Pressure of speech or pressured speech is a tendency to
speak rapidly and frenziedly. Pressured speech is motivated by an urgency that may not be apparent to the listener. The speech produced is difficult to interpret.
Such speech may be too fast, erratic, irrelevant, or too tangential for the listener to understand. It is an example of
cluttered speech
Cluttering is a speech and communication disorder characterized by a rapid rate of speech, erratic rhythm, and poor syntax or grammar, making speech difficult to understand.
Classification
Cluttering is a speech and communication disorder that ...
, and is often associated with certain mental disorders, particularly
mania
Mania, also known as manic syndrome, is a mental and behavioral disorder defined as a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together wi ...
and
schizophrenia
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social w ...
. It can be unrelenting, loud, and without pauses.
Description
Pressured speech is unrelenting, rapid, often loud talking without pauses. Those with pressured speech do not respond to verbal and nonverbal cues indicating that others wish to speak, turning from one listener to another or speaking even when no listeners remain. They are unable to listen to others, either talking nonstop until they run out of steam, or just standing there and looking at the other speaker before moving away. The speech can be either intelligible or unintelligible, and it is a hallmark symptom of a manic episode.
Causes
The pace of the speech indicates an underlying
thought disorder
A thought disorder (TD) is any disturbance in cognition that adversely affects language and thought content, and thereby communication. A variety of thought disorders were said to be characteristic of people with schizophrenia. A content-though ...
known as "
flight of ideas" wherein the flow of ideas and information through one's mind is so fast that it is difficult to follow their train of thought. This is also tied to an inability to focus on one topic or task.
People with
schizophrenia
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social w ...
, as well as anyone experiencing extreme
anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
, may also exhibit pressure of speech. Pressure of speech usually refers to the improperly verbalized speech which is a feature of
hypomanic and manic illness.
Pressure of speech has commonly been observed in people diagnosed with
attention deficit hyperactivity disorder
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inap ...
.
Stimulants
Psychostimulants such as
cocaine
Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Am ...
or
amphetamines
Substituted amphetamines are a class of compounds based upon the amphetamine structure; it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with sub ...
may cause speech resembling pressured speech in individuals with pre-existing psychopathology and produce hypomanic or manic symptoms in general, owing both to the substance's own qualities and the underlying nature of an individual's psyche. In many psychotic disorders, use of certain drugs amplifies certain expressions of symptoms, and stimulant-induced pressured speech is among them.
Related conditions
*
Cluttering
Cluttering is a speech and communication disorder characterized by a rapid rate of speech, erratic rhythm, and poor syntax or grammar, making speech difficult to understand.
Classification
Cluttering is a speech and communication disorder t ...
is a speech disorder that is related to pressure of speech in that the speech of a clutterer sounds improperly verbalized. However, cluttering is a distinct
language disorder. Even though cluttering sounds almost identical to pressure of speech, it differs in that pressure of speech is rooted in
anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
, where cluttering is not.
* Pressure of speech is an instance of
tachylalia Tachylalia or tachylogia is extremely rapid speech. Tachylalia by itself is not considered a speech disorder. Tachylalia occurs in many clutterers and many people who have speech disorders.
Tachylalia is a generic term for speaking fast, and does ...
, or rapid speech. Pressure of speech is also variously related to
agitolalia,
agitophasia,
tachyphasia, and
verbomania.
*
Circumstantial speech Circumstantial speech, also referred to as circumstantiality, is the result of a so-called "non-linear thought pattern" and occurs when the focus of a conversation drifts, but often comes back to the point.''Problem-Based Psychiatry'' by Ben Green 2 ...
is a
communication disorder
A communication disorder is any disorder that affects an individual's ability to comprehend, detect, or apply language and speech to engage in dialogue effectively with others. The delays and disorders can range from simple sound substitution to t ...
in which the focus of a conversation drifts.
[''Problem-Based Psychiatry'' by Ben Green 2009 page 15] In circumstantiality, unnecessary details and irrelevant remarks cause a delay in getting to the point.
Stutter formation
Pressured speech may also lead to the development of a
stutter
Stuttering, also known as stammering, is a speech disorder in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words, or phrases as well as involuntary silent pauses or blocks in which the ...
. The person's need or pressure to speak causes them to involuntarily stutter. Therefore, the person's need to express themselves is greater than their ability to vocalise their thoughts.
See also
*
Aphasia
Aphasia is an inability to comprehend or formulate language because of damage to specific brain regions. The major causes are stroke and head trauma; prevalence is hard to determine but aphasia due to stroke is estimated to be 0.1–0.4% in ...
*
Auditory processing disorder
*
Logorrhea
References
External links
{{Medical resources
, ICD10 = R47.8
, ICD9 = {{ICD9, 784.5
Bipolar disorder
Communication disorders
Symptoms and signs: Speech and voice