Key features of the symptoms of disorganisation include disorganised speech and behaviour, as well as inappropriate affect. Severely disorganised speech is difficult to follow, being incoherent, irrelevant and/or illogical. These symptoms are sometimes called positive formal thought disorder symptoms. Disorganised speech may also be deprived of content, which is sometimes called negative formal thought disorder symptoms. Disorganised behaviour includes bizarre or inappropriate behaviour, actions or gestures. Inappropriate (incongruous) affect involves exhibiting incorrect emotional responses for a given context. Symptoms of disorganisation have been identified as risk factors for poor illness outcome, and have a significant negative effect on a person’s day-to-day functioning and quality of life. There is evidence to suggest that disorganisation symptoms may be associated with impaired cognition.

What is the evidence for disorganised symptoms in people with bipolar disorder?

Moderate to high quality evidence suggests a small to medium-sized effect of less formal thought disorder in people with bipolar disorder than in people with schizophrenia. This effect is significant only in non-acute, stable patients.

October 2021

Image: ©A. Bueckert – stock.adobe.com

The post Disorganised symptoms appeared first on NeuRA Library.

Key features of the symptoms of disorganisation include disorganised speech and behaviour, as well as inappropriate affect. Severely disorganised speech is difficult to follow, being incoherent, irrelevant and/or illogical. These symptoms are sometimes referred to as positive formal thought disorder. Disorganised speech may also be deprived of content, which is sometimes referred to as negative formal thought disorder symptoms. Disorganised behaviour includes bizarre or inappropriate behaviour, actions or gestures. Inappropriate (incongruous) affect involves exhibiting incorrect emotional responses for a given context.

Symptoms of disorganisation have been identified as risk factors for poor illness outcome, and have a significant negative effect on a person’s day-to-day functioning and quality of life. There is evidence to suggest that disorganisation symptoms may be associated with impaired cognitive performance.

What is the evidence regarding disorganised symptoms?

Moderate to high quality evidence found small to medium-sized associations between positive and negative formal thought disorder and poor cognition in the areas of memory, attention, processing speed, planning, semantic processing, social cognition, and social functioning. Positive formal thought disorder was particularly associated with poor inhibition and syntactic comprehension, while negative formal thought disorder was particularly associated with poor fluency. There was also a medium-sized association between poor insight (overall unawareness of having a mental disorder) and increased disorganised symptoms.

There was a small to medium-sized effect of more formal thought disorder symptoms in people with schizophrenia than in people with bipolar disorder. This effect was significant only in non-acute, stable patients.

High quality evidence shows significant concordance of disorganisation symptoms in siblings with schizophrenia. Low quality evidence suggests unclear concordance in twins with schizophrenia.

February 2022

Image: ©carlosgardel – stock.adobe.com

The post Disorganised symptoms appeared first on NeuRA Library.

Schizophrenia is characterised by positive, negative and disorganised symptoms. Positive symptoms refer to experiences additional to what would be considered normal experience, such as hallucinations and delusions. Negative symptoms include blunted affect, impoverished thinking, alogia, asociality, avolition, and anhedonia. Alogia is often manifested as poverty of speech, asociality involves reduced social interaction, avolition refers to poor hygiene and reduced motivation, while anhedonia is defined as an inability to experience pleasure. Disorganised symptoms involve bizarre behaviour and disorganised thought and speech. Cognitive deficits are also a core feature of schizophrenia. These deficits may be present in chronic patients, as well as prior to onset of the disorder and during its early and acute stages. Cognitive deficits may be associated with specific symptoms as well as functional impairment.

What is the evidence for cognitive functioning relating to symptom dimensions?

Moderate to high quality evidence shows more severe overall symptoms are associated with poor prospective memory, insight, executive functioning, facial perception, facial emotion recognition, emotion processing and perception, social perception, and Theory of Mind.

More severe positive symptoms are associated with poorer insight, attention/vigilance, reasoning, problem solving, non-emotional recognition, self-recognition, psychomotor speed, executive functioning, Theory of Mind, verbal list learning and digit span performance. More severe negative symptoms are associated with poorer language fluency, IQ, attention, memory, learning, speed of processing, reasoning, executive functioning, insight, social cognition, and olfaction. More severe disorganised symptoms are associated with poorer IQ, attention, executive functioning, speed of processing, reasoning/problem solving, and memory, but not verbal working memory. Thought disorder was associated with poorer semantic priming and verbal fluency.

March 2022

Image: ©carlosgardel – stock.adobe.com

The post Cognitive functioning related to symptoms appeared first on NeuRA Library.