Thought disorder: signs, causes and ways to effectively help patients

Thinking is one of the forms of higher mental activity of a person. With the help of various senses, we receive certain information about the environment, but it is the mental processes that allow us to evaluate and analyze it, make plans for the near future, and set certain life goals. Thinking disorders are one of the first and key symptoms of many mental illnesses; it is because of this that a person gradually loses his ability to work, and sometimes the ability to perform even simple everyday skills. Therefore, the doctors at the Leto mental health center determine the treatment tactics for such disorders taking into account their root cause.

Etiology

Thinking is a single process in which both hemispheres participate. The speech center is located in the left; it provides a logical analysis of objects and phenomena based on signals received from the senses. Thanks to this, a person forms a certain opinion about a particular situation. The right hemisphere is responsible for the emergence of emotional and sensory images. They cannot always be expressed verbally; sometimes they are described as intuition, subconscious, etc.

Therefore, almost any neurological disease affects perception processes in one way or another. The most common causes of thought disorders include:

• epilepsy;
• acute and chronic infections that occur with complications on the central nervous system (encephalitis, meningitis, syphilis, undiagnosed or decompensated form of HIV/AIDS), parasitic infestations;
• neoplasms in the brain: cysts, vascular aneurysms, benign or malignant tumors;
• previous strokes;
• dyscirculatory encephalopathy;
• brain damage due to liver dysfunction;
• consequences of traumatic brain injuries;
• deficiency of B vitamins, folic acid, severe metabolic disorders.

Sometimes the syndrome is associated with genetic defects in the production of basic neurotransmitters and the formation of neuronal connections. In such cases, the symptoms of the disease manifest themselves either at an early age with speech delays, problems with the formation of logical associations, or in adults in combination with severe mental disorders.

Thinking disorders are typical for:

• schizophrenia;
• almost all forms of psychopathy;
• dementia;
• Alzheimer's disease;
• autism;
• oligophrenia;
• acute and chronic psychoses.

The syndrome may also be accompanied by depression and other affective disorders, anxiety and phobic neurosis. In such cases, the pathology is acquired. Such changes occur under the influence of stressful and traumatic factors.

The relationship between delusions and hallucinations in mentally ill patients

Where do delusional ideas come from? The answer to this question can be given if we are based on data from modern psychiatric science and the clinical course of a particular disease. A number of delusional states are inextricably linked with disturbances in the sphere of perception as a whole. For example, hallucinations are often accompanied by delusions: the patient hears voices that threaten him, and he automatically experiences delusions of persecution with an incorrect interpretation of what is happening.

Similar conditions can occur with senestopathies (when the patient feels strange or imaginary pain in any internal organ). As a result of these sensations, a hypochondriacal form of delirium appears.

Clinical features

In foreign psychiatry there is no unified classification of thinking disorders, since they are considered in the structure of other diseases. Domestic specialists prefer to work with a fairly simple classification that accurately reflects all the features of the syndrome. In accordance with it, the following forms of the disease are distinguished:

• dynamic: changing the pace of thinking;
• structural, associated with a violation of the logical sequence of thoughts, the ability to perform consistent, planned actions;
• pathologies of judgment, in which the patient cannot adequately assess what is happening around.

Dynamic thought disorders

This group includes:

• Lethargy. Accompanied by a slowdown in the train of thought, and as a result, speech. The patient prefers simple, monosyllabic sentences, as if constantly searching for words. The reaction speed decreases, the ability to systematize information deteriorates or is completely absent.
• Acceleration of thought processes. The pace of thinking increases many times over, but at the same time the person is unable to concentrate on anything, constantly “jumping” from one thing to another, but does not bring anything to its logical conclusion.
• "Jump" of thoughts. In the patient’s head, thoughts change so quickly that they resemble a kaleidoscope; he does not even have time to voice them, which is why his speeches are often called “verbal hash.”

Such forms of the syndrome are characteristic of mania, schizophrenia, and depression.

