Thought Disorders
расстройства мышления

Disorders of the Form and the Stream of Thought
(ассоциативные расстройства – расстройства мышления по форме)

    Pressure of Talk, (up to Flight of Ideas and Word salad)

(ускорение мышления вплоть до “скачки идей” и “словесной окрошки”)  redundancy of associations resulting in distractibility and chaotic speech.
(symptom of mania)

    Inhibition of Thought

(замедление мышления)        slow thinking with poor associations, patient answers in one word and fails to understand difficult sentences.
(symptom of depression or clouding of consciousness)

    Circumstantiality (Stiffness)

(патологическая обстоятельность, вязкость)
indirect speech that is delayed in reaching the point but eventually gets from original point to desired goal; characterised by an overinclusion of details and parenthetical remarks.
(symptom of epileptic personality changes)

    Reasoning, Philosophical intoxication (german Rasonierung)

(резонерство)        vague thinking (wooliness of thought) with excessive use of abstract concepts. Tangentiality: inability to have goal-directed associa­tions of thought; patient never gets from desired point to desired goal
(symptom of schizophrenia)

    Schizophasia (Incoherence)

(разорванность, шизофазия)        formal speech without any useful content, grammatically structured but void of sense
(symptom of deep schizophrenic defect)

    Incoherence                        speech that, generally, is not under­standable;

(бессвязность)        deep disorganisation of thought that appears with words or verbal combinations which have no logical or grammatical connection, often associated with disorder of consciousness.
(for example in case of amentia)

НЕ нашли? Не то? Что вы ищете?

    Stereotypie Verbale:
    (речевые стереотипии)

Perseveration                persisting verbal response to a prior stimulus
(персеверации)                after a new stimulus has been presented, often
  asso­ciated with cognitive disorders

Verbigeration                rhythmical repetition of words or meaningless

(вербигерации)        sound combinations, often associated with «clang association» (association of words similar in sound but not in meaning; words have no logical con­nection, may include rhyming and punning)

    Mentism

(наплыв мыслей, ментизм)        suddenly appeared unmanageable flow of thought, often with the feeling of distant influence
(symptom of mental automatism)

    Thought Blocking, Barrage (german – Sperrung)

(шперрунг)        abrupt interruption in train of thinking be­fore a thought or idea is finished; after a brief pause, the person indicates no recall of what was being said or was going to be said; the feeling of distant influence is usual.
(symptom of mental automatism)

    Autistic Thinking

(аутистическое мышление)        quasi-existence, preoccupation with inner, private world that results in loss of communication with reality, full of fantastic absolutely
unproductive thoughts
(symptom of schizophrenic personality changes)

    Symbol Thinking

(символическое мышление)        thinking basing on a great deal of symbols; providing common things with the special meaning, understandable only for themselves.
(symptom of schizophrenic personality changes)

    Paralogia (Illogical thinking)

(паралогическое мышление)        thinking containing erroneous con­clusions or internal contradictions; it is psychopatho­logical only when it is marked and when not caused by cultural values or intellectual deficit.
(symptom of schizophrenic personality changes)

Thought Disorders (continuation)

Disorders of the possession and the content of thought
(расстройства суждений и умозаключений – патологические идеи)

    Delusion

(бред)        false belief of great value to a patient, based on incorrect inference about external reality, which arises from internal morbid process (not consistent with patient’s intelligence and cultural background) and cannot be corrected by reasoning.
(unspecific productive symptom of different psychoses)

    Overvalued Ideas

(сверхценные идеи)        sustained ideas of great personal value, which are not absolutely false but inadequately significant in such way, that it disturbs the adaptation of individual.
(productive disorder of subpsychotic level, typical for paranoid disorder of personality)

    Obsessions

  (навязчивые  идеи)        pathological persistence of an irresistible thought or feeling that cannot be eliminated from con­sciousness by logical effort, usually associated with hypothymia and anxiety.
(unspecific productive symptom of neurotic level, usual for neuroses and schizotypal disorder)


Criteria

Delusion

Overvalued ideas

Obsession

Veracity

False ideas

True ideas

False, true or meaningless ideas

Insight

Poor

Poor

Good

Behaviour control

Poor, dangerous actions are rather probable

Poor but possible

Good, no dangerous actions 

Diagnosis

Organic or functional psychoses

Subpsychotic states (initial period of psychoses), paranoid personality

Neuroses or mild disorders (initial phase of schizophrenia or organic disorders)


