Logorrhea is a specific speech disorder consisting of uncontrolled incoherent speech production. Senseless, unregulated volitional volubility is combined with an accelerated pace of speech. The symptom is characteristic of sensory alalia, acoustic-gnostic aphasia, schizophrenia, manic disorder, dementia, etc. Diagnosis of logorrhea is carried out by speech therapists, psychiatrists within the framework of the main speech or mental disorder. Depending on the cause of the ambiguity, speech therapy correction or drug treatment can be carried out.
The term “logorrhea” (from the Greek “logos” ‒ the word “and “rhoia” ‒ expiration) means “verbal flow” in translation. Synonyms ‒ polyphasia, verbal salad, verbal okroshka, speech incontinence. Sometimes this concept is used in the meaning of “empty talk”, “chatter” in relation to various kinds of speakers, speakers, advertising agents, behind whose verbosity there is a commercial interest (to sell a service, a product, to give out as much information as possible in a short period of time). In medicine, logorrhea occurs in a number of pathological conditions studied in the framework of speech therapy and clinical psychiatry.
Causes of logorrhea
A patient with a sensory form of aphasia speaks a lot, but unintelligibly. Speech production gives the impression of a meaningless stream of words, unrelated sentences. At the same time, speech has no articulatory difficulties, it is well intoned. This ambiguity is explained by a violation of auditory attention and auditory control. Words lose their constant meaning. The patient does not understand the meaning of the sounding speech: neither his own nor those around him.
Auditory agnosia also underlies sensory alalia. Children have increased speech activity, but their speech is incoherent, consists of a set of interjections, parts of words, sound combinations. Along with logorrhea, numerous echolalia, perseverations, paraphasias, and contamination are observed. The sound-syllabic structure of the word is distorted.
The meaning of the word is unstable, as is its form. Speech is meaningless and incomprehensible to others. Verbal production is complemented by mimic and articulatory movements. There is no criticism of his speech.
Logorrhea occurs not only in speech pathologies, but also in a number of mental disorders. This phenomenon is present in the clinical picture of the following conditions:
- Schizophrenia. This group of patients is characterized by a peculiar speech disorder – schizophasia – conducting a meaningless monologue, often with delusional content. In severe cases, schizophasia can turn into logorrhea. Speech becomes incoherent, consists of an empty set of words and fragments of phrases, abounds in neologisms. Syntactic simplification, violation of grammar, frequent and unreasonable change of the topic of conversation are noted.
- Bipolar affective disorder. Increased verbal activity – logorrhea – is noted in patients with manic psychosis. Typical symptoms: accelerated pace of speech, voice volume, “jumps of thoughts”, confusion and incoherency of presentation. For others, the speech of patients becomes incomprehensible.
- Senile dementia. Logorrhea occurs in the initial phase of senile dementia. The speech of patients is lively, intonated, with expressive gestures and facial expressions. However, due to the depletion of vocabulary, spontaneous speech becomes incoherent, with a large number of stereotypes, verbal paraphasias. The patient quickly loses the outline of the conversation, switches from one topic to another.
- Frontal syndrome. Increased speech production is observed in patients with a disinhibited type of syndrome. The patient cannot control spontaneous speech, gets stuck on the previous fragments of the utterance. Oral speech is replete with cliches, stereotypes, echolalic repetitions
Disinhibition of speech by the type of “speech salad” can be observed as a transient phenomenon in some mentally healthy people. So, a kind of logorrhea is noted in people who have been isolated for a long time (living away from other people, prisoners staying in solitary confinement, etc.). When an interlocutor appears, such people begin to speak quickly, confusingly, switching from one thought to another, I lose the logic of the narrative.
Nonsense in speech occurs in people who are intoxicated. A drunk person can talk for a long time “about nothing”, often repeating himself, contradicting himself, inadequately reacting to the words of others.
Logorrhea is detected as part of the diagnosis of the underlying neurological or psychiatric syndrome. Taking into account the disease, the patient may need to consult a neurologist, psychiatrist, speech therapist, neuropsychologist. Assigned diagnostic methods:
- Clinical and anamnestic examination. It is carried out by specialist doctors as part of the initial admission. Complaints and causes of the disease are being investigated, and an analysis of symptoms is being carried out. The mental status of the patient is assessed. Based on the data obtained, the leading syndrome is distinguished.
- Instrumental diagnostics. It is necessary for organic brain lesions, as well as for the purpose of differential diagnosis of neurological and mental disorders. Brain MRI, EEG, and echoencephalography are prescribed.
- Speech therapy examination. It is required for patients with logorrhea caused by alalia, aphasia. The speech status is assessed: impressive and expressive speech, phonemic processes, the state of written speech, accounts. In aphasia, it is important to study automated and de-automated speech, understanding lexical and grammatical constructions.
- Neuropsychological testing. Various types of gnosis (auditory, visual, somato-sensory), praxis (oral, finger, constructive, symbolic) are being studied. With the help of observation, special samples, scales and questionnaires, the peculiarities of behavior, thinking, attention, and cognitive functions of the patient are studied.
There is no special treatment for logorrhea. Speech and other pathological symptoms decrease or disappear with the treatment of a causal disease. In some cases, pharmacotherapy is necessary, in others ‒ speech therapy and neuropsychological correction.
Correction of sensory alalia
The goal of speech therapy in logorrhea is the development of auditory perception and understanding of reversed speech. At the same time, it is important to use all safe analyzers. With sensory alalia , the following areas of corrective action are implemented:
- distinguishing non-speech sounds: the noise of water, the rustle of paper, the ringing of metal, the sound of toys and musical instruments;
- distinguishing and differentiating speech sounds;
- formation of the connection of the sound image of a word with a specific object or phenomenon;
- developing an understanding of verbal instructions;
- development of auditory control over one’s own speech;
Classes with a neuropsychologist are shown. In their work, specialists use sensory integration methods: sand therapy, aromatherapy, modeling of plasticine and clay, tactile toys, classes in the sensory room, etc. Fitball gymnastics, vibration massage are useful.
Correction of acoustic-gnostic aphasia
Speech rehabilitation of patients with sensory aphasia is carried out against the background of pharmacotherapy (nootropics, neurometabolites). Clinical psychologists, physical therapy instructors deal with patients. Logotherapy is aimed at:
- inhibition of unproductive speech – logorrhea;
- activation of auditory attention and control;
- restoration of the semantic meaning of the word;
- differentiated perception of speech sounds based on articulation, graphic symbols.
As the understanding of the converted and their own speech improves, uncontrolled speech activity decreases in patients, logorrhea is overcome.
Treatment of mental disorders
The goal of therapy is to stabilize or slow down the progression of the pathological process. The main method is lifelong drug therapy. Acetylcholinesterase inhibitors and NMDA antagonists are prescribed for various forms of dementia, and normotimic agents are prescribed for BAD.
The basis of the treatment of schizophrenia is antipsychotic drugs. During the period of remission, social rehabilitation activities are connected: cognitive trainings, social skills trainings, counseling of family members, etc.