Structural thinking disorders

The following syndromes include:

• Dissociation. Characteristic is the absence of a logical connection between individual judgments while maintaining consciousness.
• Incoherence. The person is completely disoriented, unable to focus on anything, speech is meaningless, sometimes it is just a collection of sounds. Usually a symptom of serious organic brain damage.
• Thoroughness. They note a tendency to become fixated on certain details. The patient answers any question in detail and thoroughly, dwelling on completely unnecessary and uninteresting details. The speech is verbose, replete with aphorisms, metaphors, and comparisons.
• Perseveration. The patient is constantly focused on the same thought, and therefore is not able to form new logical associations. This pathological process is also reflected in speech: the patient repeats the same word or phrase for a long time.
• Reasoning. There is no focus on any object. Pay attention to the tendency to fruitless and meaningless reasoning and philosophizing.
• Symbolism. Typically, the desire to give any objects a special meaning (usually negative or frightening), which determines the manner of behavior. For example, the color blue is associated with misfortune, a cut flower with death, etc.
• Autism. Characterized by a lack of connection between thinking and the surrounding reality. The patient forms images and logical chains of conclusions that are understandable only to him alone.

These types of thinking disorders are characteristic of severe mental illness, autism spectrum disorders, and schizoaffective syndrome.

Pathology of judgments

Usually develops against the background of exacerbation of pathologies of the psycho-emotional sphere or with psychosis caused by alcohol or drug use. This variant of the disease can manifest itself:

• Obsessive ideas. These are persistent thoughts that appear against the will of the patient. A person understands their absurdity and inappropriateness, but cannot get rid of them. This syndrome is not accompanied by intellectual impairment, but causes severe anxiety and restlessness, which does not have the best effect on the productivity of thinking and performance.
• Super valuable ideas. They represent judgments formed on the basis of real events, but their meaning for the patient clearly does not correspond to the situation. A striking example of people with super-valuable ideas are religious fanatics who evaluate both their own and others’ actions from the point of view of sinfulness and repentance.
• Delirious. This is a false, distorted, usually ridiculous conclusion that has nothing to do with reality. The plot of delirium is different: from ideas of jealousy and persecution to love experiences.

Overvalued ideas, manias and their features

Supervaluable ideas are understood as the patient’s thoughts that are extremely important to him. Usually they have a pronounced emotional component and are devoid of objective meaning. For example, a patient may believe that his dismissal from work is unfair and constantly thinks only about this. An overvalued idea differs from an obsessive state in that the patient does not feel the desire to get rid of it, but, on the contrary, continues to cultivate it in his mind. Such patients are deeply convinced of the importance of their ideas and their significance in the world around them. One of the mental illnesses in which they almost always appear is paranoid syndrome.

Cost of services

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Motivational aspect

The motivational and personal component of thinking is one of the most important in the study of mental disorders. Thus, in almost any form of schizophrenia, especially at an early stage or before an attack, there are symptoms such as apathy and lack of initiative. Any person should be interested in his destiny. If there is no concern for the future, then there will be no motivation to do anything to achieve it.

Moreover, it is important to note that there are two aspects of apathy. The first is associated with complete insensibility, which is observed in severe patients. The second is typical for milder cases, when apathy is considered as a common lack of motivation. With the first, everything is clear without an examination, but the second type of patient is sent to experts for examination, during which three main criteria are assessed:

• diversity of judgments;
• reasoning;
• criticality violations.

Let's take a closer look at each.

Diversity of judgments

With schizophrenia, a person’s judgments become contradictory. Their thought process can proceed on different planes, while the patient does not perceive such logical contradictions as errors. This is due to the lack of a clear goal for which the conclusion is formed.

In fact, the patient has several plans to solve one problem, each of which may be completely unrelated to the other. Moreover, one of them may contradict the second, but the patient does not understand this. Often one goal is dictated by the desire to complete a task, and the second is related to personal preferences.

The following case can be cited as an example. The patient is asked to distribute the cards into groups. At first he does this correctly, explaining everything clearly and logically, since the process of generalizing judgments, in principle, works well. Then he changes his mind and excludes mushrooms from the group on the basis that he was once poisoned by them and therefore does not eat them anymore.

In this case, there is a lack of goal setting. In everyday life, this will interfere with decision-making. As a result, a person may refuse to perform certain actions altogether.

A particular example of the diversity of thinking is its fragmentation, when the patient’s speech turns into a “word salad.” The beginning of a phrase refers to one situation, the middle to another, and the end to a third. In mild forms of schizophrenia, the patient may temporarily wander away from the topic due to various associations. However, he is still able to return to the topic, especially with support from a specialist.

