VIEWS AND REVIEWS Formal Thought Disorder and language

Formal thought disorder (FTD) is a syndrome with sever-al different symptoms, leading to thought, language and com-munication problems1, being a core feature in schizophrenia. Eugen Bleuler, who named schizophrenia, regarded FTD as central for the conceptualization of the disorder2. Today FTD remains as one of the diagnostic criteria for schizophre-nia according to the DSM-IV-TR3. Although FTD is listed as one of the five characteristic symptoms of the disorder, it has not been operationalized in the manual. Since early FTD descriptions, there has been a debate on ascribing the symptom to the field of language or thought. Bleuler used the expression Beziehungslosigkeit (associative loosening), attributing the symptom to thought. In a differ-ent approach, Chaika4 recurred to the expression “speech disorder ” to describe the symptom. She stated that only the language is appreciable, not the thought. Likewise, Andreasen argued that we can analyze only the speech, while thinking remains always somehow inaccessible5. When approaching FTD, Andreasen used the expression thought, language and communication (TLC), pointing to the construct complexity. Ultimately, the basis for FTD analysis is the verbal behavior, the speech of the patient. Empirically, thought and language are not perfectly relat-ed. For instance, people can use language to hide or distort what they really think. Also, aphasic patients find it difficult to express in words what they are able to think. In the last two decades the debate on the nature of FTD led to an increasing interest in the relation betwee