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Ordered thoughts on thought disorder

  • Ashley Rule (a1)
Abstract
Aims and Method

To review and clarify the large number of psychophenomenological terms used to describe thought disorder. The most recent editions of the major psychiatric textbooks and medical dictionaries in the library of a London teaching hospital were used to compile a list of such terms. The various, often conflicting definitions were compared.

Results

There were 68 terms identified. There was significant redundancy in these terms (i.e. more terms than significantly different concepts described). Different sources gave different definitions for the same terms.

Clinical Implications

The understanding of many of the terms used to describe thought disorder is poor. This is confusing for clinicians, trainees and patients.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Ordered thoughts on thought disorder

  • Ashley Rule (a1)
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eLetters

Further thoughts on Ordered thoughts

Arun K Chopra, Senior House Officer in Psychiatry
05 December 2005

Editor-

Rule highlights the confusion shared by clinicians, trainees and patients over the different terms used to describe similar phenomenon (Psychiatric Bulletin 2005; 29: 462-464).I recently discussed how to perform a mental state examination with undergraduate medical students in their psychiatry placement. They were confused by the number of different terms used to describe similar concepts which they had been taught by different trainees and consultants and they criticized the lack of consensus and objectivity. This becomes more poignant considering Sims (2003) describes descriptive psychopathology as the unique skill of the psychiatrist.

Rule reports significant redundancy amongst the terms used to describe concepts.It would be useful for psychiatrists to have a discussion on which terms are preferred and which terms can now be droppedfrom daily practice. Clear definitions of the phenomena described by these preferred terms could also be written.

This would have several advantages.With the emphasis on multidisciplinary team work and the implications of the EWTD on junior doctor’s working hours, more professionals are involved in the care of a patient.Clear terminology would facilitate communication between colleagues. This would result in more precise assessments of changes in mental states. Trainees would also welcome a reduction of terms as well asmore clear definitions of the preferred terms used to describe clinical phenomenon. This would be useful if presenting mental states is to be partof the work based assessments. Finally, this might encourage more medical students to enter higher training in psychiatry.

SIMS, A.C.P. (2003) Symptoms in the Mind: An introduction to Descriptive Psychopathology (3rd edn). Edinburgh: Elsevier Science.
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