Tangential speech maybe a pattern of speaking in which a person wanders off the topic and never returns to answer the original question. Their thoughts are loosely related to the question but become increasingly irrelevant.
It could be considered a thought process disorder (a disturbance in the organization of thinking) and may be observed during a mental status examination.
Example
Question: “Have you been sleeping well?”
Tangential response: “Sleep is interesting because people dream. Dreams remind me of movies I watched as a child. My favorite actor was Tom Hanks. Movies have changed a lot over the years…”
Notice that the person never answers whether they have been sleeping well.
How it differs from related speech patterns
- Tangential speech: Goes off on related topics and never returns to answer the question.
- Circumstantial speech: Includes excessive, unnecessary detail but eventually comes back to answer the question.
- Flight of ideas: Rapidly shifts from one idea to another with understandable associations, may often seen in mania.
- Loose associations (derailment): Ideas jump from one topic to another with weak or illogical connections, making the conversation difficult to follow.
Possible conditions associated with tangential speech
Tangential speech may occur in several psychiatric and neurological conditions: (Please consult with a Neurologist and/or Psychiatrist), including:
- Schizophrenia and other psychotic disorders
- Mania (as part of bipolar disorder)
- Some neurocognitive disorders (such as dementia): Please consult with a Neurologist.
- Certain brain injuries or neurological conditions: Please consult with a Neurologist.
By itself, tangential speech may not diagnose any specific condition. It must be interpreted in the context of the person’s overall symptoms and clinical evaluation.
A simple way to remember it is:
Tangential speech: “goes off on a tangent” and never gets back to the point.
Shervan K Shahhian
LIBERTY PSYCHOLOGICAL ASSOCIATION 