Disorders of the stream of thought

• Knight's move thinking (asyndetic thinking, derailment of thought) is abrupt transition from one topic to another semi-related one.

• Concrete thought is inability to appreciate abstract concepts, although some patients show the opposite tendency and assume symbolic meanings that are not intended.

• Poverty of thought is one of the 'negative' symptoms characteristic of the chronic stages of the illness.

Of course, our only way of knowing about patients' thoughts is through their talk, which may be vague and difficult to follow. Sometimes, the patient will make sense in respect of individual sentences, but drift gradually off the point. They may seem to be articulate, and it may be some time before one appreciates that they are 'talking past the point' or are 'tangential' or 'over-inclusive'. There may be odd changes of topic, or the content may be incomprehensibly bizarre.

Some patients keep repeating the same words or phrases (verbigeration), use idiosyncratic words (neologisms), or, in very severe psychosis, speak in a jumble of words or even word fragments (word salad).

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