II. Exam: Thought Form
- See Disorganized Speech
- Logical flow of ideas or circumstantial with lengthy story of loosely related or unrelated details?
- Flight of ideas (rapidly moving from one idea to another related idea)?
- Evasive?
- Tangential (Loose Associations between unrelated thoughts, although connected in the patient's view)?
- Perseveration (frequently repeated thought or phrase)?
- Blocking (interrupted speech or train of thought, only to be resumed minutes later)?
III. Exam: Thought Content
- Preoccupation or Obsession
- Obsessions are Delusions with insight that the intrusive thoughts are not normal
- Do you think about some things often?
- Excessively suspicious, phobic, ritualistic?
- Hypochondriacal symptoms?
- Deja Vu Sensations?
- Depersonalization?
- Harm to self or others?
- Suicidal Thoughts?
- Homicidal Thoughts?
- Delusions
- Fixed, false beliefs (e.g. persecutory, grandiose, influential) not consistent with external reality
- Persistent bizarre Delusions suggest Schizophrenia or schizoaffective disorder
- Acute Delusions suggest Alcohol or drug Intoxication
- Do you have strong ideas that other people rarely see the same way?
- Lack of Insight (unaware that thoughts are abnormal)?
IV. Exam: Concreteness
- Concreteness is a loss of abstract thinking
- Ask about relatedness between objects (what is similar?)
- Baseball and orange
- Car and train
- Desk and bookcase
- Happy and sad
- Test proverbs (what do these mean?)
- When the cats away, the mice will play
- You can lead a horse to water but you cannot make him drink
- Haste makes waste
- Ignorance is bliss
V. Interpretation
- Abnormal Thought Process suggests Psychosis (especially Schizophrenia)
- Obsessions are seen in Psychosis and Obsessive Compulsive Disorder
- Concreteness with normal intelligence suggests Psychosis (especially with bizarre or personalized answers)
VI. References
- Zum, Swaminathan and Egan in Herbert (2014) EM:Rap 14(7): 11-13
- Tomb (1992) Psychiatry, 4th Ed, Williams and Wilkins, Baltimore, p. 6-11
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Related Studies
| Definition (MSHCZE) | Porucha myšlení, jejímž základem je chorobný a falešný výchozí předpoklad, o němž je však člověk nezvratně přesvědčen. Z něho pak vyvozuje (již logicky) další závěry, které mohou výrazně ovlivňovat jeho chování a jednání. B. se klasicky dělí na makromanické (velikášské), mikromanické (s pocity malosti) a úkorné (s rysy vztahovačnosti a paranoidity). Nemocný je např. přesvědčen o své velikosti a moci, o své genialitě a geniálních vynálezech nebo se naopak domnívá, že něco zavinil, že mu chybí některý orgán, že je sledován, ozařován různými paprsky apod. Bludy bývají součástí psychózy. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
| Definition (NCI_CTCAE) | A disorder characterized by false personal beliefs held contrary to reality, despite contradictory evidence and common sense. |
| Definition (NCI) | False personal beliefs held contrary to reality, despite contradictory evidence and common sense. |
| Definition (MSH) | A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. |
| Definition (PSY) | False personal beliefs held despite contradictory evidence and common sense. |
| Definition (CSP) | false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. |
| Concepts | Mental or Behavioral Dysfunction (T048) |
| MSH | D003702 |
| SnomedCT | 2073000, 139595000, 162323009 |
| LNC | LP121741-5, MTHU020845 |
| English | DELUSION, delusions (physical finding), fixed beliefs contradicted by reality (delusions), fixed beliefs contradicted by reality, fixed beliefs contradicted by reality (symptom), delusions, Delusion NOS, Delusional symptoms, delusion, Delusion, Delusional ideas, Delusional thoughts, Delusions (finding), delusional, Delusion, NOS, Delusions |
