Thought Disorder: Symptoms, Traits, Causes, Treatment (2023)

What Is a Thought Disorder?

A thought disorder involves a disturbance in how thoughts are organized and expressed. It causes disorganized thinking and leads to people expressing themselves in unusual ways when speaking or writing.

Formal thought disorder is also known as disorganized speech. It is marked by disruption to the structure or form of thought. It is one of the key symptoms of schizophrenia and psychotic disorders. Because these symptoms can be observed, they can be used to help assess the severity of psychosis.

Thinking requires the ability to think about a subject and organize those thoughts mentally and then express those thoughts in an understandable way. A thought disorder can create problems with any or all of these areas.

Disruptions in thought are connected to difficulties in day-to-day functioning, social relationships, and psychological well-being.

This article discusses the symptoms, causes, and types of thought disorders. It also covers how a thought disorder is diagnosed and some of the treatment options that are available.

Symptoms

While thought disorders are characterized by problems with thought and language, those symptoms are not enough on their own for a diagnosis. This is because such symptoms can also occur temporarily when people are over-stressed or over-tired.

These symptoms can become indicative of a thought disorder depending on their frequency, severity, and the impairment that they cause. Symptoms associated with a thought disorder can include:

  • An inability to stay on topic
  • Lack of speech
  • Rapid, pressured speech
  • Incoherence
  • Illogical speech
  • Wandering train of thought

Other symptoms that can be associated with thought disorders include delusions, hallucinations, poor judgment, changes in movement, irritability, lack of emotion, lack of expression, and paranoia.

Such symptoms are associated with conditions including schizophrenia, schizoaffective disorder, and psychosis.

Identifying Thought Disorder

Thought disorders are diagnosed by a healthcare professional. A diagnosis usually involves asking people open-ended questions and then assessing their verbal responses.

Several assessment tools can be utilized to measure thought disorders, including:

  • The Rorschach inkblot test: The Rorschach inkblot test is a projective test in which people are shown a series of ambiguous inkblots. Mental health professionals can then use a scoring system when interpreting verbal responses to the inkblots to look for signs of disordered thinking.
  • The Thought Disorder Index (TDI): This assessment involves a health professional engaging in a conversation with the individual that is recorded and then transcribed. The TDI (also known as the Delta index) is then used to evaluate the exchange, including looking at 23 different areas that may indicate a thought disturbance.
  • Scale for the Assessment of Thought, Language, and Communication (TLC): One of the most widely used thought disorder assessments. It involves making observations and giving them a severity rating based on definitions of different aspects of thought disorders.

Many medical conditions can also impact verbal and written language performance. These may include:

  • Autism spectrum disorder
  • Attention deficit hyperactivity disorder (ADHD)
  • Endocrine disorders
  • Hearing loss
  • Infections
  • Intellectual disabilities
  • Metabolic disorders
  • Substance use
  • Traumatic brain injury
  • Vitamin deficiencies

A doctor will need to rule out underlying medical factors before diagnosing a thought disorder. In addition to evaluating the individual’s speech, a doctor may also give the individual a physical exam and conduct lab tests to look at overall health and check for other medical conditions.

(Video) Thought Disorders: Different Types & Diagnoses – Psychiatry | Lecturio

Abnormalities in language are pretty common in everyday speech and often due to stress and lack of sleep. Johns Hopkins Medicine notes that the severity and frequency of symptoms are important factors to consider when making a diagnosis.

Diagnosing a thought disorder involves observing and evaluating a person's verbal responses to questions. In addition to these assessments, medical providers must also rule out other conditions that can cause similar symptoms affecting speech.

Causes

The exact causes of thought disorders are not known. However, it is believed that a number of variables may play a contributing role including genetics, brain abnormalities, and environmental factors.

Disorganized thought can be seen in a number of mental health conditions, including schizophrenia. In the case of schizophrenia, some research has suggested that the condition is linked to abnormalities in the brain's semantic system.

Types

Each type of thought disorder has its own set of symptoms that interfere with the thought process. However, in each case, there is a disruption to the organization and expression of ideas and thoughts.

Some of the many different types of thought disorders include:

  • Alogia: This thought disorder is characterized by poverty of speech and is commonly seen in people with schizophrenia or dementia. Responses are often abrupt and incomplete.
  • Blocking: People with thought disorders may stop speaking mid-sentence and pause for an extended period. When they resume speaking, it is often on an entirely different topic.
  • Circumstantial thinking: This type of disorganized thinking involves including a lot of unnecessary detail that is often indirect or even unrelated to the main point of the conversation.
  • Clanging: This involves using words based on their sounds rather than their meaning. This includes rhyming words or puns.
  • Echolalia: This involves repeating back the speech of other speakers. They may often repeat sounds or words that they hear from others.
  • Neologism: This involves coining new words spontaneously. These words are meaningless and unrecognizable but incorporated into speech.
  • Tangentiality: This type of disordered thought involves moving from one idea to another. The ideas are connected superficially but never get to the main point.
  • Word salad: This involves a mixture of random words and phrases that are unintelligible.

