Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-25T14:44:18.440Z Has data issue: false hasContentIssue false

4 - Disorders of Thought and Speech

Published online by Cambridge University Press:  12 January 2024

Patricia Casey  and
Brendan Kelly
Patricia Casey
Affiliation:
University College Dublin
Brendan Kelly
Affiliation:
Trinity College, Dublin
Get access

Summary

Disorders of thought include disorders of intelligence, disorders of the stream of thought, disorders of thought possession and obsessions, and disorders of the content and form of thinking. This chapter outlines disorders of intelligence, disorders of thinking, disorders of thought tempo, disorders of the continuity of thinking and disorders of the content of thinking. It presents descriptions of obsessions and primary and secondary delusions, as well as detailed examinations of specific delusions of persecution, infidelity, love, grandiosity, ill-health, guilt, nihilism and poverty. Speech disorders are also explored, along with aphasias. The chapter concludes with suggested questions for eliciting specific symptoms in clinical practice, in addition to standard history-taking and mental state examination. Disorders of thought and speech are central to the manifestation and diagnosis of many psychiatric disorders, including schizophrenia, and this chapter provides both descriptions and explanations of key signs and symptoms in this field.

Keywords

psychopathologyintelligenceformal thought disorderobsessionsdelusionsspeech disordersaphasia
Type
Chapter
Information
Fish's Clinical Psychopathology
Signs and Symptoms in Psychiatry
 , pp. 42 - 62
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (5th ed.) (DSM-5). Washington, DC: American Psychiatric Association.Google Scholar
Ardila, A. (1999) A Neuropsychological Approach to Intelligence. Neuropsychology Review, 9, 117–36.Google ScholarPubMed
Bentall, R. P. (ed.) (1990) Reconstructing Schizophrenia. London: Routledge.Google Scholar
Bentall, R. P. (2003) Madness Explained: Psychosis and Human Nature. London: Allen Lane.Google Scholar
Blackwood, N. J., Bentall, R. P., Ffytche, D. H. et al. (2004) Persecutory Delusions and the Determination of Self-Relevance: An fMRI Investigation. Psychological Medicine, 34, 591–6.CrossRefGoogle ScholarPubMed
Blackwood, N. J., Howard, R. J., Ffytche, D. H. et al. (2000) Imaging Attentional and Attributional Bias: An fMRI Approach to the Paranoid Delusion. Psychological Medicine, 30, 873–83.CrossRefGoogle Scholar
Bleuler, E. (1911) Dementia Praecox or the Group of Schizophrenias. Reprinted 1950 (trans. & ed. Zinkin, J. ). New York: International University Press.Google Scholar
Cameron, N. (1944) Experimental Analysis of Schizophrenic Thinking. In Language and Thought in Schizophrenia (ed. Kasanin, J.). Berkeley, CA: University of California Press, pp. 50–64.Google Scholar
Dowling, F. G., Pato, M. T., & Pato, C. N. (1995) Comorbidity of Obsessive–Compulsive and Psychotic Symptoms: A Review. Harvard Review of Psychiatry, 3, 75–83.CrossRefGoogle ScholarPubMed
Eisen, J. L., & Rasmussen, S. A. (1993) Obsessive–Compulsive Disorder with Psychotic Features. Journal of Clinical Psychiatry, 54, 373–9.Google Scholar
Foussias, G., Agid, O., Fervaha, G., & Remington, G. (2014) Negative Symptoms of Schizophrenia: Clinical Features, Relevance to Real World Functioning and Specificity versus Other CNS Disorders. European Neuropsychopharmacology, 24, 693–709.Google Scholar