Obsessive-Phobic syndrome

Obsessions        different types of persistent irrational ideas,

(навязчивые мысли)        for example:

Rumination (мыслительная жвачка)        
irrational burdensome operating with thoughts, symbols, words or numbers

Contrast ideas (контрастные навязчивости)
irrational painful thoughts about possibility of dangerous or antisocial actions

Phobias

(навязчивые страхи)        persistent, irrational, exaggerated, and in­variably pathological dread of some specific type of stimulus or situation; results in a compelling desire to avoid the feared stimulus

Social phobia: dread of public humiliation, as in fear of public speaking, performing, or eating in public Agoraphobia: dread of open places Claustrophobia: dread of closed places Nosophobia: dread of illness (i. e. cardiophobia, syphilophobia, AIDSphobia ) Thanatophobia: dread of death Panphobia: dread of everything Acrophobia: dread of high places Xenophobia: dread of strangers Zoophobia: dread of animals
Rituals (compulsions)        (навязчивые действия, ритуалы)
repeated symbolic actions, compulsive in na­ture, anxiety-reducing in origin


Delusions

Types according to content:

Persecutory delusions
бред преследования

Depressive
delusions
депрессивный бред

Grandiose delusions бред величия
    ideas of  persecution
    преследования ideas of control
    (of distant influence)
    воздействия ideas of  poisoning
    отравления ideas of jealousy
    ревности ideas of self-reference
    отношения (особого значения) ideas of fabrication, staging, putting-up, personal doubles
    (Capgras’ syndrome)
    инсценировки (двойников) ideas of pilferage
    материального ущерба querulous ideas
    сутяжный (кверулянтский)
    ideas of guilt
    самообвинения, самоуничижения ideas of poverty
    бедности hypochondriacal ideas ипохондрический dysmorpho­phobic
    дисморфомани­чес­кий nihilistic delusions
    (Cotard’s syndrome)
    нигилистический
    ideas of self-importance
    собственно величия ideas of riches
    богатства erotic ideas
    любовный ideas of power and might
    могущества

Emotions of fear, anxiety or anger

Depressive mood

Euphoria or indifference

Danger of aggression in some cases

Danger of suicide

Dangerous behaviour is not typical

Primary delusion
(первичный бред)
independent disorder of thought which are not associated with other mental dysfunction

Secondary delusion
(вторичный бред)
secondary disorder of thought, which represent the disturbance  of  other mental functions (affect, perception,
memory, consciousness etс.

Systematised delusion
(систематизированный бред)
false ideas confirmed with some logic associations (in case of persecution patient can in details describe the persecutors, their aims and methods, so he can answer the questions «Who?», «Why?», How?»)
(symptom of chronic delusional states)

Non-systematised delusion
(несистематизированный бред)
fragmentary, not associated false ideas
(symptom of either acute delusional states or of late stages of chronic processes)

Error of interpretation
(интерпретативный бред)
based on logic, systematised
(usually chronic process)

Error of perception

(чувственный бред)
delusional mood, delusional
perception, autochtonous delusion
(usually acute disorders)


Criteria of Acute Delusion:

    non-systematised bright affect (fear, anxiety, mania, depression, happiness, guilt) mood-congruent ideas of self-reference, fabrication, staging

Acute delusional states can be well controlled by antipsychotic drugs; there is a real possibility of remission or full recovery.

Stages of Chronic Delusion by V. Magnan:
(typical for paranoid schizophrenia)

Paranoia        primary systematised ideas of persecution, jealousy or invention without hallucinations

(паранойяльный синдром)

Paranoid        hallucinational and delusional states with persecutory ideas of control (distant influence) or poisoning, often associated with mental automatism

(параноидный синдром)

Paraphrenia        hallucinational and delusional states with bizarre ideas of grandeur or persecution, delusional memories, falsification of memory usually associated with mental automatism, often non-systematised

(парафренный синдром)

Chronic delusional states can be partially controlled by antipsychotic drugs, remission of high quality and full recovery are not possible.

Syndrome of Mental Automatism

(Schneiderian first rank symptoms of schizophrenia – FRS):

(синдром психического автоматизма Кандинского-Клерамбо)

    Pseudohallucinations        (псевдогаллюцинации – , 1880) Mental Automatism        (психический автоматизм)

Alienation of Thoughts        идеаторный автоматизм

Alienation of Perceptions and Emotions        сенсорный автоматизм

Alienation of Movements        моторный автоматизм

    Delusion of control (of distant influence)