Disordered form
Deviation from rational, logical goal directed thinking.
Autistic thinking
Directed by inner fantasies associated with social withdrawal less subject to correction by reality is normal thinking.
Blocking
Sudden cessation in the flow of thought or speech, occurs in Schizophrenia.
Schizophrenic thought disorder
Disturbance in association leading to subtle discontinuities in the flow of speech (knight’s move, derailment). May lead to neologisms (newly invented words), or incoherence when severe.
Pressure of speech
Rapid talk, voluble and difficult to interrupt. Often related anxiety.
Flight of ideas
High speed leaps from one subject to another connected tenuously, together and distractible in response to environmental stimuli. Often includes punning. Common in hypomanic illness.
Clang associations
Dictates by chance sounds of words rather than their meanings. Often found flight of ideas.
Retardation
Slowing of speech as in depression when it may be part of a general picture of psychomotor retardation.
Mutism
Refusal to speak whether for conscious or unconscious reasons.
Disordered content
Obsessions
The pathological presence of a persistent and repetitive thought, feeling or impulse that cannot be eliminated from consciousness by any logical effort. On quiet reflection the patient recognizes that it has no rational basis and that it is due to his own psychological processes rather than some outside influence. Resistance to it is accompanied by anxiety. In obsessional compulsive neurosis may lead to severe disturbance in bahaviour.
Delusions
A false idea which is held against all evidence to the contrary and which is out of context with the patient’s cultural background. It is incorrigible and egocentric.
Types
Paranoid : ideas of persecution and injustice. Depressive morbid guilt, self blame, futility.
Hypochondriacal concern with bodily and personal attributes and may be bizarre.
Grandiose : over-estimation of personal qualities, abilities. Financier (as in hypomanic illness).
References : excessive focus of attention from others, often associated with undue sensitivity or paranoid ideation.
Autochthonous (apophanous) : sudden onset fully elaborated apparently not related to situations or current preoccupation in schizophrenia).
Systematized : usually in chronic schizophrenic psychosis, when a rational internal consistency between various delusions is developed.
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