Bipolar Disorder Symptoms Clang Association in Bipolar Disorder and Schizophrenia By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on November 25, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Cultura RM Exclusive/Matelly / Getty Images Table of Contents View All Table of Contents What They Sound Like Part of "Word Salad" Writing Associations Clang associations are groupings of words, usually rhyming words, that are based on similar-sounding sounds, even though the words themselves don't have any logical reason to be grouped together. A person who is speaking this way may be showing signs of psychosis in bipolar disorder or schizophrenia. In bipolar disorder, clang associations generally appear in psychotic episodes in the manic phases of the illness. In schizophrenia, clang associations are closely linked with a thought disorder, one of the hallmark features of the illness. "Clanging" also has been referred to as "glossomania" in medical literature relating to speech alterations in schizophrenia and bipolar disorder. What Clang Associations Sound Like Clang associations generally sound a bit like rhyming poetry, except that the poems don't seem to make any sense. (They don't make sense because there's no logical reason for those particular words to be grouped together into a poem.) For example, in the song "X Amount of Words" by Blue October's Justin Furstenfeld (who has bipolar disorder), the words "pathetic" and "sympathetic" are rhymed with "prosthetic" and "paramedic": Imagine the worstSystematic, sympatheticQuite pathetic, apologetic, paramedicYour heart is prosthetic These words don't have much of a logical reason to be grouped together, but they create a catchy, clang-y sort of rhythm ... hence the term "clang associations." You can have a clang association with any words that don't make sense when grouped. Here's another: Auto, tomorrow, swallow, Zoro, borrow The words used in clang associations generally rhyme, although they may only rhyme partially. Part of "Word Salad" In bipolar disorder and schizophrenia, clang associations are considered to be part of a language disorder condition called schizophasia (popularly known as "word salad"). In fact, language disturbance is a major feature of schizophrenia. A person is said to have schizophasia when his speech is jumbled, repetitious, and simply doesn't make sense. This speech may feature neologisms, which are made-up words or expressions or simply be mumbled and impossible to understand. People whose speech features clang associations and other symptoms of schizophasia may also have a flat-sounding voice or another unusual voice quality. They may seem to have problems with remembering words or using them correctly, as well. Writing Associations Along with leading to clang associations, neologisms, and another jumbled spoken language, schizophasia may also affect written the language. In 2000, Université de Montréal researchers tested the writing and dictation ability of people with "paranoid schizophrenia with glossomanic schizophasia." They found that the patients weren't able to write down dictated words accurately—they replaced letters in words with similar-sounding, but not identical letters, for example. This indicates that the language problems inherent in schizophrenia extend beyond spoken language in patients. In fact, there's some speculation that language problems in schizophrenia, such as clang associations, may connect to the genetic basis for the condition: "Recent research has begun to relate schizophrenia, which is partly genetic, to the genetic endowment that makes human language possible," concluded one group of clinicians. 5 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Fountoulakis KN. The emerging modern face of mood disorders: a didactic editorial with a detailed presentation of data and definitions. Ann Gen Psychiatry. 2010;9:14. Published 2010 Apr 12. doi:10.1186/1744-859X-9-14 Bipolar Disorder. National Institute of Mental Health. Kuperberg GR. Language in schizophrenia Part 1: an Introduction. Lang Linguist Compass. 2010;4(8):576–589. doi:10.1111/j.1749-818X.2010.00216.x Schizophrenia. National Institute of Mental Health. Coron AM, Stip E, Dumont C, Lecours AR. Writing impairment in schizophasia: two case studies. Brain Cogn. 2000 Jun-Aug;43(1-3):121-4. PMID: 10857677. By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? 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