| ICD-10 | R47.8 |
|---|---|
| ICD-9 | 784.5 |
Pressure of speech is a tendency to speak rapidly and frenziedly, as if motivated by an urgency not apparent to the listener. The speech produced, sometimes called pressured speech, is difficult to interrupt and may be too fast or too tangential for the listener to understand; it is an example of cluttered speech. It can be unrelating, loud and without pauses. (Videbeck 2010) It is a hallmark of mania and is often seen during manic periods in patients with bipolar disorder. The pace of the speech indicates an underlying thought disorder known as “flight of ideas” where the information going through the person’s head is so fast that it is difficult to follow their train of thought.[1]
People with schizophrenia, as well as anyone experiencing extreme anxiety, 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.[2]
Psychostimulants such as cocaine, dextroamphetamine, Adderall, etc. may cause "pressured speech" in individuals with pre-existing psychopathology and produce hypomanic or manic symptoms in general.
Cluttering is a speech disorder that is related to pressure of speech in that the speech of a clutterer sounds improperly verbalized, but cluttering is a distinct language disorder, whereas pressure of speech is a symptom of mania, anxiety, or schizophrenia. 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.
It may also lead to the development of a stutter. 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. If a stutter is persistent it may become chronic. [3]
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