Formal thought disorder is characterised by impaired lexical access

Recent studies have proposed that difficulty with accessing the lexical–semantic memory store may underpin some of the specific linguistic problems associated with formal thought disorder (FTD). We examined the consistency of name retrieval as an indicator of the ability to access lexical–semantic knowledge in patients with and without marked FTD to see if problems are specific to the former or common to schizophrenic patients in general. A graded naming test was administered on two separate occasions 8–16 weeks apart to 48 participants in three groups: 16 schizophrenic patients with high ratings of FTD, 16 schizophrenic patients with low ratings of FTD and 16 healthy controls. We compared the groups for naming consistency across time and the relationship between naming consistency and specific symptoms of FTD. Both patient groups had impaired naming and this was significantly greater in high than low FTD patients. The high FTD patients showed a profile that differed from both low FTD patients and healthy controls insofar as their naming was inconsistent across time, characteristic of an access disorder. Specifically, the FTD symptoms of derailment, tangentality and incoherence were related to the ability to access the lexical– semantic store. In conclusion, most patients with schizophrenia show an impaired semantic memory store. Nevertheless, FTD is associated with additional lexical–semantic difficulties that are quantitatively different to those seen in patients without FTD, and which may reflect disorganized semantic access.