Bifid tongue

Page most recently updated 7 September 2026

This page focuses on bifid tongue as a morphologic feature of conditions that may also be associated with psychiatric manifestations, such as psychosis, mania, autism spectrum disorder, ADHD, OCD, and self-injurious behaviours. The page begins with a clinical definition of bifid tongue based on the standardized Elements of Morphology terminology, together with visual examples from the same source. This is followed by a list of conditions in which bifid tongue has been described in association with psychiatric manifestations.

Of note, to optimize clinical utility, the list does not include conditions associated with intellectual disability in the absence of other psychiatric features.

Each condition listed below is linked to a dedicated page within this resource. These pages describe the psychiatric manifestations associated with each condition, as well as other morphologic and broader clinical features, allowing the differential diagnosis to be considered from multiple perspectives.

Bifid tongue

Image credit: National Human Genome Research Institute (NHGRI), Elements of Morphology.

Definition

Objective: Tongue with a median apical indentation or fork.

Note: Bifid tongue can be associated with ankyloglossia, but this should be considered separately. Small indentations of the tip of the tongue should not be described as bifid tongue.

Conditions with potential psychiatric associations

Selected references and further reading — Morphologic lens

Allanson JE, Biesecker LG, Carey JC, Hennekam RCM. Elements of morphology: introduction. Am J Med Genet A. 2009;149A(1):2-5.

Hennekam RCM, Biesecker LG, Allanson JE, Hall JG, Opitz JM, Temple IK, Carey JC; Elements of Morphology Consortium. Elements of morphology: general terms for congenital anomalies. Am J Med Genet A. 2013;161A(11):2726-2733.

Jones KL, Jones MC, del Campo M. Smith's recognizable patterns of human malformation. 8th ed. Philadelphia: Elsevier; 2021.

Reardon W. The bedside dysmorphologist: a guide to identifying and assessing congenital malformations. 2nd ed. Oxford: Oxford University Press; 2016.