The cognitive aspect of formal thought disorder and its relationship with global social functioning and the quality of life in schizophrenia



It was expected that using a comprehensive scale like the Thought and Language Disorder Scale (TALD) for measurement of FTD would enable assessing its heterogeneity and its associations with cognitive impairment and functionality. This study has aimed to analyze the relationship between formal thought disorder (FTD) and cognitive functions, functionality, and quality of life in schizophrenia.


This cross-sectional exploratory study included 46 clinical participants meeting the DSM-5 diagnostic criteria for schizophrenia and 35 healthy individuals as the control groups. Data were acquired by means of the Turkish language version of the TALD, the Positive and Negative Syndrome Scale, the Clinical Global Impression Scale, the Functioning Assessment Short Test, the Social Functioning Scale, the World Health Organization Quality of Life Instrument-Short Form, and a neuropsychological test battery on executive functions, working memory, verbal fluency, abstract thinking, and response inhibition. Correlation analyses were conducted to detect significant relationships.


The clinical group scored failures in all cognitive tests. The objective positive FTD was associated with deficits in executive functions and social functioning. The objective negative FTD was associated with poor performance in all cognitive domains, physical quality of life, and social and global functioning. The subjective negative FTD was negatively correlated with psychological quality of life.


This study demonstrated that objective FTD factors reflect different underlying cognitive deficits and correlate with different functioning domains. Significant correlation was determined between subjective negative FTD and psychological quality of life. Given the close relationship of FTD with functioning and quality of life, the FTD-related cognitive deficits should be the key treatment goal in schizophrenia.

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We present our special thanks to all the patients who participated in this study. The preliminary results of this study were accepted as a poster presentation for the 2020 Congress of the Schizophrenia International Research Society. We wish to thank Dr. Burak Bilbay for his contribution to Fig 1. Fig 1 is created by


This research did not receive any specific grant from funding agencies in the public, commercial, or the non-profit organizations.

Author information




All authors contributed to the conception of this study. EM and AEAY designed the study and wrote the protocol. EM, AE, ŞCG, and AEAY managed patient recruitment. EM and HA collected the data. EM and AEAY managed the literature searches. EM and EB undertook the statistical analysis. MKY, AE, HA, and EA helped to interpret the results. MKY, EB, AE, ŞCG, and EA helped drafting the manuscript. EM and AEAY wrote the first draft of the manuscript. All authors contributed to and have approved the final manuscript.

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Correspondence to Emre Mutlu.

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The approval was obtained from Hacettepe University Ethics Commission. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed written consent was obtained from all individual participants before inclusion in the study.

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Mutlu, E., Abaoğlu, H., Barışkın, E. et al. The cognitive aspect of formal thought disorder and its relationship with global social functioning and the quality of life in schizophrenia. Soc Psychiatry Psychiatr Epidemiol (2021).

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  • Formal thought disorder
  • Psychosis
  • Cognitive functions
  • Language processing
  • Social functioning