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Ashley Rule
Ordered thoughts on thought disorder
Psychiatric Bulletin 2005; 29: 462-464 [Abstract] [Full text] [PDF]
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[Read eLetter] Further thoughts on Ordered thoughts
Arun K Chopra   (5 December 2005)

Further thoughts on Ordered thoughts 5 December 2005
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Arun K Chopra,
Senior House Officer in Psychiatry
Queens Medical Centre, Derby Road, Nottingham, NG7 2UH

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Re: Further thoughts on Ordered thoughts

arun2111{at}hotmail.com Arun K Chopra

Editor-

Rule highlights the confusion shared by clinicians, trainees and patients over the different terms used to describe similar phenomenon (Psychiatric Bulletin 2005; 29: 462-464).I recently discussed how to perform a mental state examination with undergraduate medical students in their psychiatry placement. They were confused by the number of different terms used to describe similar concepts which they had been taught by different trainees and consultants and they criticized the lack of consensus and objectivity. This becomes more poignant considering Sims (2003) describes descriptive psychopathology as the unique skill of the psychiatrist.

Rule reports significant redundancy amongst the terms used to describe concepts.It would be useful for psychiatrists to have a discussion on which terms are preferred and which terms can now be dropped from daily practice. Clear definitions of the phenomena described by these preferred terms could also be written.

This would have several advantages.With the emphasis on multidisciplinary team work and the implications of the EWTD on junior doctor’s working hours, more professionals are involved in the care of a patient.Clear terminology would facilitate communication between colleagues. This would result in more precise assessments of changes in mental states. Trainees would also welcome a reduction of terms as well as more clear definitions of the preferred terms used to describe clinical phenomenon. This would be useful if presenting mental states is to be part of the work based assessments. Finally, this might encourage more medical students to enter higher training in psychiatry.

SIMS, A.C.P. (2003) Symptoms in the Mind: An introduction to Descriptive Psychopathology (3rd edn). Edinburgh: Elsevier Science.