Descriptive Psychopathology: The Signs and Symptoms of ...

242 Section 3: Examination domainsKraepelin recognized various aphasic-like speech problems in patients withdementia praecox, defining these as akataphasia. This speech was described asproblems in word-finding, and included derailments, substituted homonyms forthe correct words, and misusing words. Kraepelin offered the following exampleswhich today are recognized as paraphasias:Instead of “under the protection of the police” a patient said he “lived under protected police”.Instead of saying that “his fiancée continued to speak to him” a patient said “his fiancée alwaysin speech”. 52Circumloculatory speechCircumloculatory speech is identified when the patient refers to an object, event,or person by descriptive terms (e.g. its function or physical characteristics) ratherthan by its name. Circumloculatory speech is associated with paraphasias andobservable difficulties in word-finding.Example:When describing how he made breakfast, a patient said: “I put the jelly on theburnt bread [semantic paraphasia for toast]. I make it in the ...you know ...themetal box with the heating thing” [toaster].NeologismNeologisms are new words that do not convey meaning. Some slang words wereonce new words (e.g. boogie-woogie, jazz, hep, jo), but they now convey meaning.Shakespeare is purported to have created hundreds of new words. Neologisms canbe phonemic paraphasias, clang words, or portmanteau words. Malapropismsare also new words or misused but without clinical significance. They reflectfailed efforts to sound educated and are often humorous as personified byMrs. Malaprop, a character in Sheridan’s play The Rivals (1775).“...promise to forget this fellow – to illiterate him, I say, quite from your memory.” [obliterate]“I have since laid Sir Anthony’s preposition before her;” [proposition]“I am sorry to say, Sir Anthony, that my affluence over my niece is very small.” [influence]Portmanteau wordsA portmanteau is a satchel. It holds many things. A portmanteau word is aneologism constructed from two or more words, such as parastantial as a combinationof parallel and circumstantial. In addition to patients with schizophrenia, it is