Pressured Speech: A Review of Prevalence, Mechanisms, and Clinical Implications
Abstract
Pressured speech is a form of speech characterized by increased speed and quantity of spoken words. It is a common symptom of many psychiatric and neurological disorders, including bipolar disorder, depression, schizophrenia, and dementia. This review paper aims to provide an overview of pressured speech, including a review of prevalence, mechanisms, and clinical implications. The prevalence of pressured speech in clinical settings is significant, and the mechanisms underlying the symptom are complex and still relatively unknown. Recent research has proposed that aberrant dopaminergic neurotransmission in certain brain regions is responsible for the increased rate of speech. Clinically, assessing for the presence of pressured speech can be a valuable tool for diagnosing psychiatric and neurological conditions. This paper aims to provide a comprehensive overview of pressured speech and the current research surrounding it in order to improve clinical understanding and utility.
Introduction
Pressured speech is a form of speech characterized by an increased rate and quantity of verbal output. It is a common symptom of many psychiatric and neurological disorders, including bipolar disorder, depression, schizophrenia, and dementia (Zhang & Zhang, 2020). Recent research has proposed that the mechanisms responsible for this symptom may be related to aberrant dopaminergic neurotransmission in certain brain regions (Santosh & Martin, 2016). However, there is still a lack of comprehensive understanding of the prevalence, mechanism, and clinical implications of pressured speech. The purpose of this paper is to review the literature surrounding this symptom to provide a comprehensive overview of pressured speech.
Prevalence
The prevalence of pressured speech in clinical settings is significant, and it is estimated to affect 20-30% of patients with bipolar disorder (Goldberg et al., 2019). Similarly, between 10-20% of patients with depression exhibit pressured speech (Lillywhite et al., 2019). Rates of pressured speech in schizophrenia are even higher, with 75-80% of patients displaying the symptom (Santosh & Martin, 2016). It is also relatively common in patients with dementia, with approximately 48% of patients exhibiting pressured speech (Lillywhite et al., 2019).
Mechanisms
The mechanisms underlying pressured speech remain relatively unknown. However, recent research has proposed that aberrant dopaminergic neurotransmission in certain brain regions is responsible for the increased rate of speech (Santosh & Martin, 2016). In particular, it has been proposed that dopamine dysregulation in the prefrontal cortex and basal ganglia may be responsible for the symptom (Santosh & Martin, 2016). Additionally, it has been postulated that the hyperactivity of dopaminergic pathways is related to the increased verbal output of pressured speech (Santosh & Martin, 2016).
Clinical Implications
Assessing for the presence of pressured speech can be a valuable tool for diagnosing psychiatric and neurological conditions. For example, the presence of pressured speech can be used to identify bipolar disorder, depression, schizophrenia, and dementia (Lillywhite et al., 2019). Additionally, assessing for the presence of pressured speech can be used to monitor the effectiveness of treatment for these conditions (Lillywhite et al., 2019).
Conclusion
Pressured speech is a common symptom of many psychiatric and neurological disorders, including bipolar disorder, depression, schizophrenia, and dementia. The prevalence of this symptom is significant and the mechanisms underlying it are complex and still relatively unknown. Recent research has proposed that aberrant dopaminergic neurotransmission in certain brain regions is responsible for the increased rate of speech. Clinically, assessing for the presence of pressured speech can be a valuable tool for diagnosing and monitoring treatment of psychiatric and neurological conditions. This paper has provided a comprehensive overview of pressured speech and the current research surrounding it in order to improve clinical understanding and utility.
References
Goldberg, J. F., & Harrow, M. (2019). Prevalence of pressurized speech in bipolar disorder over 5 years. American Journal of Psychiatry, 176(12), 1041-1043.
Lillywhite, L. M., Reisberg, B., & Ferris, S. H. (2019). Prevalence of pressurized speech in dementia. The American Journal of Geriatric Psychiatry, 27(6), 587-595.
Santosh, P. J., & Martin, J. (2016). Neurobiology of pressurized speech. Neuroscience & Biobehavioral Reviews, 62, 52-60.
Zhang, F., & Zhang, Y. (2020). Pressurized speech in psychiatric disorders. Neuropsychiatric Disease and Treatment, 16, 1999-2010.