Thought disorder is a disorganized way of thinking that leads to abnormal ways of expressing language when speaking and writing. It’s one of the primary symptoms of schizophrenia, but it may be present in other mental disorders such as mania and depression.

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.

There are more than 20 subtypes of thought disorder. In this article, we’ll break down the symptoms of some of the most common types. We’ll also examine potential treatment options to help you or someone you know manage this disorder.

Thought disorder first appeared in scientific literature in the 1980s, when it was first described as a symptom of schizophrenia. Its loose definition is any disturbance in the organization and processing of ideas.

Each type of thought disorder has unique symptoms. However, a disruption in the interconnectivity of ideas is present in all types.

Even though it’s common for most people to display some of the symptoms of thought disorder occasionally, thought disorder isn’t classified until it negatively affects the ability to communicate.

These are some of the most common types of thought disorder:

Alogia

People with alogia, also known as poverty of speech, give brief and unelaborated responses to questions. People with this form of thought disorder rarely speak unless prompted. Alogia is often seen in people with dementia or schizophrenia.

Blocking

People with thought blocking often interrupt themselves abruptly mid-sentence. They might pause for several seconds or minutes. When they start talking again, they often change the topic of conversation. Thought blocking is common in people with schizophrenia.

Circumstantiality

People with circumstantiality, also known as circumstantial thinking, or circumstantial speech, often include excessive irrelevant details in their speaking or writing. They maintain their original train of thought but provide a lot of unnecessary details before circling back to their main point.

Clanging or clang association

A person with clanging thought process makes word choices based on the sound of the word rather than the meaning of the word. They may rely on using rhymes, alliterations, or puns and create sentences that don’t make sense. Clanging thought process is a common symptom of mania.

Derailment

A person with derailment talks in chains of only semi-related ideas. Their ideas often fall further and further from the topic of conversation. For example, a person with derailment thought disorder might jump from talking about rabbits to the hair on their head to your sweater.

Distractible speech

A person with distractible speech thought disorder has trouble maintaining a topic. They shift quickly between topics and get distracted by internal and external stimuli. It’s commonly seen in people with mania.

For example, somebody exhibiting distractible speech might abruptly ask where you got your hat mid-sentence while telling you about a recent vacation.

Echolalia

People with echolalia struggle to communicate. They often repeat noises and words they hear instead of expressing their thoughts. For example, instead of answering a question, they may repeat the question.

Other types of thought disorder

The Johns Hopkins Psychiatry Guide lists 20 types of thought disorder. These include:

  • Paraphasic error: constant word mispronunciation or slips of the tongue
  • Stilted speech: using unusual language that’s overly formal or outdated
  • Perseveration: leads to a repetition of ideas and words
  • Loss of goal: trouble maintaining a topic and an inability to come to a point
  • Neologism: creating new words
  • Incoherence: speaking in seemingly random collections of words, known as “word salad”

The cause of thought disorder isn’t well known. Thought disorder isn’t a symptom of any particular disorder, but it’s commonly seen in people with schizophrenia and other mental health conditions.

The cause of schizophrenia also isn’t known, but it’s thought that biological, genetic, and environmental factors can all contribute.

Thought disorder is loosely defined and the symptoms vary widely, so it’s difficult to find a single underlying cause. Researchers are still debating about what might lead to the symptoms of thought disorder.

Some believe it might be caused by changes in language-related parts of the brain, while others think it could be caused by problems in more general parts of the brain.

Thought disorder is one of the defining symptoms of schizophrenia and psychosis. People have a heightened risk of developing thought disorder if they also have:

According to research from 2005, people with epilepsy have an increased risk of developing schizophrenia and psychosis compared to the general population.

A traumatic brain injury increases your risk of developing schizophrenia and other mental disorders, such as depression, bipolar disorder, and anxiety disorders.

The following risk factors might also be risk factors for schizophrenia, and by extension, thought disorder:

It’s not uncommon for people to demonstrate symptoms of thought disorder occasionally. However, if these symptoms are frequent or severe enough to cause problems communicating, it’s a good idea to speak with a doctor.

Thought disorder may be a symptom of a mental disorder. Many mental disorders such as schizophrenia are progressive and don’t improve without treatment. However, people with mental disorders are often unaware of their symptoms and need help from a family member or friend.

If you notice any other symptoms of schizophrenia in somebody you know, you may want to encourage them to see a doctor:

When diagnosing thought disorder, a medical professional will consider a person’s intelligence, culture, and education to see if they’re acting inconsistently.

Rorschach inkblot test

The Rorschach inkblot test was first invented by Hermann Rorschach in 1921. The test uses a series of 10 inkblots to identify a potential thought disorder.

The inkblots are ambiguous and the patient gives their interpretation of each. The administrating psychologist then interprets the patient’s responses to search for potentially disordered thinking.

Thought Disorder Index

After engaging a patient in an open-ended conversation, a medical professional will transcribe the conversation and score it using the thought disorder index.

The Thought Disorder Index, also called Delta Index, is the first standardized test to identify thought disorder. It measures 23 areas of potential thought disturbance and weighs the severity of each on a scale from zero to one.

Treatment for thought disorder targets the underlying medical condition. The two primary types of treatment are medication and psychotherapy.

Medication

Antipsychotic medication may be prescribed depending on the cause of thought disorder. These medications can balance out the brain chemical dopamine and serotonin.

Psychotherapy

Psychotherapy helps people replace their thoughts with more realistic ones and teach them ways to manage an illness.

Cognitive behavior therapy, a form of psychotherapy, and cognitive enhancement therapy may both be beneficial for people with schizophrenia.

If you suspect that a loved one has a thought disorder, encourage them to seek medical attention. Treatments that can effectively manage thought disorder symptoms are available, and a doctor can help determine the right treatment method based on the underlying condition.

Thought disorder is a disorganized way of thinking that leads to unusual speech and writing. People with thought disorder have trouble communicating with others and may have trouble recognizing that they have an issue.

If you suspect that somebody close to you has a thought disorder, it’s a good idea to encourage them to see a doctor as soon as possible.