Pressure of speech

Specialty| Psychiatry, clinical psychology

Pressure of speech (or pressured speech) is a speech fast and frenetic (i.e. mainly without pauses), including some irregularities in loudness and rhythm or some degrees of circumstantiality; it is hard to interpret and expresses a (generally non-apparent) feeling/affect of emergency.[1][2] It is mainly a neuropsychological symptom of specific mental disorders, like bipolar disorders, thought disorders, stress-related disorders, etc. - see below.

## Contents

* 1 Description
* 2 Causes
* 2.1 Mental disorders' symptoms
* 2.2 Stimulants
* 3 Effects
* 4 Related conditions
* 5 See also
* 6 References
* 7 External links

## 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.

## Causes

### Mental disorders' symptoms

Pressure of speech mainly happens in the bipolar disorders, during the hypomanic and manic episodes.[3][1] It also happens because of acute or chronic over-stress in post-traumatic stress disorder and complex post-traumatic stress disorder.[4][5] Thought disorders' symptoms like flight of ideas can induce pressured speech, with some degrees of circumstantiality or tangential speech.[6] It is also a direct or indirect symptom of anxiety disorders,[7] attention deficit hyperactivity disorder,[8] autism spectrum disorders,[9] and schizophrenia.[10]

### Stimulants

Psychostimulants such as cocaine or amphetamines 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.

## Effects

Pressured speech may lead to stuttering, e.g. whenever the persons want expressing themselves faster than their ability to utter their thoughts.[11]

## Related conditions

* Cluttering 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, where cluttering is not.
* Pressure of speech is an instance of tachylalia, or rapid speech. Pressure of speech is also variously related to agitolalia, agitophasia, tachyphasia, and verbomania.
* Circumstantial speech is a communication disorder in which the focus of a conversation drifts.[12] In circumstantiality, unnecessary details and irrelevant remarks cause a delay in getting to the point.[13]

## See also

* Aphasia
* Auditory processing disorder
* Logorrhea

## References

1. ↑ 1.0 1.1 Videbeck, Sheila (2010). Psychiatric-Mental Health Nursing (5th ed.). Lippincott Williams and Wilkins. pp. 186, 303, 305. ISBN 978-1605478616.
2. ↑ World Health Organization (2023). "MB23 Pressured speech". International Classification of Diseases, eleventh revision – ICD-11. Genova – icd.who.int.
3. ↑ "Pressure of speech". https://gpnotebook.com/simplepage.cfm?ID=-483065844.
4. ↑ Keane, Terence M. (Summer 2013). "Patient management exercise: post-traumatic stress disorder". Clinical Synthesis 11 (3): 352–357. doi:10.1176/appi.focus.11.3.352.
5. ↑ O'Connor, Manjula (2020). "Adjunctive therapy with brexpiprazole improves treatment resistant complex post traumatic stress disorder in domestic family violence victims". Australasian Psychiatry 28 (3): 264–266. doi:10.1177/1039856219889303. PMID 31896271.
6. ↑ Stevens, Lesley; Rodin, Ian (23 April 2001). Psychiatry: an illustrated colour text. Elsevier Health Sciences. pp. 24–. ISBN 978-0-443-05703-8. https://books.google.com/books?id=RMoisJndtvoC&pg=PA24. Retrieved 25 November 2010.
7. ↑ Banazak, Deborah A. (1997). "Anxiety disorders in elderly patients". The Journal of the American Board of Family Practice 10 (4): 280–289. PMID 9228623. https://www.jabfm.org/content/jabfp/10/4/280.full.pdf.
8. ↑ Baroni, Argelinda; Lunsford, Jessica R.; Luckenbaugh, David A.; Towbin, Kenneth E.; Leibenluft, Ellen (March 2009). "Practitioner Review: The assessment of bipolar disorder in children and adolescents". Journal of Child Psychology and Psychiatry 50 (3): 203–215. doi:10.1111/j.1469-7610.2008.01953.x. PMID 19309325.
9. ↑ Kroncke, Anna P.; Willard, Marcy; Huckabee, Helena (February 2016). "Emotions, mood, behavior, and adaptive assessment". Assessment of autism spectrum disorder. Springer. ISBN 978-3-319-25504-0.
10. ↑ Sakakibara, Eisuke; Nishida, Takuji; Sugishita, Kazuyuki; Jinde, Seiichiro; Inoue, Yushi; Kasai, Kiyoto (July 2012). "Acute psychosis during the postictal period in a patient with idiopathic generalized epilepsy: Postictal psychosis or aggravation of schizophrenia? A case report and review of the literature". Epilepsy & Behavior 24 (3): 373–376. doi:10.1016/j.yebeh.2012.04.127. PMID 22652424.
11. ↑ Perkins, William H. (1 January 1993). "What Is Stuttering and Why?". in Boberg, Einer. Neuropsychology of stuttering. University of Alberta. p. 226. ISBN 978-0-88864-239-4. https://books.google.com/books?id=HjB9cGkloPgC&pg=PA226. Retrieved 13 December 2010.
12. ↑ Green, Ben (2009). Problem-Based Psychiatry. Abingdon: Radcliffe. p. 15. ISBN 978-1-84619-042-1. https://books.google.com/books?id=Wu81Mnpc2AYC&pg=PA15.
13. ↑ "Circumstantiality". Dorland's Medical Dictionary Online. https://www.dorlandsonline.com/dorland/definition?id=9922.

## External links

Classification|

* ICD-10: R47.8
* ICD-9-CM: 784.5

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