| Italian | Delirio, Sintomi deliranti, Illusioni, Delirio NAS, Delusioni |
| Dutch | wanen, wanen NAO, waansymptomen, waan, Waan, Waanvoorstellingen, Wanen, Waanideeën |
| French | Illusions, Délire SAI, IDEE DELIRANTE, Idée délirante, Symptômes délirants, Délire, Délires |
| German | Wahn NNB, WAHNIDEEN, Wahnvorstellung, Wahn, Wahnvorstellungen |
| Portuguese | Ideias delirantes NE, Ideias delirantes, IDEIAS DELIRANTES, Sintomas delirantes, Delírio, Delusões |
| Spanish | Ideas delirantes, Trastorno delirante NEOM, DELUSION, delirio (hallazgo), delirio, delusión (hallazgo), delusión, ideas delirantes, pensamientos delirantes, Trastorno delirante, Síntomas delirantes, Deluciones |
| Japanese | 妄想, 妄想ＮＯＳ, 妄想症状, ﾓｳｿｳNOS, ﾓｳｿｳ, ﾓｳｿｳｼｮｳｼﾞｮｳ |
| Swedish | Vanföreställningar |
| Czech | bludy, Blud NOS, Blud, Bludné symptomy, Bludy |
| Finnish | Harhaluulot |
| Russian | BRED, БРЕД |
| Polish | Urojenia |
| Hungarian | Téveszme, Téveszme tünetek, Téveszmék, Téveszme k.m.n. |
| Norwegian | Vrangforestillinger |
Ontology: Obsessions (C0233697)
| Concepts | Mental or Behavioral Dysfunction (T048) |
| MSH | D009770 |
| SnomedCT | 67698009, 247886007 |
| English | Obsession, obsessions, obsessions (physical finding), obsessive ruminations, obsession, obsessional thoughts, Obsessive rumination, Obsessional ruminations, Obsessional thoughts, Obsessional thoughts (finding), obsessional; rumination, rumination; obsessional, Obsessions |
| Italian | Ruminazione ossessiva, Ossessione, Ossessioni |
| Dutch | obsessie, obsessief; ruminatie, ruminatie; obsessief, obsessief rumineren, Obsessies |
| French | Obsession, Obsessions, Rumination obsessionnelle |
| German | Zwangssyndrom, Zwangsvorstellungen, Zwangsgruebeln |
| Portuguese | Obsessão, Obsessões, Ruminação obsessiva |
| Spanish | Obsesión, obsesión, Obsesiones, Rumiación obsesiva, obsesión (hallazgo), pensamientos obsesivos (hallazgo), pensamientos obsesivos |
| Japanese | 強迫, 強迫反すう症, ｷｮｳﾊｸﾊﾝｽｳｼｮｳ, ｷｮｳﾊｸ |
| Czech | Obsese, Obsedantní ruminace, obsese, nutkavé představy, nutkání |
| Hungarian | Kínzó töprengés, Kényszer |
| Norwegian | Tvangstanker |
Ontology: Abstract thinking ability (C0459920)
| Concepts | Mental Process (T041) |
| SnomedCT | 58092009, 397620004, 247656003, 363878000 |
| English | Abstract thought, Ideas, abstract thinking, abstract thought, abstract thoughts, ideas, Abstract thinking (finding), Abstract thinking, Abstract thought (finding), Ability to think abstractly, Ability to think abstractly (observable entity), Abstract thinking ability |
| Spanish | pensamiento abstracto, pensamiento abstracto (hallazgo), pensamiento, abstracto (hallazgo), pensamiento, abstracto, capacidad para el pensamiento abstracto (entidad observable), capacidad para el pensamiento abstracto, capacidad para pensar de manera abstracta, ideación abstracta (hallazgo), ideación abstracta |
Ontology: Thought process - finding (C1286920)
| Concepts | Finding (T033) |
| SnomedCT | 365252004 |
| English | Finding of thought process, Finding of thought process (finding), Thought process - finding |
| Spanish | proceso del pensamiento - hallazgo (hallazgo), proceso del pensamiento - hallazgo |
Ontology: Content of thought (C2584294)
| Definition (ICF) | Mental functions consisting of the ideas that are present in the thinking process and what is being conceptualized. |
| Definition (ICF-CY) | Mental functions consisting of the ideas that are present in the thinking process and what is being conceptualized. |
| Concepts | Mental Process (T041) |
| English | Content of thought |
