Thoughts
This section aims to evaluate what the patient is thinking about and how the patient is thinking. For clarity thoughts are split into two separate sub sections content and form.
Content (or nature)
Examine what is on the patients mind during the interview and most of the time at the moment? Inquire about any preoccupations, worries, phobias or recurrent thoughts.
'What has been on your mind lately?'
'Is there anything you have been giving alot of thought to?'
From the patients answers you have to decide if the thought content is normal or abnormal within perceived social and cultural norms for each patient...
Obsession
Repetitive irrational thoughts that are recognised by the patient to be irrational. Themes are commonly religious, sexual or violent.
Overvalued idea
Unreasonable and sustained preoccupation with a belief which is not quite delusional in intensity e.g. a anorexic who believes she is fat around the thighs and has to loose weight.
Delusion
A false belief which is firmly held in spite of evidence to the contrary. It is not in keeping with cultural, religious and social norms.
Form
This is the formation of thoughts. You can make an assessment of thought flow from the way in which the patient responds to a question try to follow the train of thought from what is said.
If you are not able to follow the thought flow then it is best to quote a sample of what is being said.
| Example. Miss. Andrews |
| . |
'Miss. Andrews expressed a keen interest in symbolism and tarot cards. She offered to read my cards there and then using a pack she "always carries around."
She explained that what she sees day to day has significance to the current state of the universal equilibrium ‘"If I see many women who are of bearing child in any given day tis a sign that mother earth is fertile... a fertile earth means good things to come"
She explained that she believed she was a communicator from a ‘higher dimension' she calls - "seenadom" and that she had "duties to fulfil'... to save mother earth from a a evil " which she explained was the entity behind terrorist attacks and political turmoil today.
Although her delusions are somewhat grandiose they were not accompanied by elevated affect, in fact she appeared to have blunted affect.' |
| . |
| . |
- Talked a lot about mystical symbols
- Tarot cards
- Delusion system with spiritual theme
- Delusions of grandeur
- Mood incongruent
- Neologism - " seenadom: higher dimension "
- Blunted affect |
|
 Descriptive Word List [psychiatric dictionary] |
| Content / Nature |
Delusions / Phobias |
Form |
Compulsion
Egomania
Erotomania
Hypochondria
Monomania
Obsession
Over valued idea
Poverty of thought
Pseudologia fantastica
Trend of thought |
Delusions
Bizarre
Control
Grandeur
Mood congruent
Mood incongruent
Nihilistic
Paranoid
Persecutory
Referential
Self accusatory
Somatic
Systematized
Simple
Social
Acrophobia
Agoraphobia
Claustrophobia
Xenophobia
Zoophobia |
Abstract thinking
Autistic thinking
Circumstantiality
Clang associations
Concrete thinking
Condensation
Derailment
Drivelling
Flight of ideas
Formal thought disorder
Glossolalia
Illogical thinking
Incoherence
Irrelevant answers
Loosening of associations
Neologism
Preservation
Tangentiality
Thought block
Transitory thinking
Word salad |
| |
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... |
