Thought disorder

Thought disorder
Other namesFormal thought disorder (FTD), thinking disorder
Textile art embroidered by a person diagnosed with schizophrenia, showing non-linear text with multiple colors of thread
Cloth embroidered by a person diagnosed with schizophrenia; non-linear text has multiple colors of thread.
SpecialtyPsychiatry, clinical psychology

A thought disorder (TD) is a disturbance in cognition which affects language, thought and communication.[1][2] Psychiatric and psychological glossaries in 2015 and 2017 identified thought disorders as encompassing poverty of ideas, neologisms, paralogia (a reasoning disorder characterized by expression of illogical or delusional thoughts), word salad, and delusions—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 thought disorder is often used to refer to an FTD:[3] a disruption of the form (or structure) of thought.[4] Also known as disorganized thinking, FTD results in disorganized speech and is recognized as a major feature of schizophrenia and other psychoses[5][6] (including mood disorders, dementia, mania, and neurological diseases).[7][5][8] Disorganized speech leads to an inference of disorganized thought.[9] Thought disorders include derailment,[10] pressured speech, poverty of speech, tangentiality, verbigeration, and thought blocking.[8] 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."[11]

Formal thought disorder affects the form (rather than the content) of thought.[12] Unlike hallucinations and delusions, it is an observable, objective sign of psychosis.[12] 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.[8][13] It reflects a cluster of cognitive, linguistic, and affective disturbances that have generated research interest in the fields of cognitive neuroscience, neurolinguistics, and psychiatry.[8]

Eugen Bleuler, who named schizophrenia, said that TD was its defining characteristic.[14] Disturbances of thinking and speech, such as clanging or echolalia, may also be present in Tourette syndrome;[15] other symptoms may be found in delirium.[16] 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.[17]

  1. ^ Hart M, Lewine RR (May 2017). "Rethinking Thought Disorder". Schizophrenia Bulletin. 43 (3): 514–522. doi:10.1093/schbul/sbx003. PMC 5464106. PMID 28204762.
  2. ^ "Thought disorder". APA Dictionary of Psychology. Washington, DC: American Psychological Association. n.d. Retrieved 23 February 2020.
  3. ^ Hardan, Antonio Y.; Gilbert, Andrew R. (2009). "Schizophrenia, Phobias, and Obsessive-Compulsive Disorder". Developmental-Behavioral Pediatrics. pp. 474–482. doi:10.1016/B978-1-4160-3370-7.00048-1. ISBN 978-1-4160-3370-7.
  4. ^ "Formal thought disorder". APA Dictionary of Psychology. Washington, DC: American Psychological Association. n.d. Retrieved 23 February 2020.
  5. ^ a b "Disorganized speech". APA Dictionary of Psychology. Washington, DC: American Psychological Association. n.d. Retrieved 23 February 2020.
  6. ^ Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). American Psychiatric Association. 2013. p. 88. ISBN 9780890425541.
  7. ^ Cite error: The named reference Saddock-thought disorder was invoked but never defined (see the help page).
  8. ^ a b c d Roche E, Creed L, MacMahon D, Brennan D, Clarke M (July 2015). "The Epidemiology and Associated Phenomenology of Formal Thought Disorder: A Systematic Review". Schizophrenia Bulletin. 41 (4): 951–62. doi:10.1093/schbul/sbu129. PMC 4466171. PMID 25180313.
  9. ^ Roche, Eric; Creed, Lisa; MacMahon, Donagh; Brennan, Daria; Clarke, Mary (July 2015). "The Epidemiology and Associated Phenomenology of Formal Thought Disorder: A Systematic Review: Fig. 1". Schizophrenia Bulletin. 41 (4): 951–962. doi:10.1093/schbul/sbu129. PMC 4466171. PMID 25180313.
  10. ^ "Derailment". APA Dictionary of Psychology. Washington, DC: American Psychological Association. n.d. Retrieved 23 February 2020.
  11. ^ "The history of OCD | OCD-UK". Retrieved 12 May 2023.
  12. ^ a b Kircher T, Bröhl H, Meier F, Engelen J (June 2018). "Formal thought disorders: from phenomenology to neurobiology". The Lancet. Psychiatry. 5 (6): 515–526. doi:10.1016/S2215-0366(18)30059-2. PMID 29678679. S2CID 5036067.
  13. ^ Bora E, Yalincetin B, Akdede BB, Alptekin K (July 2019). "Neurocognitive and linguistic correlates of positive and negative formal thought disorder: A meta-analysis". Schizophrenia Research. 209: 2–11. doi:10.1016/j.schres.2019.05.025. PMID 31153670. S2CID 167221363.
  14. ^ Colman, A. M. (2001) Oxford Dictionary of Psychology, Oxford University Press. ISBN 0-19-860761-X
  15. ^ Barrera A, McKenna PJ, Berrios GE (2009). "Formal thought disorder, neuropsychology and insight in schizophrenia". Psychopathology. 42 (4): 264–9. doi:10.1159/000224150. PMID 19521143. S2CID 26079338.
  16. ^ Noble, John (1996). Textbook of Primary Care Medicine. Mosby. p. 1325. ISBN 978-0-8016-7841-7.
  17. ^ Jefferson JW, Moore DS (2004). Handbook of medical psychiatry. Elsevier Mosby. p. 131. ISBN 0-323-02911-6.