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Formal thought disorder in people at ultra-high risk of psychosis

Research output: Contribution to journalArticle

Arsime Demjaha, Sara Weinstein, Daniel Stahl, Fern Day, Lucia Valmaggia, Grazia Rutigliano, Andrea De Micheli, Paolo Fusar-Poli, Philip McGuire

Original languageEnglish
Pages (from-to)165-170
Number of pages6
JournalBritish Journal of Psychiatry Open
Issue number4
Early online date14 Jul 2017
StateE-pub ahead of print - 14 Jul 2017


King's Authors


BACKGROUND: Formal thought disorder is a cardinal feature of psychosis. However, the extent to which formal thought disorder is evident in ultra-high-risk individuals and whether it is linked to the progression to psychosis remains unclear.

AIMS: Examine the severity of formal thought disorder in ultra-high-risk participants and its association with future psychosis.

METHOD: The Thought and Language Index (TLI) was used to assess 24 ultra-high-risk participants, 16 people with first-episode psychosis and 13 healthy controls. Ultra-high-risk individuals were followed up for a mean duration of 7 years (s.d.=1.5) to determine the relationship between formal thought disorder at baseline and transition to psychosis.

RESULTS: TLI scores were significantly greater in the ultra-high-risk group compared with the healthy control group (effect size (ES)=1.2), but lower than in people with first-episode psychosis (ES=0.8). Total and negative TLI scores were higher in ultra-high-risk individuals who developed psychosis, but this was not significant. Combining negative TLI scores with attenuated psychotic symptoms and basic symptoms predicted transition to psychosis (P=0.04; ES=1.04).

CONCLUSIONS: TLI is beneficial in evaluating formal thought disorder in ultra-high-risk participants, and complements existing instruments for the evaluation of psychopathology in this group.


COPYRIGHT AND USAGE: © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

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