Comparison of Formal Thought Disorder in the Acute Episode of Schizophrenia and Manic Episode of Bipolar Affective Disorder

2022 33(4): 223-232
DOI: 10.5080/u25886
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Objective: The aim of this study was to compare the formal thought
disorder (FTD) in the acute episode of schizophrenia (SCHZ)
and bipolar affective disorder (BPAD), and to determine the FTD
dimensions associated with BPAD.
Method: The study included a total of 34 SCHZ patients not meeting
the standardized remission criteria and 20 patients in BPAD manic
episode. The patients completed the Positive and Negative Syndrome
Scale (PANSS), the Clinical Global Impression Scale (CGI), the Young
Mania Rating Scale (YMRS), the Hamilton Depression Rating Scale
(HAM-D) and the Thought and Language Disorder Scale (TALD) in
order to assess FTD. The association of FTD with the diagnoses was
analyzed by a logistic regression model including the TALD factors and
the SCHZ and BPAD groups.
Results: Statistically significant differences were not determined between
the demographic features, the CGI scores and the TALD objective
positive factor scores of the SCHZ and BPAD groups. The objective
negative and subjective negative factors (p<0.001 for all) were higher in
SCHZ group and the subjective positive factor were significantly higher
in BPAD group (p=0.028). In the logistic regression model, the TALD
subjective positive factor was associated with BPAD diagnosis, and the
objective negative factor was associated with SCHZ diagnosis. In the
BPAD group, the TALD total score correlated positively with the manic
episode severity, and the scores on the subjective negative and subjective
positive factors correlated negatively with disease duration.
Conclusion: The study results show that FTD is common to the acute
episodes of both SCHZ and BPAD and that assessment of the subjective
positive FTD symptoms and objective negative FTD symptoms may
be useful to differentiate the acute episode of SCHZ from the BPAD
manic episode.
Keywords: Formal thought disorder, schizophrenia, bipolar affective
disorder manic episode