Thought disorders

Thought disorders can be divided into formal and content-related thought disorders. They do not represent diseases in their own right, but occur in the context of mental disorders, neurological diseases or individual syndromes. The therapy of the thinking disorder depends on the respective underlying disease.

What are thought disorders?

Thought disorders occur in the context of various mental disorders; Symptoms that are typical for them can also manifest themselves as a result of various physical causes, such as poisoning, brain damage, strokes and others.
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Thought disorders represent mental abnormalities that can occur in the context of various mental disorders, syndromes and neurological diseases. The “Working Group for Methodology and Documentation in Psychiatry” (AMDP) differentiates between formal and content-related thought disorders.

Formal thought disorders are restrictions on the flow of thought. The AMDP finding evaluates the cognitive functioning of a patient based on the following criteria such as slow thinking, inhibition of thinking, restricted thinking, perseveration, brooding and flight of ideas.

The other category of thought disorders, content-related thought disorders, are composed primarily of various delusional thoughts, but also of compulsions and overrated ideas. Depending on what the delusion is aimed at, the AMDP finding divides content-related thought disorders into the following categories: Delusions, delusions, delusions of relationships, delusions of impairment and persecution, delusions of jealousy and delusions of guilt. But impoverishment and hypochondriac madness can also occur.

causes

Thought disorders occur in the context of various mental disorders; Symptoms that are typical for them can also manifest themselves as a result of various physical causes, such as poisoning, brain damage, strokes and others.

An example of a formal thinking disorder is inhibited thinking, which is often the result of a "depression" or other mental disorder. Affected people experience their own thinking or the thought process as slowed down or blocked. Some patients have the feeling that they have to "think" against an inner resistance, which prevents them from following a clear thought to its end.

This is a typical cognitive effect of depression, which is a mood disorder, that is, a disorder of emotional sensation. The main characteristics of depression are a depressed mood most of the day - over a period of two weeks or more - and a loss of joy and / or interest in (almost) anything.

However, inhibited thinking can also occur in the context of numerous other diseases and syndromes. An example of a substantive thinking disorder is paranoia, best known as paranoia related to schizophrenia. Schizophrenia is a psychotic disorder that often fully manifests itself by the beginning of the third decade of life.

In addition to delusional ideas, schizophrenia can also include hallucinations, which can affect any modality, but primarily occur as visual, acoustic or haptic hallucinations. Psychology and psychiatry refer to these symptoms as positive symptoms; On the other hand, the potential negative symptoms include, among other things, the flattening of the affect: those affected experience a limited range of emotions.

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Diseases with this symptom

• autism
• concussion
• schizophrenia
• poisoning
• stroke

• Brain tumor
• Alzheimer
• paranoia
• dementia
• Affective disorders

• Creutzfeldt-Jakob disease
• Obsessive-compulsive disorder
• psychosis
• Hallucinations
• Depressive mood

Diagnosis & course of disease

Formal and substantive thought disorders are usually only part of the diagnosis and are not independent diseases. Doctors, psychologists and therapists diagnose thought disorders based on the AMDP guidelines, among other things. The AMDP publishes checklists that the attending physician can go through in conversation with the patient or that he can fill out after a session.

The practitioner assesses the patient on the basis of various criteria that correspond to the individual formal and content-related thought disorders. Since thinking disorders usually affect the conduct of a conversation, observation is usually sufficient.

In addition, standardized cognitive tests can provide information about the current performance of the patient. Certain tests, such as the clock test or the CERAD test battery, are potentially suitable for finding a difference between dementia-related limitations and impaired performance that can be traced back to other psychological and neurological syndromes, disorders or diseases.

The course of a thinking disorder depends on the specific cause it is based on. Many thought disorders are treatable. An early diagnosis is of great importance and can significantly influence the success of the treatment.

Complications

The underlying subdivision into formal and substantive thought disorders also separates the areas of complications into mental disorders, neurological diseases and individual syndromes.

In the case of formal thought disorders, complications become noticeable through unusual observations, such as altered speech behavior and the content of what is spoken. A sudden loss of thought or slurred speech are signs of possible deterioration. Affected people may not be able to speak at all or suffer from sudden fluency. People give incomprehensible, incoherent answers, and sometimes memory contents cannot be accessed. Some of the thoughts only consist of individual scraps of words.

Complications with content-related thought disorders often show up in recurring threatening obsessive-compulsive thoughts and impulsive ideas. A distorted perception and misinterpretation of real conditions characterize the conditions, which are usually accompanied by massive discomfort. An intense emotionality in the will formation influences those affected, who are so convinced of a central idea. This leads to neglect of the activities of daily living. The person is only partially accessible for objections.

