Tangentiality

Tangentiality as a medical symptom is a physical symptom observed in speech that tends to occur in situations where a person is experiencing high anxiety, as a manifestation of the psychosis known as schizophrenia, in dementia or in states of delirium.

The term refers simplistically to a thought disorder shown from speech with a lack of observance to the main subject of discourse, such that a person whilst speaking on a topic deviates from the topic. Further definition is of speech that deviates from an answer to a question that is relevant in the first instance but deviates from the relevancy to related subjects not involved in a direct answering of the question. In the context of a conversation or discussion the communication is a response that is ineffective in that the form is inappropriate for adequate understanding. The person's speech seems to indicate that their attention to their own speech has perhaps in some way been overcome during the occurrence of cognition whilst speaking, causing the vocalized content to follow thought that is apparently without reference to the original idea or question; or the person's speech is considered evasive in that the person has decided to provide an answer to a question that is an avoidance of a direct answer.

Earlier phenomonological description (Schneider 1930;et al.) allowed for further definition on the basis of formal characteristic rather than content, producing later practice relying upon clinical assessment (Andreasen 1979). The term has undergone a re-definition to refer only to a persons speech in response to a question, and to provide the definition separation from the similar symptoms loosening of association and derailment (Andreasen 1979).

According to the St. Louis system for the diagnosis of schizophrenia, tangentiality is significantly associated with a low IQ prior to diagnosis (AU Parnas et al 2007).

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