Rational Thought Processes

Thought Disorders and Mental Status Examination

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 together ordered sequences of ideas and can affect a person’s behavior by causing them to experience paranoia, delusions, hallucinations, or other symptoms.

What is a thought disorder?

Thought disorders are usually diagnosed when a person’s behavior or speaking indicates problematic, illogical, or incoherent patterns of thinking.

Thinking normally involves three parts: thinking about something, stringing thoughts together on what you are thinking about, and, finally, the delivery or flow of a thought pattern.

A thought disorder disrupts one or more aspects of the thought process.

A thought disorder is distinct from speech disorders, which occur as a result of difficulty with speech patterns and production, rather than an underlying problem with thought processes.

Schizophrenia is a type of thought disorder, and delusions — false beliefs that a person persists in believing despite conflicting evidence — can also be caused by thought disorders.

Symptoms of Thought Disorders

When people are diagnosed with a thought disorder, they are often diagnosed with some other condition that causes or contributes to disordered thinking. Common symptoms of thought disorders include:

  • rapid, incoherent, or illogical speech;
  • frequent interruptions in a person’s train of thought;
  • the belief that a person or entity has removed the person’s thoughts;
  • delusions and false beliefs;
  • extremely tangential speech patterns, during which a person rapidly discusses several apparently unrelated topics;
  • inability to follow a logical train of thought or to clearly tell a story or convey an idea.

Thought disorder is one of the most difficult mental disorders to diagnose and treat, as many people exhibit symptoms of thought disorder occasionally.

Some people may demonstrate thought disorder only when they’re tired.

How are thought disorders treated?

People with schizophrenia commonly demonstrate symptoms of thought disorders, but other mental health issues — such as bipolar disorder, schizotypal personality, and psychotic episodes — can also produce symptoms of a thought disorder.

Treatment often involves psychotherapy and in some cases may include antipsychotic medications or mood stabilizers.

Psychotherapy is beneficial to individuals experiencing symptoms of a thought disorder because it allows a therapist to address behavioral and emotional issues that may be linked to or exacerbate the thought disorder.

This type of treatment helps improve the quality of life for the person experiencing a thought disorder and may be part of a collaborative treatment approach.

Sometimes thought disorders can put people who experience them in danger. A person might, for example, believe something is safe that is unsafe, engage in risky behavior, or act on false beliefs that put others in danger.

When a thought disorder interferes with safety, people with the condition may require psychiatric hospitalization.

Mental Status Examination

A mental status examination is an essential tool that aids physicians in making psychiatric diagnoses. Familiarity with the components of the examination can help physicians evaluate for and differentiate psychiatric disorders.

The mental status examination includes a historic report from the patient and observational data gathered by the physician throughout the patient encounter.

Major challenges include incorporating key components of the mental status examination into a routine office visit and determining when a more detailed examination or referral is necessary.

A mental status examination may be beneficial when the physician senses that something is “not quite right” with a patient.

In such situations, specific questions and methods to assess the patient’s appearance and general behavior, motor activity, speech, mood and affect, thought process, thought content, perceptual disturbances, sensorium and cognition, insight, and judgment serve to identify features of various psychiatric illnesses.

The mental status examination can help distinguish between mood disorders, thought disorders, and cognitive impairment, and it can guide appropriate diagnostic testing and referral to a psychiatrist or other mental health professional.

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