Racing and crowded thoughts in mood disorders: A data-oriented theoretical reappraisal

Area of Science:

• Psychiatry
• Cognitive Neuroscience

Background:

• Speed of thought, specifically racing and crowded thoughts, is a key feature of mood disorders.
• A previous review in 2013 discussed these phenomena.

Purpose of the Study:

• To update the understanding of racing and crowded thoughts in mood disorders based on the last decade of research.
• To explore the complexity beyond a simple dichotomous view.

Main Methods:

• A narrative review of publications from the past ten years.
• Inclusion of recent research from the authors' group.
• Systematic literature search on PubMed.

Main Results:

• The traditional racing vs. crowded thoughts dichotomy is more complex than previously thought.
• Racing/crowded thoughts are strongly associated with mixed depression and hypomania (particularly with irritability), not non-mixed depression.
• These thought patterns are distinct from rumination and associated with anxiety, ADHD, and insomnia.

Conclusions:

• Racing and crowded thoughts represent a significant aspect of mental activity in mood disorders.
• A dimensional approach is recommended for studying these thought patterns.
• Their relevance extends beyond mood disorders to other conditions.