Garety, P. A, Hemsley, D. R., & Wessely, S. (1991) Reasoning in Deluded Schizophrenia and Paranoid Patients. Journal of Nervous and Mental Disease, 179, 194–201.Google Scholar
Gilleen, J., & David, A. S. (2005) The Cognitive Neuropsychiatry of Delusions: From Psychopathology to Neuropsychology and Back Again. Psychological Medicine, 35, 5–12.Google Scholar
Goldstein, K. (1944) Methodological Approach to the Study of Schizophrenic Thought Disorder. In Language and Thought in Schizophrenia (ed. Kasanin, J. ). Berkeley, CA: University of California Press, pp. 17–40.Google Scholar
Hamilton, M. (1974) Fish’s Clinical Psychopathology. Bristol: Wright.Google Scholar
Hua, A., & Major, N. (2016) Selective Mutism. Current Opinion in Pediatrics, 28, 114–20.Google Scholar
Huq, S. F., Garety, P. A., & Hemsley, D. R. (1988) Probabilistic Judgements in Deluded and Nondeluded Subjects. Quarterly Journal of Experimental Psychology, 40A, 801–12.Google Scholar
Jaspers, K. (1997) General Psychopathology (trans. J. Hoenig & M. W. Hamilton). Baltimore: Johns Hopkins University Press.Google Scholar
Katsumi, A., Hoshino, H., Fujimoto, S. et al. (2017) Effects of Cognitive Remediation on Cognitive and Social Functions in Individuals with Schizophrenia. Neuropsychological Rehabilitation, 7, 1–13.Google Scholar
Kelly, B. D. (2005) Erotomania: Epidemiology and Management. CNS Drugs, 19, 657–69.Google Scholar
Kelly, B. D. (2018) Love as Delusion, Delusions of Love: Erotomania, Narcissism and Shame. Medical Humanities, 44, 15–9.Google Scholar
Kennedy, N., McDonagh, M., Kelly, B. et al. (2002) Erotomania Revisited: Clinical Course and Treatment. Comprehensive Psychiatry, 43, 1–6.CrossRefGoogle Scholar
Kircher, T., Bröhl, H., Meier, F., & Engelen, J. (2018) Formal Thought Disorders: From Phenomenology to Neurobiology. Lancet Psychiatry, 5, 515–26.Google Scholar
Knowles, R., McCarthy-Jones, S., & Rowse, G. (2011) Grandiose Delusions: A Review and Theoretical Integration of Cognitive and Affective Perspectives. Clinical Psychology Review, 31, 684–96.Google Scholar
Kozak, M. J., & Foa, E. B. (1994) Obsessions, Overvalued Ideas, and Delusions in Obsessive Compulsive Disorder. Behaviour Research and Therapy, 32, 343–53.Google Scholar
Kuperberg, G., & Heckers, S. (2000) Schizophrenia and Cognitive Function. Current Opinion in Neurobiology, 10, 205–10.Google Scholar
Lishman, W. A. (1998) Organic Psychiatry: The Psychological Consequences of Cerebral Disorder (3rd ed.). Oxford: Blackwell Science.Google Scholar
McKenna, P. J. (1984) Disorders with Overvalued Ideas. British Journal of Psychiatry, 145, 579–85.Google Scholar
McKenna, P. J., Tamlyn, D., Lund, C. E. et al. (1990) Amnesic Syndrome in Schizophrenia. Psychological Medicine, 20, 967–72.CrossRefGoogle ScholarPubMed
McPherson, F. M. (1996) Psychology in Relation to Psychiatry. In Companion to Psychiatric Studies (5th ed.) (eds. Kendell, R. E. & Zealley, A. K. ). Edinburgh: Churchill Livingstone, pp. 23–42.Google Scholar
Miozzo, M., Fischer-Baum, S., & Caccappolo-van Vliet, E. (2013) Perseverations in Alzheimer’s Disease: Memory Slips? Cortex, 49, 2028–39.Google Scholar
Mullen, R., & Linscott, R. J. (2010) A Comparison of Delusions and Overvalued Ideas. Journal of Nervous and Mental Disease, 198, 35–8.Google Scholar
Mullins, S., & Spence, S. A. (2003) Re-examining Thought Insertion: Semi-structured Literature Review and Conceptual Analysis. British Journal of Psychiatry, 182, 293–8.Google Scholar
