Thinking Disorders: The Schizophrenia Spectrum and Other Psychotic Disorders

Thinking disorders are a disorganized manner in thoughts displayed in abnormal language, speech, and writing. They are considered weird mental disorders because they are illogical, and most lack understanding of them. 

There are three aspects to thinking: thinking about a topic, putting thoughts together about the topic, and speaking about those thoughts logically. A physician will diagnose thinking disorders when thoughts, behavior, or speaking become problematic, illogical, or incoherent.

Diagnosing Psychotic Disorders

Thinking disorders can be challenging to diagnose and treat as many people experience and exhibit these conditions occasionally. For example, when you are overly exhausted and have been deprived of sleep or have suffered from frequent sleep interruptions.

Symptoms of thinking disorders include the following:

  • Rapid speech that is illogical, incoherent, disorganized, and lacks flow
  • Speech that includes multiple tangents and random, unrelated topics
  • Inability to maintain a consistent train of thought without frequent interruptions
  • Inability to tell a story or express an idea in a logical manner
  • Delusions or beliefs despite evidence to the contrary
  • The belief that your thoughts have been removed or altered by another person or being

If you are diagnosed with a thinking disorder, it is typically in conjunction with one or more issues, such as a schizophrenia experience. Two examples of primary mental health conditions causing thinking disorders are schizophrenia and schizotypal personality.

What is Schizophrenia?

Schizophrenia is a chronic mental health disorder affecting less than one percent of people in the United States. Schizophrenic cases cause delusions, hallucinations, and trouble organizing thoughts and speech. 

 

There is a genetic link to schizophrenia and biological and environmental factors contributing to some developing the condition. Men and women are diagnosed with the disorder fairly equally. Ongoing research continues to reveal more information on how people develop the condition.

Schizotypal Personality Disorder

Schizotypal personality disorder causes sufferers to have difficulty forming close relationships and understanding how their behavior affects others. 

 

If you or a loved one has schizotypal personality disorder, you may find you often lack trust in others and misinterpret other people’s behaviors. You may also have difficulty with appropriate responses and reacting to social cues. 

While this mental disorder is considered a personality disorder more than a psychotic disorder, it does have psychotic symptoms. These include paranoid thoughts, eccentric behavior, and thinking.

Bipolar Disorder

Bipolar disorder is also known as manic depressive disorder and involves significant mood swings. These include clinical depression on the low emotional end to mania on the opposite high emotional end. 

When in a state of mania, you may have a mixture of easy irritability, anger, and depression. You may find yourself in a state of euphoria when in a manic state, causing you to exhibit risky behavior, overconfidence, overspending, promiscuity, and other extreme behaviors. 

 

Bipolar disorder is classified as a mood disorder due to the shifts of extreme highs and lows. However, during these extreme shifts in mood, individuals can have periods of psychosis. This disconnection is similar to the psychosis felt from schizophrenia or dementia.

Schizoaffective Disorder vs. Schizophrenia

In schizophrenia, mood symptoms can occur without psychotic symptoms. In schizoaffective disorder, psychotic symptoms may or may not be evident when you are displaying signs of depression or mania.

Those suffering from schizophrenia have more persistent psychotic episodes. Hallucinations, delusions, and disorganized thoughts are chronic and ongoing. However, those suffering from schizoaffective disorder also experience a mood disorder as well. 

Essentially, where there is a lack of psychotic symptoms, those suffering from schizoaffective disorder experience shifts in moods. Opposingly, where there is a lack of mood shifts, those suffering from schizophrenia experience psychotic episodes.

The Many Subtypes of Thinking Disorders

There are more than 20 subtypes of thinking disorders, meaning treatment must be appropriate for the condition and these weird mental disorders. If you or a loved one has been diagnosed with a mental health disorder, you may exhibit one of several thinking disorders.

Alogia

This is known as “poverty of speech.” Someone may provide only brief responses to questions, such as simply “yes” or “no” with no elaboration or details. People with alogia often remain silent unless specifically addressed by others.

Blocking

It is defined as a self-interruption abruptly in mid-sentence. There may be a pause in speaking, but it is often on a different topic, unrelated to the previous conversation when the person resumes speaking.

Circumstantiality

This includes unrelated, irrelevant details in speech or writing. It is a direct product of random, disorganized thinking. Sometimes this is referred to as “non-linear thought” or a delay in reaching the point.

Clang Association

Describes the speech of a person who makes word choices based on word sound rather than word meaning. They may engage in rhyming speech, puns, or sentences that simply make no sense.

