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Electronic Letters to:

REVIEW ARTICLES: SIMON MULLINS and SEAN A. SPENCE Re-examining thought insertion: Semi-structured literature review and conceptual analysis The British Journal of Psychiatry 2003; 182: 293-298 [Abstract] [Full text] [PDF]

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Electronic letters published:

Thought insertion ? - The Symptom of Schizophrenia

SUJA KURIAN   (25 June 2003)

Thought insertion ? - The Symptom of Schizophrenia 25 June 2003
SUJA KURIAN, doctor Dept.of Psychiatry,CMC,Vellore,India Send letter to journal: Re: Thought insertion ? - The Symptom of Schizophrenia kuriansuja{at}hotmail.com SUJA KURIAN	Thought insertion? - The Symptom of Schizophrenia Sir, Mullins & Spence (2003) in their review on thought insertion have brought out the narrow and broad definitions of the phenomena very clearly. This was an interesting article and I wish to make few comments. While considering the cultural beliefs about thought insertion, the effect of black magic seems to be one of the commonly held beliefs in countries like India. Sathyaseelan et al. (2001) had looked at patient perspectives on mental illness and had shown that patients hold beliefs about black magic and evil spirits as the cause of their illness. Similar beliefs have also been reported in less severe illnesses like dissociative disorders (Hillard & Rockwell, 1978). The author also mentions about the centrality of first rank symptoms to the diagnosis of schizophrenia in standard diagnostic manuals like ICD- 10. However ICD- 10 has clubbed thought insertion along with other thought phenomena and thought echo in the first group of symptoms in the diagnostic criteria for schizophrenia (WHO, 1992). The phenomena of thought insertion is given an equal status along with the other two thought phenomena and thought echo. The inter rater reliability of first rank symptoms is widely accepted, however, thought insertion per se does not occupy a higher position among them. We also find in our clinical practice that out of three thought phenomena in first rank symptoms, thought insertion is less frequent compared to thought broadcast and thought withdrawal. This is also in keeping with the findings of the Study of Factors Associated with the Course and Outcome of Schizophrenia (ICMR 1988). Hillard, J.R., Rockwell, W.J. (1978) Dysesthesia, Witchcraft and Conversion Reaction. A case successfully treated with Psychotherapy. JAMA, 240 (16): 1742-1744. Indian Council of Medical Research Final Report (1988) Report on Multi centered collaborative Study of Factors Associated with Course and Outcome of Schizophrenia. Vellore: ICMR. Mullins, S., Spence, S. A. (2003) Re-examining thought insertion. Semi-structured literature review and conceptual analysis. British Journal of Psychiatry, 182:293-298. Sathyaseelan, M., Seema, P., Maret J., et al (2001) Patient perspectives on Psychosis. Indian Journal of Psychiatry, 43 (S): 72. World Health Organization (1992) The ICD-10 Classification of Mental and Behavioural Disorders: Clinical description and Diagnostic guidelines. Geneva: WHO.