MEDizzy - You assess a 26-year-old woman with a diagnosis of bipolar

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Psychopathology

You assess a 26-year-old woman with a diagnosis of bipolar disorder in the emergency department. She is speaking very quickly and is difficult to interrupt. She scarcely finishes a sentence before starting another. She speaks about a range of topics, but her words make sense and the topics are clearly linked to one another. What sign is she exhibiting?

ExplanationThis woman is exhibiting pressure of speech, a common feature of manic or hypomanic episodes. It is often accompanied by flight of ideas, which is an acceleration in the flow of thinking with little focus on the ‘goal’ of thinking, although with maintenance of logical connections between thoughts. See Oyebode (2008).