In my view, these factors can be: the emotional meaning of the theme for the patient, anxious sympyoms caused by the situation or the interviewer, a relatedness feeling with the interviewer, a feeling of intimacy or friendship with the interviewer or a sense of safety from a risky emotional contact during the interview. I would like to know more about these factors and maybe also about their relation with the ( variable) insight of the patient.
What do you mean by "psychotic features of the speech" ?
Please describe more. Question looks interesting.
Psychotic features of the speech concerns the presentation in the speech both or formal anomalies of thougth ( circumstantiality, tangentiality, incoerency ) both content anomalies of thougth ( delusional themes ). These features make up the " Psychiatric State " in the interview but, actually, I find them variables.
Yes I do agree, these do look like varying depending on the interviewer's behavior and style of questioning. I have dealt with few "thought disordered" patients who generally don't make any sense if direct questions are asked. But they do give "correct" answers and explanations if questions are twisted. For example, if you will ask "Where do you live?". They may come up with a delusional answer, like, "I live on planet Mars." But if you will ask the same question in indirect ways (say, this person lives in London) like, "Do you live in New York (or Berlin or Moscow etc.)?" In such cases, they will come up with accurate or near accurate answers. So this negating answers (in response to confusing questions) would actually be correct even if affirmative answers are incorrect.
Thought disorder can largely be considered a communication disorder because the person doesn't process information through obvious routes. During questioning, it needs to be seen whether the person lacks information or just doesn't communicate it properly. If compelled to think, the person can reach a definitive answer which in most cases would be a correct response. But this doesn't imply that the person doesn't have the ability to think logically or concretely. Logic is intricate part of human thinking and can be observed even in most disordered patients possible. It's the social communicative process that gets impacted the most.
We need to see schizophrenic people differently. Despite large progresses in science, we still carry stereotypes in daily professional practice. These people do carry deficits in thinking and speech, but still carry scope of improvement if approached in open-minded manner.
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