Logorrhea (psychology)

In psychology, logorrhea or logorrhoea (from Ancient Greek λόγος logos "word" and ῥέω rheo "to flow") is a communication disorder that causes excessive wordiness and repetitiveness, which can sometimes lead to incoherency. This disorder is also known as press speech. Logorrhea is sometimes classified as a mental illness, though it is more commonly classified as a symptom of mental illness or brain injury. This ailment is often reported as a symptom of Wernicke's aphasia, where damage to the language processing center of the brain has made it difficult for the patient to self-monitor their speech.

Characteristics

Logorrhea is characterized by the constant need to talk.[1] Occasionally, patients suffering from logorrhea may produce speech with normal prosody and a slightly fast speech rate. [2]Other related symptoms include the use of neologisms (new words without clear derivation, i.e. hipidomateous for hippopotamus), words that bear no apparent meaning, and, in some extreme cases, the creation of new words and morphosyntactic constructions.[3] From the "stream of unchecked nonsense often under pressure and the lack of self-correction” that the patient may exhibit, and their circumlocution (the ability to talk around missing words) we may conclude that they are unaware of the grammatical errors they are making[4].

Examples of Logorrhea

When a clinician asks says, "tell me what to do with a comb", to a patient who is suffering from Wernicke’s aphasia which produces the symptom of logorrhea, the patient may respond:

“What do I do with a comb … what I do with a comb. Well a comb is a utensil or some such thing that can be used for arranging and rearranging the hair on the head both by men and by women. One could also make music with it by putting a piece of paper behind and blowing through it. Sometimes it could be used in art – in sculpture, for example, to make a series of lines in soft clay. It's usually made of plastic and usually black, although it comes in other colors. It is carried in the pocket or until it's needed, when it is taken out and used, then put back in the pocket. Is that what you had in mind?”[5]

In this case the patient maintains proper grammar and does not exhibit any signs of neologisms. However, the patient does use an overabundance of speech in responding to the clinician, as most people would simply respond, “I use a comb to brush my hair.”

In a more extreme version of logorrhea aphasia, a clinician asks the patient what brought them to the hospital. The patient responds:

“Is this some of the work that we work as we did before? … All right … From when wine [why] I'm here. What’s wrong with me because I … was myself until the taenz took something about the time between me and my regular time in that time and they took the time in that time here and that’s when the the time took around here and saw me around in it’s started with me no time and I bekan [began] work of nothing else that's the way the doctor find me that way…” [6]

In this example, the patient's aphasia is much more severe. Not only is this a case of logorrhea, but this includes neologisms and a loss of proper sentence structure.

Causes

Logorrhea has been shown to be associated with traumatic brain injuries in the frontal lobe[7] as well as with lesions in the thalamus[8][9] and the ascending reticular inhibitory system[10] and has been associated with aphasia.[11] Strokes have also been known to cause logorrhea in patients[12]. Logorrhea can also result from a variety of psychiatric and neurological disorders[10] including tachypsychia,[13] mania,[14] hyperactivity,[15] catatonia,[16] and schizophrenia.[17]

Aphasias

Wernicke's Aphasia, amongst other aphasias, are often associated with logorrhea. Aphasia refers to the neurological disruption of language that occurs as a consequence of brain disfunction. For a patient to truly have an aphasia, they cannot have been diagnosed with any other medical condition that may affect their cognition[12]. Logorrhea is a common symptom of Wernicke's Aphasia, along with circumlocution, paraphasias, and neologisms. Often a patient with aphasia may present all of these symptoms at one time.

Treatment

Excessive talking may be a symptom of an underlying illness and should be addressed by a medical provider if combined with hyperactivity or symptoms of mental illness, such as hallucinations.[18] Treatment of logorrhea depends on its underlying disorder, if any. Antipsychotics are often used, and lithium is a common supplement given to manic patients.[19] For patients with lesions of the brain, attempting to correct their errors may upset and anger the patients, since the language center of their brain may not be able to process that what they are saying is incorrect and wordy. Speech therapy has been shown to improve press speech for patients with lesions to the brain.[12] The success of therapy depends on the knowledge of the clinical picture, localization of brain damage, etiology, and the remaining speech and cognitive abilities. [12] .

