THOUGHT DISTURBANCES IN MANIA AND SCHIZOPHRENIA

Abstract

While many investigators have considered thought disorder to be a typically schizophrenic phenomenon, few studies have addressed the question of disturbances in thinking in other diagnostic groups. This study investigated disturbances in thinking in hospitalized manic-depressive (manic type) patients and a comparison group of schizophrenic inpatients. The major hypotheses were that (1) schizophrenic patients would manifest more overall thought disorder, including bizarreness and concreteness and (2) manic patients would evidence more abstract and correct thinking. Further, it was predicted that manics would show more extreme emotional reactions, and would exhibit more irrelevant, overelaborated thinking. Thirty male manic and thirty male schizophrenic inpatients were tested. The Wechsler Adult Intelligence Scale (Verbal), the Rorschach and the Benjamin Proverbs Test were administered and scored according to several scales of thought disorder. The Idiosyncratic-Bizarre Response Scale assesses bizarreness in WAIS and Proverb responses. The Thought Quality Scale evaluates Rorschach responses for illogic. The Overspecificity Scale rates Rorschach responses for unjustified elaboration. The Affect Elaboration Scale assesses Rorschach responses for emotional embellishment. The Abstract-Concrete Scale assesses abstract and concrete proverb interpretation responses. All subjects were dichotomously classified according to age, educational background and IQ (WAIS Verbal). T-tests revealed no significant differences between manics and schizophrenics on global measures of thought disorder. On specific thought disorder indices, manics manifested more inappropriate elaboration, autistic logic and irrelevance than schizophrenics. Chi-square analysis revealed that manics' responses were more abstract (without regard to correctness) than schizophrenics'. Schizophrenics manifested more concrete thinking and more "private" language, e.g. neologisms, than manics. Analysis of variance revealed that subjects in the low IQ group, regardless of diagnosis, manifested more thought disorder on many of the scales than subjects in the high IQ group. Advanced education was associated with thought disturbances having to do with excessive verbiage. Age had little effect on any of the measures. These findings were discussed in terms of recent theoretical views which extend the concept of mania as primarily a disturbance in mood to include other psychotic manifestations. Diagnostic questions regarding the representativeness of "atypical" psychopathology were considered.