Munro, A. (1999) Delusional Disorder: Paranoia and Related Illnesses. Cambridge: Cambridge University Press.Google Scholar
Oyebode, F. (2023) Sims’ Symptoms in the Mind: Textbook of Descriptive Psychopathology (7th ed.). Edinburgh: Elsevier.Google Scholar
Pawar, A. V., & Spence, S. A. (2003) Defining Thought Broadcast: Semi-structured Literature Review. British Journal of Psychiatry, 183, 287–91.Google Scholar
Petrolini, V. (2015) When Emotion and Cognition Do (Not) Work Together: Delusions as Emotional and Executive Dysfunctions. The Behavioral and Brain Sciences, 38, e84.Google Scholar
Prasad, K. M., Patel, A. R., Muddasani, S. et al. (2004) The Entorhinal Cortex in First-Episode Psychotic Disorders: A Structural Magnetic Resonance Imaging Study. American Journal of Psychiatry, 161, 1612–9.CrossRefGoogle ScholarPubMed
Roche, E., Lyne, J. P., O’Donoghue, B. et al. (2015) The Factor Structure and Clinical Utility of Formal Thought Disorder in First Episode Psychosis. Schizophrenia Research, 168, 92–8.CrossRefGoogle ScholarPubMed
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2009) Kaplan and Sadock’s Comprehensive Textbook of Psychiatry (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.Google Scholar
Schneider, C. (1930) [Psychologie der Schizopheren] (Psychology of Schizophrenics). Leipzig: Thieme.Google Scholar
Schneider, K. (1959) Clinical Psychopathology (trans. M. Hamilton). New York: Grune & Stratton.Google Scholar
Sharma, T., & Antonova, L. (2003) Cognitive Function in Schizophrenia: Deficits, Functional Consequences, and Future Treatment. Psychiatric Clinics of North America, 26, 25–40.Google Scholar
Szeszko, P. R., Bilder, R. M., Lencz, T. et al. (1999) Investigation of Frontal Lobe Subregions in First-Episode Schizophrenia. Psychiatry Research, 90, 1–15.CrossRefGoogle ScholarPubMed
Tan, E. J., Neill, E., & Rossell, S. L. (2015) Assessing the Relationship between Semantic Processing and Thought Disorder Symptoms in Schizophrenia. Journal of the International Neuropsychological Society, 21, 629–38.Google Scholar
Thomas, P., Kearney, G., Napier, E. et al. (1996) Speech and Language in First Onset Psychosis Differences between People with Schizophrenia, Mania, and Controls. British Journal of Psychiatry, 168, 337–43.CrossRefGoogle ScholarPubMed
Thomas, P., King, K., Fraser, W. I. et al. (1990) Linguistic Performance in Schizophrenia: A Comparison of Acute and Chronic Patients. British Journal of Psychiatry, 156, 204–10.CrossRefGoogle ScholarPubMed
Thoresen, C., Endestad, T., Sigvartsen, N. P. et al. (2014) Frontotemporal Hypoactivity during a Reality Monitoring Paradigm Is Associated with Delusions in Patients with Schizophrenia Spectrum Disorders. Cognitive Neuropsychiatry, 19, 97–115.Google Scholar
Tippett, D. C. (2015) Update in Aphasia Research. Current Neurology and Neuroscience Reports, 15, 49.Google Scholar
Tippett, D. C. (2020) Classification of Primary Progressive Aphasia: Challenges and Complexities. F1000Research, 9, 64.Google Scholar
World Health Organization (2019) ICD-11: International Classification of Diseases (11th ed.). Geneva: World Health Organization.Google Scholar
Zarrabi, H., Khalkhali, M., Hamidi, A. et al. (2016) Clinical Features, Course and Treatment of Methamphetamine-Induced Psychosis in Psychiatric Inpatients. BMC Psychiatry, 16, 44.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×