Derailment

Describes a speech that jumps from topic to topic with little relation between them. The topic of reference often changes from one thought or one sentence to the next. 

Distractible Speech

This is a conversation that struggles to stay on topic. It involves quick movement between topics mid-sentence as a result of distractions. Someone that is experiencing mania may exhibit this symptom. 

Echolalia

Constant repeating of noises and words overheard rather than those that express thoughts and ideas. For example, a person with echolalia may mimic others or repeat questions rather than answers.

Stilted speech

They use an outdated or formal language that is not the norm. 

Paraphrastic Error

Constant word mispronunciation.

Neologism

The creation of new words. It could even be part of their language.

Diagnosing Psychotic Disorders

Anyone can occasionally display a thinking disorder. However, if the cause results from one or more weird mental disorders, the condition will worsen without proper treatment. The diagnosis process for schizophrenic cases involves a series of tests conducted by a physician or psychologist. 

These tests will include evaluating whether your behavior is consistent with your culture, education, and intelligence level.

Examples of testing include the following:

  • Rorschach inkblot test: This test includes a series of 10 inkblots that the healthcare professional will show you and ask for your first interpretation or thought of each, looking for disordered or random thinking
  • Thought Disorder Index, or Delta Index: A physician or psychologist will talk with you for an extended time, engaging in conversation and looking for an ability to remain on topic and exhibit logical, ordered thinking. The healthcare professional will score the conversation using the thought disorder index, which is a standardized test that measures 23 areas on a scale from zero to one and weighs the severity of each area.

Treatment of Psychotic Disorders

Treating thinking (psychotic) disorders requires addressing the primary mental health condition causing the disorder. Medication and psychotherapy are the two primary ways healthcare professionals treat people with weird mental disorders.

Inpatient Treatment

Inpatient treatment for schizophrenia spectrum and other psychotic disorders is required when a patient is at risk of self-harm, harm to others, or has a schizophrenia experience occurring frequently and cannot be appropriately treated in a less restrictive setting. Inpatient treatment facilities may be geared for adults aged 18 and older or children under age 18. Inpatient facilities often combine an antipsychotic medication for delusions and hallucinations with individual and group therapy sessions to treat schizophrenic cases.

Outpatient Treatment

Outpatient treatment for schizophrenia spectrum and other psychotic disorders typically involve one or more mental health treatment services without an inpatient facility stay. Treatment typically includes a combination of therapy. This includes individual counseling, group therapy, and an antipsychotic medication for delusions and hallucinations.

Therapy

Therapy includes individual psychotherapy, group therapy, and family therapy. Each is designed to address the individual patient as well as the family unit that is so important in support and treatment. 

Individual psychotherapy is a one-on-one counseling session where you will talk with a therapist or healthcare professional. 


Group therapy involves a healthcare provider and multiple patients dealing with mental health conditions that have similar symptoms. Family therapy involves family members, along with you and your therapist. Some healthcare providers will suggest a combination of these therapy sessions to address symptoms and multiple coping techniques.

Holistic Treatment

Holistic treatment is designed to treat you or your loved one without the use of medication. In the case of treating schizoaffective disorder vs. schizophrenia, there may be ways to cope with thought disorders without the use of medications.

Common forms of holistic treatment include:

Antipsychotic Medications

Antipsychotic medications may be prescribed by a physician to balance the chemicals dopamine and serotonin in the brain. Medication for delusions, hallucinations, and thought disorders do not provide a cure for schizophrenia spectrum and other psychotic disorders. However, they do offer an effective way to manage the symptoms of a schizophrenia experience. Many antipsychotic medications have been used for decades, as well as new antipsychotic drugs.

 

Because newer medications often have fewer side effects and have undergone recent testing trials, physicians often prescribe them first. However, older antipsychotic medications have been in the market longer and have a great deal of data on their effectiveness. This leads some physicians to rely on their longevity. Some medications are administered by injection and are taken one to two times a month or even one time per quarter. Other drugs are taken daily in pill form.

Help for Psychotic Disorders

Thinking disorders affect the ability to think clearly and formulate thoughts and ideas, affecting speech, writing, and behavior. This leads to issues with communication with others and may lead to risky behavior and inappropriate responses. If you or a loved one are exhibiting a thinking disorder symptoms, contact us today for more information on how we can help.

References

https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia

https://www.psychologytoday.com/us/conditions/schizotypal-personality-disorder

https://www.psychologytoday.com/intl/basics/bipolar-disorder