Thought Problems

What is formal thought disorder?

Thought disorder is a disorganized way of thinking that leads to abnormal ways of expressing language when speaking and writing. It’s one of the primary symptoms of schizophrenia, but it may be present in other mental disorders such as mania and depression.
Thought disorder is one of the most difficult mental disorders to diagnose and treat, as many people exhibit symptoms of thought disorder occasionally. Some people may demonstrate thought disorder only when they’re tired.
There are more than 20 subtypes of thought disorder. In this article, we’ll break down the symptoms of some of the most common types. We’ll also examine potential treatment options to help you or someone you know manage this disorder.

Types and symptoms of thought process disorder

Each type of thought disorder has unique symptoms. However, a disruption in the interconnectivity of ideas is present in all types.
Even though it’s common for most people to display some of the symptoms of thought disorder occasionally, thought disorder isn’t classified until it negatively affects the ability to communicate.

These are some of the most common types of thought disorder:


People with alogia, also known as poverty of speech, give brief and unelaborated responses to questions. People with this form of thought disorder rarely speak unless prompted. Alogia is often seen in people with dementia or schizophrenia.


People with thought blocking often interrupt themselves abruptly mid-sentence. They might pause for several seconds or minutes. When they start talking again, they often change the topic of conversation. Thought blocking is common in people with schizophrenia.


People with circumstantiality, also known as circumstantial thinking, or circumstantial speech, often include excessive irrelevant details in their speaking or writing. They maintain their original train of thought but provide a lot of unnecessary details before circling back to their main point.

Clanging or clang association

A person with clanging thought process makes word choices based on the sound of the word rather than the meaning of the word. They may rely on using rhymes, alliterations, or puns and create sentences that don’t make sense. Clanging thought process is a common symptom of mania.


A person with derailment talks in chains of only semi-related ideas. Their ideas often fall further and further from the topic of conversation. For example, a person with derailment thought disorder might jump from talking about rabbits to the hair on their head to your sweater.

Distractible speech

A person with distractible speech thought disorder has trouble maintaining a topic. They shift quickly between topics and get distracted by internal and external stimuli. It’s commonly seen in people with mania.

For example, somebody exhibiting distractible speech might abruptly ask where you got your hat mid-sentence while telling you about a recent vacation.


People with echolalia struggle to communicate. They often repeat noises and words they hear instead of expressing their thoughts. For example, instead of answering a question, they may repeat the question.

Other types of thought disorder

The Johns Hopkins Psychiatry Guide lists 20 types of thought disorder. These include:

  • Paraphasic error: constant word mispronunciation or slips of the tongue
  • Stilted speech: using unusual language that’s overly formal or outdated
  • Perseveration: leads to a repetition of ideas and words
  • Loss of goal: trouble maintaining a topic and an inability to come to a point
  • Neologism: creating new words
  • Incoherence: speaking in seemingly random collections of words, known as “word salad”