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Assessment of the psychiatric patient
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Disordered thinking occurs with schizophrenia. The speech becomes difficult to understand or unintelligible, and the logical sequence of thoughts is difficult to follow. This is also referred to as ‘loosening of associations’ or ‘knight’s move thinking’. In its most severe form, speech becomes an incoherent mixture of words and phrases (‘word salad’).
Questions and Answers
Published in David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly, MRCPsych Paper I One-Best-Item MCQs, 2017
David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly
Answer: D. Echolalia is the repetition of words or part of clauses spoken by others. Logorrhoea means verbosity. Paraphasia is a destruction of words with interpolation of garbled sounds. It is also used as a synonym for ‘approximate answers’. Word salad is a severe thought disorder where there is a loss of grammatical and syntactical coherence. [D. pp. 163, 165; M. pp. 63–4]
100 MCQs from Dr. Brenda Wright and Colleagues
Published in David Browne, Selena Morgan Pillay, Guy Molyneaux, Brenda Wright, Bangaru Raju, Ijaz Hussein, Mohamed Ali Ahmed, Michael Reilly, MCQs for the New MRCPsych Paper A, 2017
Dr Olivia Gibbons, Dr Marie Naughton, Dr Selena Morgan Pillay
Paragrammatism refers to the disorder of grammatical construction. In schizophrenia it is termed word salad. Cluttering is a disturbance of fluency involving an abnormally rapid rate and erratic rhythm of speech that impedes intelligibility. In echolalia the patient repeats words or parts of sentences that are spoken to him or in his presence. It most often occurs in excited schizophrenic states, with learning disability and with organic states. Logoclonia describes the spastic repetition of syllables that occurs in Parkinsonism. Palilalia is the repetition of a word or phrase. It is a perseveratory phenomenon. (5, pp 158–9, 14, pp 849–59)
Behavioural equivalents of schizophrenia in people with intellectual disability and autism spectrum disorder. A selective review
Published in International Journal of Developmental Disabilities, 2021
Disorganized speech and disorganized behaviour are the two most thoroughly described symptoms in the selected articles. Research points to features of formal thought disorder, manifested by disorganised speech, as being present both in individuals with SCZ and ASD (Bakken et al.2009, Konstantareas and Hewitt 2001, O’Dwyer 2000, Rumsey et al., 1986). Persons with ASD have cognitive and information-processing impairments, which will affect their thinking and language (Volkmar et al.2004). Both people with autism and people with schizophrenia will show features of thought disorder, but differently. Adults with schizophrenia will tend to show more incoherent speech, also referred to as ‘word salad’, pressure of speech and severe derailment, during acute phases, whereas adults with autism will show more impoverished speech, poverty of content of speech, deviant responses and inappropriate thinking. Other differences regarding disorganized speech found in individuals with ASD compared to individuals with SCZ, are that the ASD group tend to show more perserveration, and paucity of expressive gestures (Rumsey et al.1986). Additionally, clinical experience indicates that individuals with ASD usually have problems with taking turns and flexibility related to topics and taking the perspectives of the communication partner (Robinson et al.2017). The latter is rarely seen in patients with SCZ when the acute phase is in remission. However, patients with ASD will show the same features of disorganised speech as other patients, when they are in acute psychotic phases (Bakken 2014).
What Milton Erickson said about being Ericksonian
Published in American Journal of Clinical Hypnosis, 2020
From 1934 to 1948 Dr. Erickson lived in Eloise, Michigan as the Director of Psychiatric Research Training at Wayne County General Hospital. During that time, he worked with the young man who had been a patient there for five years. He would only identify himself as George but no one on the staff, nor could any of the patients, manage to get George to speak anything other than an incomprehensible word-salad. Erickson had his secretary tape-record and transcribe (as closely as possible) the gibberish that George spoke. Dr. Erickson went over it carefully enough to be able to nearly replicate it in his own speech. Then, once introduced to George, he began commenting back to George in the same word-salad that George communicated to him. This process of communication with George continued for several days. “The next morning George returned the usual greeting and added about two sentences of nonsense. The author [Erickson] replied with similar length of nonsense. George replied, ‘talk sense, doctor.’ ‘Certainly, I’ll be glad to. What is your last name?’ ‘O’Donovan, and it’s about time someone who knows how to talk asked. Over five years in this lousy joint’ … (To which was added a sentence or two of word salad). The author replied, ‘I’m glad to get your name George. Five years is too long a time’ … (And about two sentences of word salad were added)” (Erickson, 1980h, p. 214). Erickson’s report of this case continues to add that communication continued much the same from that time forward – two sentences of word salad and then almost perfect English – ended with two sentences of word salad.
“I would have told you about being forgetful, but I forgot”: the experience of cognitive changes and communicative participation after head and neck cancer
Published in Disability and Rehabilitation, 2020
Susan Bolt, Carolyn Baylor, Michael Burns, Tanya Eadie
Language difficulties were experienced by most participants. On the expressive side, participants talked about difficulties with word finding, “the inability to grab the right word” (P2). Receptively, participants talked about difficulties parsing written language. While P5 referred to it as “word salad,” P4 talked about not being able to read prescription bottles: