Thought disorder

Thought disorder
Other namesFormal thought disorder (FTD), thinking disorder
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 multifaceted construct that reflects abnormalities in thinking, language, and communication.[1][2] Thought disorders encompass a range of thought and language difficulties and include poverty of ideas, perverted logic (illogical or delusional thoughts), word salad, delusions, derailment,[3] pressured speech, poverty of speech, tangentiality, verbigeration, and thought blocking.[4] One of the first known public presentations of a thought disorder, specifically obsessive–compulsive disorder (OCD) as it is now known, was in 1691, when Bishop John Moore gave a speech before Queen Mary II, about "religious melancholy."[5]

Two subcategories of thought disorder are content-thought disorder, and formal thought disorder.[2][6] CTD has been defined as a thought disturbance characterized by multiple fragmented delusions. A formal thought disorder is a disruption of the form (or structure) of thought.[7][8] Also known as disorganized thinking, FTD affects the form (rather than the content) of thought.[9][10] FTD results in disorganized speech and is recognized as a key feature of schizophrenia and other psychotic disorders[11][10] (including mood disorders, dementia, mania, and neurological diseases).[12][11][4] Unlike hallucinations and delusions, it is an observable, objective sign of psychosis.[9] 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.[4][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.[4]

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. ^ a b Uzman Özbek S, Alptekin K (January 2022). "Thought Disorder as a Neglected Dimension in Schizophrenia". Alpha Psychiatry. 23 (1): 5–11. doi:10.1530/alphapsychiatry.2021.21371 (inactive 17 July 2025). PMC 9674097. PMID 36425242.{{cite journal}}: CS1 maint: DOI inactive as of July 2025 (link)
  3. ^ "Derailment". APA Dictionary of Psychology. Washington, DC: American Psychological Association. n.d. Retrieved 23 February 2020.
  4. ^ 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.
  5. ^ "The history of OCD | OCD-UK". Retrieved 12 May 2023.
  6. ^ "Thought disorder". APA Dictionary of Psychology. Washington, DC: American Psychological Association. n.d. Retrieved 23 February 2020.
  7. ^ 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.
  8. ^ "Formal thought disorder". APA Dictionary of Psychology. Washington, DC: American Psychological Association. n.d. Retrieved 23 February 2020.
  9. ^ 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.
  10. ^ a b Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). American Psychiatric Association. 2013. p. 88. ISBN 9780890425541.
  11. ^ a b "Disorganized speech". APA Dictionary of Psychology. Washington, DC: American Psychological Association. n.d. Retrieved 23 February 2020.
  12. ^ Cite error: The named reference Saddock-thought disorder was invoked but never defined (see the help page).
  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.
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