Disorganized Thinking (Speech)

Disorganized Thinking (Speech) Disorganized thinking (formal thought disorder) is typically inferred from the individual’s speech. The individual may switch from one topic to another (derailment or loose associa­tions). Answers to questions may be obliquely related or completely unrelated (tangential­ity). Rarely, speech may be so severely disorganized that it is nearly incomprehensible and resembles receptive aphasia in its linguistic disorganization (incoherence or “word salad”). Because mildly disorganized speech is common and nonspecific, the symptom must be se­vere enough to substantially impair effective communication. The severity of the impair­ment may be difficult to evaluate if the person making the diagnosis comes from a different linguistic background than that of the person being examined. Less severe dis­ organized thinking or speech may occur during the prodromal and residual periods of schizophrenia.

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