psychopathology of formal thaught disorder

1. PSYCHOPATHOLOGY OF FTD

3.  Normal form is how the person can join letters to
form words and words to form sentences and
sentences to form a comprehensive subject.
 FTD is synonymous to disorders of conceptual or
abstract thinking.
DEFINITION

4.  According to Schneider :
1. constancy : persistence of the content
2. organization : the contents are related to each
other and separated in organized way.
3. continuity: ideas are arranged in order in the whole
content
Features of healthy thinking

5. 1. Negative FTD : losing previous ability to think with
no unusual concepts. E.g. poverty of thinking and
blocking
2. Positive FTD : producing false concepts. e.g.
circumstantiality , derailment
3. Each one may be subjective or objective
Classification

6. 1. Other disorders of thinking
2. Speech disorders
D.D

7.  Describes FTD as disorganized thinking or speech
 Because mild disorganized speech is common and
non specific , the symptom must be severe enough to
impair effective communication.
 Mild impairment may occur in prodroma and residual
periods of schizophrenia
DSM 5

8.  Andreasen (1986) : described 18 abnormalities in his
thought , language and communication (TLC) scale
 Kertcher et.al (2014) : described 30 abnormalities in
their thought and language disorder scale (TALD)
Types

9.  Schneider classify FTD into 3 groups:
1. Transitory thinking: disordered constancy
2. Drivelling thinking: disordered organization
3. Desultory thinking : disordered continuity

10.  1. Neologism
 Patients speaks in abnormal language he/ she may
name it
 Some authors see that neologism may be the words
of auditory hallucinations, others see it as a form of
dysphasia
 2. Incoherence
 Patient can not form a sentence (word salad).

11.  3. Loose association
 Schizophrenic patient is unable to preserve
conceptual boundaries so his concepts are
over-including to another ideas (overinclusion).
 It is similar to what is called asyndesis, which is lack of
adequate connection between two successive
thoughts.

12.  4.Derailment : Sudden breakdown of association and
shift from the central idea to another unrelated
central idea
 5. Off pointing: The patient can not conceptualize the
questions so he / she gives inappropriate answers.

13.  Literalness of expression and understanding
 Normal thinking is based on formation of concepts
not on words.
 Patient with concrete thinking has not the ability to
conceptualize the words.
 So patients with concrete thinking did not understand
what is said to him and what he read so academic
deterioration resulted.
Concrete thinking as a form
disturbance

14.  Positive and negative symptom scale collect formal
thought disorder , thought blocking,
circumstantiality, tangentialty and mutism and called
them conceptual disorganization.
 According to PANSS the most severe form of
conceptual disorganization is neologism, incoherence
and mutism.
Conceptual disorganization

15. 1. Organic : dementia , delirium
2. Substance abuse
3. Psychosis
4. Mood : mania , hypomania
5. Personality : obsessive , histrionic
6. can occur in normal situations
Causes

16.  Once thought to be specific for schizophrenia , but
can occur in other disorders and normal control.
 Presence of comorbid substance abuse and FTD make
it more severe
 The presence of FTD is negatively correlated with the
diagnosis of anxiety disorder in schizophrenia.
 social functioning significantly affected by the
presence of FTD.
Importance

17.  In patients with FTD, hospital admission is both more
likely and significantly longer, and involuntary
admission is more likely.
 clinically significant FTD prevalence is 27.4%.
 In newly diagnosed patients with schizophrenia, FTD
predicted worse global outcome