These are characterized as both types of thought disorders as well as symptoms of formal thought disorder.

Treatment

Treatments are available that can help people manage the symptoms of thought disorders. Some treatment strategies that may be used are discussed below.

Psychotherapy


Therapy may be useful for helping people who are also experiencing symptoms of delusional or distorted thoughts. Types of therapy that might be utilized depending on the individual's symptoms include:

  • Cognitive-behavioral therapy (CBT) can help people identify and change distorted thoughts.
  • Family therapy can help families learn what they can do to support their loved one who has a thought disorder.
  • Group therapy can be a useful treatment for practicing skills and finding support.

Medications

Medications may sometimes be prescribed to help treat symptoms associated with schizophrenia or psychotic disorders. Such medications may include antipsychotics, antidepressants, and mood stabilizers.

Coping

In addition to therapy and medications, people with thought disorders can also benefit from life skills training and social support:

  • Social skills training: Because problems with disorganized thinking affect communication, it can create challenges in relationships. Learning and practicing social skills can help people with thought disorders find ways to improve their communication abilities in ways that benefit their relationships.
  • Social support: Social support is also essential for people who have disorders that impact thought organization. Family therapy and support groups may be helpful for both people who have this condition as well as family members and other loved ones.
  • Stress management: Relaxation techniques may also be helpful since stress can sometimes worsen the symptoms of conditions such as schizophrenia.

An Overview of Stress Management

A Word From Verywell

If you are experiencing symptoms of a thought disorder that are affecting your ability to communicate, you should talk to your doctor. They can evaluate your symptoms and make a diagnosis. Getting the right diagnosis is the best way to ensure that you receive an appropriate treatment that can help you manage the symptoms that you are experiencing.

(Video) Obsessive compulsive disorder (OCD) - causes, symptoms & pathology

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Hart M, Lewine RR. Rethinking thought disorder. Schizophr Bull. 2017;43(3):514-522. doi:10.1093/schbul/sbx003

  2. Roche E, Creed L, MacMahon D, Brennan D, Clarke M. The epidemiology and associated phenomenology of formal thought disorder: a systematic review. Schizophr Bull. 2015;41(4):951-962. doi:10.1093/schbul/sbu129

  3. American Speech-Language-Hearing Association. Spoken language disorders.

  4. Rivkin P, Barta P. Thought disorder. Johns Hopkins Psychiatry Guide. Updated August 2, 2017.

  5. Kircher T, Bröhl H, Meier F, Engelen J. Formal thought disorders: from phenomenology to neurobiology. The Lancet Psychiatry. 2018;5(6):515-526. doi:10.1016/S2215-0366(18)30059-2

  6. Balaram K, Marwaha R. Circumstantiality. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Updated May 9, 2021.

    (Video) OCD Intrusive Thoughts: 4 Examples and A Look Into Compulsions

  7. L, Parnas J. Thought disorder, subjectivity, and the self. Schizophr Bull. 2017;43(3):497-502. doi:10.1093/schbul/sbx032

  8. Almerie MQ, Okba Al Marhi M, Jawoosh M, et al. Social skills programmes for schizophrenia. Cochrane Database Syst Rev. 2015;(6):CD009006. doi:10.1002/14651858.CD009006.pub2

  9. Caqueo-Urízar A, Rus-Calafell M, Urzúa A, Escudero J, Gutiérrez-Maldonado J. The role of family therapy in the management of schizophrenia: Challenges and solutions. Neuropsychiatr Dis Treat. 2015;11:145-151. doi:10.2147/NDT.S51331

Thought Disorder: Symptoms, Traits, Causes, Treatment (1)

By Kendra Cherry
Kendra Cherry, MS, is an author and educational consultant focused on helping students learn about psychology.

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FAQs

What is the treatment for thought disorder? ›

Medications and therapy are both helpful tools for treating thought disorders. Doctors commonly prescribe antipsychotic medications to help with symptoms. They may also recommend cognitive-behavioral therapy (CBT) to treat thought disorders.

What are thought disorder symptoms? ›

An individual with a thought disorder may experience a variety of different symptoms, including:
  • Visual/auditory hallucinations.
  • Incoherence.
  • Disorders of movement.
  • Diminished interaction with others.
  • Monotonous voice.
  • Poor judgment/insight.
  • Euphoria.
  • Grandiose thinking.

How do you get thought disorder? ›

The cause of formal thought disorder is not established. Research has implicated abnormalities in the semantic system in patients with schizophrenia. Thought disorder is often accompanied by executive function problems and general disorganization.

Are thought disorders curable? ›

Although patients can have some scary symptoms, thought disorders can be treated. Medications, therapy, and other therapeutic approaches may help. At Banyan Mental Health, our residential mental health program in Boca can aid in the treatment of thought disorders.

Is thought disorder a mental illness? ›

Thought disorders are often symptoms of other mental health disorders, most commonly schizophrenia or psychotic disorders, among others. A person suffering from this disorder will often require formal mental health treatment to see improvement.