See also

References
  1. "Logorrhea". CCM Health. Archived from the original on 2018-04-10. Retrieved 9 April 2018.
  2. Hallowell, Brooke (2008). "Introduction to language intervention strategies in adult aphasia". Language Intervention Strategies in Aphasia and related neurogenic communication disorders. 5: 3–19.
  3. Nagels, Arne; Kircher, Tilo. "Symptoms and Neurobiological Models of Language in Schizophrenia". Science Direct. Archived from the original on 2018-05-09. Retrieved 9 April 2018.
  4. Prigatano, George (2010). The Study of Anosognosia. New York: Oxford University Press.
  5. Brookshire, R (2003). "Introduction to neurogenic communication disorders". Introduction to neurogenic communication disorders: 155.
  6. Obler, Loraine (1999). Language and the Brain. Cambridge: Cambridge University Press. ISBN 0-521-46641-5.
  7. "Logorrhea Definition and Examples after Brain Injury". Brain Injury Help. Archived from the original on 2018-04-10. Retrieved 9 April 2018.
  8. Bogousslavsky J, Ferrazzini M, Regli F, Assal G, Tanabe H, Delaloye-Bischof A (January 1988). "Manic delirium and frontal-like syndrome with paramedian infarction of the right thalamus". J. Neurol. Neurosurg. Psychiatry. 51 (1): 116–9. doi:10.1136/jnnp.51.1.116. PMC 1032723. PMID 3258356.
  9. Trillet M, Vighetto A, Croisile B, Charles N, Aimard G (1995). "[Hemiballismus with logorrhea and thymo-affective disinhibition caused by hematoma of the left subthalamic nucleus]". Rev. Neurol. (Paris) (in French). 151 (6–7): 416–9. PMID 7481408.
  10. Arseni, C.; Dănăilă, L. (1977). "Logorrhea Syndrome with Hyperkinesia". European Neurology. 15 (4): 183–7. doi:10.1159/000114831. PMID 872837.
  11. Paquier PF, Van Dongen HR (June 1996). "Review of research on the clinical presentation of acquired childhood aphasia". Acta Neurol. Scand. 93 (6): 428–36. doi:10.1111/j.1600-0404.1996.tb00022.x. PMID 8836305.
  12. Klebic, Jasmina (2011). "Aphasia Disorders Outcome After Stroke". MED ARH. 65: 283–286.
  13. "Logorrhea". CCM Health. Archived from the original on 2018-04-10. Retrieved 9 April 2018.
  14. "Clinical Management of Bipolar Disorder". Archived from the original on 2017-09-19. Retrieved 9 April 2018.
  15. Caplan, Louis R. (2010). "Delirium: A Neurologist's View—The Neurology of Agitation andOveractivity". Disease State Review. 7. Archived (PDF) from the original on 2018-04-10.
  16. Ungvari, Gabor S.; White, White; Pang, Alfred H. T. (December 1995). "Psychopathology of catatonic speech disorders and the dilemma of catatonia: a selective review". The Australian and New Zealand Journal of Psychiatry. 29 (4): 653–660. doi:10.3109/00048679509064981. PMID 8825829.
  17. Nagels, Arne; Kircher, Tilo (2016). "Symptoms and Neurobiological Models of Language in Schizophrenia". Science Direct. Archived from the original on 2018-05-09. Retrieved 9 April 2018.
  18. "Excessive Talking Symptoms, Causes & Treatment Options". Buoy Health. Archived from the original on 2018-04-10. Retrieved 9 April 2018.
  19. "Logorrhea". CCM Health. Archived from the original on 2018-04-10. Retrieved 9 April 2018.
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