The realization of one's own convictions against social norms becomes a life goal. Religious fundamentalists or political fanatics can be found here and are close to delusion and obsessive-compulsive disorders. A common complication of depression is attempted suicide. Triggers can be extreme stressful situations, which in the case of persecution or relationship delusions also bring a danger to others.

When should you go to the doctor?

Temporary thought disorders are usually unproblematic. A doctor should be consulted if the symptoms appear suddenly and without an apparent cause, worsen over the course of the disease, or make normal everyday functioning difficult or even impossible due to the intensity and occurrence of the symptoms. In addition, a doctor should be consulted if additional symptoms such as headaches, anxiety attacks or depressive attacks occur.

Most thought disorders occur in stressful phases of life and lead to the fact that the stress continues to increase. Those affected who find themselves in difficult circumstances should therefore quickly consult a specialist and have the symptoms clarified. The thought disorders can usually be resolved quickly through rapid treatment. If the symptoms arise as a result of drug consumption or in the course of treatment with medication, this also requires professional clarification by the doctor.

In old age, poor concentration and thought disorders usually increase - a doctor's visit is advisable if this happens beyond the normal range or if other symptoms can be observed. Low heart rate and fatigue may indicate kidney weakness or hypotension, and tightness in the chest may indicate arteriosclerosis. A doctor should always be consulted with children and infants who suffer from thought disorders or who give the impression of reduced mental performance.

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Treatment & Therapy

The therapy of a thinking disorder depends on its cause. Basically, both psychological / psychotherapeutic and psychiatric / pharmacological treatments can be considered. Thought disorders that can be traced back to a neurological or other physical cause require appropriate medical treatment for the underlying disease.

In particular, psychological and pharmacological therapies are by no means mutually exclusive, but can be used simultaneously and one after the other. For example, severe depression and psychotic disorders often require drug treatment as well.

If patients are (temporarily) no longer able to look after themselves due to the present thought disorder and other possible signs of illness, inpatient treatment may be indicated. Above all, self-endangerment makes inpatient therapy necessary, for example in the case of suicide attempts, very urgent and intrusive thoughts of death, serious self-harm and others.

In addition, thought disorders, especially content-related thought disorders, can result in a threat to others, for example in persecution or relationship delusions. The selection of the appropriate therapy method depends not only on the underlying cause, but also on individual factors, so that a generalization is not possible.

Outlook & forecast

With a thinking disorder, there is usually no prospect of a cure without the use of medication or extensive medical and psychological treatment. A thinking disorder is often present from childhood and does not appear suddenly. Exceptions here are accidents after which a person can have thought disorders.

The prognoses for a treatment are very different and can hardly be universally predicted. The patient's own will is often of great importance here. This can also be supported by friends and family so that the process of thinking returns to normal and the thinking disorders disappear.

In most cases, a psychiatrist or a psychologist is consulted in the case of thought disorders, who deals with the patient through various games on tasks and thereby helps him with the problem.

However, the disorder can also lead to aggression and misconduct if the thinking disorders are severe and not treated. Under no circumstances should the patient be isolated and must learn to deal with the problem properly.

In the case of content-related thought disorders, it is not uncommon for medication for mental disorders to be taken to eliminate the symptom.

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prevention

Targeted prevention of thought disorders is not possible because they do not occur in isolation, but in the context of other diseases, disorders or syndromes. If they have a known underlying disease, patients can partially prevent relapses by taking their prescribed medication and not stopping it willfully.

Especially (but not exclusively) in the case of psychotic illnesses, this circumstance is a frequent reason for relapse. In addition, general coping strategies can help to avoid extreme stressful situations that could trigger a relapse. However, these measures are only general prevention; Patients may be able to take additional measures depending on the underlying disorder.

You can do that yourself

Thought disorders can have a major impact on the lives of those affected and reduce the quality of life. As a rule, there are not very many opportunities for self-help, as the thinking disorders mainly occur in old age and are related to the normal aging process. A person who has thought disorders often needs help from other people. Above all, this includes your own family as well as friends and relatives. If the care of the person concerned is difficult, the help of a care facility can be accepted. There the person is in the care of trained specialists and above all in safety. Because it often happens that people with thought disorders put themselves in danger or injure other people.

In a few cases, the thought disorders can also be transformed into psychopathic thoughts, if these disorders are caused by the influence of violence. In such cases, a psychologist must be consulted urgently, who will treat the person in therapy. In this way, further possible conflicts can be avoided. Treatment with medication is also possible in this case.

If the disturbances affect the memory, exercises for memory training can be used here. In addition, motivation for the person is important so that there are no more thought disorders.