Based on one conversation with a person, it is impossible to draw a conclusion about the fragmentation or diversity of thinking. It is necessary to carry out various techniques, including “classification” and “exclusion of items”. If contradictions appear when performing most of the tasks, appropriate conclusions are drawn about thinking disorders.

Reasoning

Reasoning is typical idle talk, a tendency to meaningless reasoning, fruitless philosophizing, which does not lead to the formation of a full-fledged intellectual product. This phenomenon is typical not only for sick people, but also for healthy people.

As an example, we can mention a student’s uncertain answer in an exam, when he does not know how to fill in his lack of knowledge of a particular subject. In such cases, he simply talks about what comes to mind, just so as not to remain silent. In general, this is an adequate human reaction to a complex and unpredictable situation. In a sense, he's just buying time.

In schizophrenia, idle talk occurs without any purpose, out of nowhere. In this case, the patient usually speaks pretentiously, pretentiously or mannered, trying to impress. He can speak with a smart look and complete platitudes that do not require any philosophizing. He does not listen to the opinions of other people at such moments. It is simply important for him to speak, especially on topics that are directly related to him. As a result, the speech turns into a long and lengthy monologue that has no clear content.

Criticality Violations

Uncriticality is characterized by a loss of purposefulness of thinking, its incompleteness. The thought process ceases to be a regulator that limits and controls a person’s actions.

To assess criticality, a simple test, or Ebbinghaus test, is performed. The patient is offered a text with gaps that he must fill in with words. He selects concepts himself, based on subjective opinion. However, in the end he must prepare a logically coherent and understandable text.

Then the expert reads it. If contradictions are detected, he asks the patient to find and correct them himself. Then the error correction rate begins to be assessed. If the subject does not see the errors, the experimenter points them out, but the patient must still make corrections on his own.

Experts distinguish three types of criticality:

• to the presence of a disease or specific symptoms;
• personal;
• to the effectiveness of their activities during experiments.

The last type of criticality is directly related to thinking. The doctor points out mistakes, and the patient corrects them. A healthy person should be interested in this, since he has a goal and his fate is important to him. A schizophrenic is usually indifferent to comments. If he was told that he did something wrong, he will accept it and do nothing. In other words, he doesn’t care - “whether it’s will or not.”

The described complex of symptoms of thinking damage is not observed in all patients. It all depends on the specific form of pathology and its stage.

Schizophrenia affects not only thinking, but also other cognitive abilities of a person - perception, attention and memory. Let's touch on them, since they are largely related to the subject discussed in the article - the thought process.

Treatment and diagnosis of thought disorders

Before prescribing treatment, the medical doctor excludes possible functional pathologies of the central nervous system using X-ray or tomographic scanning, examination of cerebral vessels, clinical and laboratory blood tests.

If the syndrome is caused by neurological causes, a highly specialized specialist is invited for consultation. In the absence of organic brain damage, psychosocial testing is performed to determine the specific type of mental illness and its severity.

Treatment directly depends on the diagnosis. Thus, for schizophrenia and psychopathy, neuroleptics and tranquilizers are prescribed, and psychotherapy is only auxiliary and is indicated outside the period of exacerbation. Psychoses require hospitalization and intensive drug treatment. Neuroses and depression respond well to cognitive behavioral therapy.

Thinking disorders are a strict indication for seeing a doctor, and the earlier treatment is started, the higher the likelihood of a favorable prognosis and long-term remission. To consult with a doctor, you must either make an appointment or arrange a specialist home call from our operators by calling 8(969)060-93-93 .

How do specialists work?

Our clinic employs experienced specialists who know how to effectively approach solving these problems. The patient is given training, after which memory, attention and thinking are strengthened. Modern tests focus on word repetition; drawing up a single picture from several abstract concepts; text analysis; solving problems using ingenuity.

If necessary, specialists will select a complex of vitamins and medications necessary to eliminate the problem, which are selected individually, depending on the cause and stage of manifestation of the disorders.

The goal of our specialists is to develop a set of measures to restore vital functions. We strive to completely change the patient’s lifestyle, making it the most favorable for recovery.