Disorganized Thinking it may be a disturbance in the way a person organizes and expresses their thoughts. It could be recognized through speech because we may not directly observe thoughts themselves.
Common features include:
- Loose associations (derailment): Ideas shift from one topic to another with little or no logical connection.
- Tangentiality: Answers may be related to the question but never actually reach the point.
- Circumstantiality: Speech may include excessive unnecessary details before eventually answering the question.
- Incoherence (“word salad”): Words and sentences may become so disorganized that they are difficult or impossible to understand.
- Illogical thinking: Conclusions may not logically follow from the information presented.
- Thought blocking: The person may suddenly stop speaking because their train of thought seems to disappear.
Disorganized thinking may be associated with conditions such as:
- Schizophrenia
- Bipolar disorder during severe manic episodes
- Severe depression with psychotic features
- Delirium
- Some neurological disorders or substance intoxication: “Please, Consult with a Medical Doctor, Neurologist or a Psychiatrist.”
For example:
- Question: “Why did you come to the hospital?”
- Response: “Well, hospitals have windows. Windows let in sunshine. Sunshine grows flowers. My neighbor likes flowers.”
The response may contain a chain of loosely connected ideas rather than a logical answer to the question.
It could be important to distinguish disorganized thinking from simply being distracted, anxious, or speaking in a rambling style. Disorganized thinking is typically severe enough to interfere with effective communication and may indicate an underlying psychiatric or neurological condition that requires evaluation: “Please, Consult with a Medical Doctor, Neurologist or a Psychiatrist.”
Shervan K Shahhian
LIBERTY PSYCHOLOGICAL ASSOCIATION 