II. Exam: Thought Form

  1. See Disorganized Speech
  2. Logical flow of ideas or circumstantial with lengthy story of loosely related or unrelated details?
  3. Flight of ideas (rapidly moving from one idea to another related idea)?
  4. Evasive?
  5. Tangential (Loose Associations between unrelated thoughts, although connected in the patient's view)?
  6. Perseveration (frequently repeated thought or phrase)?
  7. Blocking (interrupted speech or train of thought, only to be resumed minutes later)?

III. Exam: Thought Content

  1. Preoccupation or Obsession
    1. Obsessions are Delusions with insight that the intrusive thoughts are not normal
    2. Do you think about some things often?
  2. Excessively suspicious, phobic, ritualistic?
  3. Hypochondriacal symptoms?
  4. Deja Vu sensations?
  5. Depersonalization?
  6. Harm to self or others?
    1. Suicidal Thoughts?
    2. Homicidal Thoughts?
  7. Delusions
    1. Fixed, false beliefs (e.g. persecutory, grandiose, influential) not consistent with external reality
    2. Persistent bizarre Delusions suggest Schizophrenia or schizoaffective disorder
    3. Acute Delusions suggest Alcohol or drug Intoxication
    4. Do you have strong ideas that other people rarely see the same way?
  8. Lack of Insight (unaware that thoughts are abnormal)?

IV. Exam: Concreteness

  1. Concreteness is a loss of abstract thinking
  2. Ask about relatedness between objects (what is similar?)
    1. Baseball and orange
    2. Car and train
    3. Desk and bookcase
    4. Happy and sad
  3. Test proverbs (what do these mean?)
    1. When the cats away, the mice will play
    2. You can lead a horse to water but you cannot make him drink
    3. Haste makes waste
    4. Ignorance is bliss

V. Interpretation

  1. Abnormal Thought Process suggests Psychosis (especially Schizophrenia)
  2. Obsessions are seen in Psychosis and Obsessive Compulsive Disorder
  3. Concreteness with normal intelligence suggests Psychosis (especially with bizarre or personalized answers)

VI. References

  1. Zum, Swaminathan and Egan in Herbert (2014) EM:Rap 14(7): 11-13
  2. Tomb (1992) Psychiatry, 4th Ed, Williams and Wilkins, Baltimore, p. 6-11

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Ontology: Delusions (C0011253)

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, モウソウショウジョウ
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