Differences in single positive formal thought disorder symptoms between closely matched acute patients with schizophrenia and mania

Eur Arch Psychiatry Clin Neurosci. 2022 Apr;272(3):395-401. doi: 10.1007/s00406-021-01263-x. Epub 2021 May 7.


Formal thought disorders (FTD) are a hallmark diagnostic feature of schizophrenia (SZ) and (bipolar) mania (MA). FTD can be separated into positive (pFTD) and negative dimensions. It is unclear whether there are differences in pFTD on a single symptom level between acutely ill patients with SZ and MA, which cannot be attributed to cognitive impairment. We compared single pFTD symptoms in two groups of acutely ill patients with ICD-10 bipolar mania and schizophrenia, closely matched for age, sex, pFTD TALD score, verbal IQ and neuropsychological test performance (executive function, verbal fluency, attention, and working memory). SZ patients had higher severity of the TALD symptoms "perseverations" and "poverty of content of speech" than those with MA (Mann-Whitney U, significant, Bonferroni corrected). Speech in acute SZ patients differs from MA in that it conveys little information and adheres to previously mentioned ideas and topics. Matching for confounding variables, such as IQ and cognition, is important when comparing patients with different diagnoses.

Keywords: Formal thought disorder; Mania; Perseveration; Poverty of content of speech; Schizophrenia; TALD.

MeSH terms

  • Cognition Disorders* / diagnosis
  • Cognition Disorders* / etiology
  • Cognition Disorders* / psychology
  • Executive Function
  • Humans
  • Mania
  • Neuropsychological Tests
  • Schizophrenia* / complications
  • Schizophrenia* / diagnosis