R (September 2008).

4425: 4423: 3567:, Appendix B Glossary of Psychiatry and Psychology Terms. " 385:

Somatic: belief that one has a disease or medical condition

5024: