A patient speaks rapidly, making it difficult to listen, and may not stop at appropriate points. This is known as?

Appeared in: NIMHANS Nursing Officer - 2021

Explanation

The term for speech that is rapid, excessive, and difficult to interrupt is 'Pressure of speech'.
This symptom is characteristic of mania or hypomania, where the individual feels an internal drive to speak continuously.
The key features described in the question—speaking rapidly and not stopping at appropriate points—are the defining characteristics of pressured speech.
Unlike normal rapid speech, pressured speech is often loud and feels urgent and forceful to the listener.

Why Other Options Were Wrong

Option A: 'Pressure of words' is not a standard or recognized clinical term in psychiatry.
Option B: 'Pressure of vocal code' is not a recognized medical or psychiatric term.
Option C: 'Pressure of tone' is incorrect. Tone refers to the emotional quality, pitch, and intonation of the voice, not the rate or flow of speech.

Related Visual

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Identification of pressured speech as a psychiatric symptom in acute care settings.
Recognizing pressured speech is a critical nursing assessment skill, as it is a key indicator of a manic or hypomanic episode in bipolar disorder, requiring immediate intervention.
Nursing care for a patient with pressured speech includes ensuring patient safety, reducing environmental stimuli, speaking in a calm and concise manner, and monitoring for exhaustion, dehydration, and poor nutrition.
It is vital to document the presence of pressured speech, including its rate, volume, and interruptibility, as this provides an objective measure of the patient's mental state and response to treatment.

How to Approach the Question

First, analyze the keywords in the question stem: 'speaks rapidly,' 'difficult to listen,' and 'not stop at appropriate points.'
These descriptors point to a specific type of speech pattern characterized by increased speed and flow.
Next, evaluate the options provided. This is a recall-based question requiring knowledge of standard psychiatric terminology.
Eliminate options that are not recognized clinical terms, such as 'pressure of vocal code' and 'pressure of tone.'
Differentiate between 'pressure of words' and 'pressure of speech.' Recognize that 'pressure of speech' is the formally accepted term in psychiatry.
Select the option that accurately and professionally names the symptom described.

Concept Tested & Keywords

Concept Tested: Identification of pressured speech as a psychiatric symptom.
Stem keywords: speaks rapidly, difficult to listen, not stop at appropriate points
Lead-in keywords: known as
Negative lead-in flag: false

Question ID

Q5nwFIICNUZVxhS4t6xkH8

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 3794-3796, 3246-3248, 3852-3854

Practise the full NIMHANS Nursing Officer - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.

Attempt this paper Attempt in the NPrep app