What mental illness causes unwanted thoughts? ›

People who are distressed by recurring, unwanted, and uncontrollable thoughts or who feel driven to repeat specific behaviors may have obsessive-compulsive disorder (OCD). The thoughts and behaviors that characterize OCD can interfere with daily life, but treatment can help people manage their symptoms.

What is the most common thought disorder? ›

Research found that most formal thought disorders are commonly found in schizophrenia and mood disorders, but poverty of speech content is more common in schizophrenia.

Is ADHD a thought disorder? ›

Clinical observations in children and adults with ADHD were offered as presumptive evidence of what was thought to represent a new phenomenological description of thought disorder in this condition; “Patients with a diagnosis of ADHD describe experiencing “multiple tracks” of thought.

Can anxiety cause thought disorder? ›

"Most often it is because of anxiety." Irrational thoughts can also be triggered by specific mental health conditions, especially anxiety disorders or psychotic disorders.

Do I have thought disorder? ›

Symptoms of a Thought Disorder

Symptoms that someone is suffering from a thought disorder are: Rapid or illogical speech. Frequent interruptions in a person's train of thought. Delusions and false beliefs.

Is bipolar a thought disorder? ›

While bipolar disorder is generally considered a mood disorder, symptoms can also include disorders of thought—particularly during manic episodes. People in a manic state may have difficulty filtering out meaningful versus non-meaningful input and may thus respond to their environment in surprising ways.

What is the best medication for obsessive thoughts? ›

Antidepressants approved by the U.S. Food and Drug Administration (FDA) to treat OCD include:
  • Clomipramine (Anafranil) for adults and children 10 years and older.
  • Fluoxetine (Prozac) for adults and children 7 years and older.
  • Fluvoxamine for adults and children 8 years and older.
  • Paroxetine (Paxil, Pexeva) for adults only.
11 Mar 2020

What is intrusive thought disorder? ›

Intrusive thoughts are unwanted thoughts, images, impulses, or urges that can occur spontaneously or that can be cued by external/internal stimuli. Typically, these thoughts are distressing (hence “intrusive”) and tend to reoccur.

What does ADHD thoughts feel like? ›

The symptoms include an inability to focus, being easily distracted, hyperactivity, poor organization skills, and impulsiveness. Not everyone who has ADHD has all these symptoms. They vary from person to person and tend to change with age.

What are 3 signs of ADHD? ›

Symptoms in children and teenagers
  • having a short attention span and being easily distracted.
  • making careless mistakes – for example, in schoolwork.
  • appearing forgetful or losing things.
  • being unable to stick to tasks that are tedious or time-consuming.
  • appearing to be unable to listen to or carry out instructions.

What do people with ADHD think like? ›

People in the ADHD world experience life more intensely, more passionately than neurotypicals. They have a low threshold for outside sensory experience because the day-to-day experience of their five senses and their thoughts is always on high volume.

Why do I think crazy thoughts? ›

They're usually harmless. But if you obsess about them so much that it interrupts your day-to-day life, this can be a sign of an underlying mental health problem. Intrusive thoughts can be a symptom of anxiety, depression, or obsessive-compulsive disorder (OCD).

› 2019/05/21 › wha... ›

A thought disorder is when someone has trouble creating logical sentences through speech and/or writing. Thought disorders are often symptoms of other mental he...

What are Thought Disorders

https://www.banyanmentalhealth.com › 2018/04/13 › wha...
https://www.banyanmentalhealth.com › 2018/04/13 › wha...
What are thought disorders?What is a thinking disorder? Are they the same thing? Are people with thought disorders crazy? Can you even treat thought disorders? ...

Thought Disorder

https://www.goodtherapy.org › ... › PsychPedia
https://www.goodtherapy.org › ... › PsychPedia
A thought disorder is a mental health condition that affects a person's beliefs, thoughts, or perceptions. Thought disorders alter the way a person puts tog...

What is the most common thought disorder? ›

Research found that most formal thought disorders are commonly found in schizophrenia and mood disorders, but poverty of speech content is more common in schizophrenia.

Is ADHD a thought disorder? ›

Clinical observations in children and adults with ADHD were offered as presumptive evidence of what was thought to represent a new phenomenological description of thought disorder in this condition; “Patients with a diagnosis of ADHD describe experiencing “multiple tracks” of thought.

What is intrusive thought disorder? ›

Intrusive thoughts are unwanted thoughts, images, impulses, or urges that can occur spontaneously or that can be cued by external/internal stimuli. Typically, these thoughts are distressing (hence “intrusive”) and tend to reoccur.

Why does my brain think things I don't want it to? ›

The two most common diagnoses associated with intrusive thoughts are anxiety and Obsessive-Compulsive Disorder (OCD). They can also be a symptom of depression, Post-Traumatic Stress Disorder (PTSD), Bipolar Disorder, or Attention Deficit-Hyperactivity Disorder (ADHD).

Why does my brain get stuck on thoughts? ›

It's just another indication of elevated stress and/or fatigue. It's not an indication of serious mental illness. Most people experience stuck thoughts from time to time. It becomes more prevalent when stress and fatigue are factors.

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