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Circumstantial speech (also referred to as circumstantiality) is the result of a non-linear thought pattern and occurs when the focus of a conversation drifts, but often comes back to the point.^[1] In circumstantiality, unnecessary details and irrelevant remarks cause a delay in getting to the point.^[2] If someone exhibits circumstantial speech during a conversation, they will often "talk the long way around" to their point, which can be seen in contrast to linear speech, which is direct, succinct, and to the point.

Circumstantial speech is more direct than tangential speech in which the speaker wanders and drifts and usually never returns to the original topic, and is far less severe than logorrhea.^[3] A helpful metaphor is traveling to a destination. If someone is thinking and speaking linearly, then they will go directly to the point. Circumstantial speech is more like taking unnecessary detours, but the speaker eventually arrives at the intended destination. In tangential speech, the speaker simply gets lost along the way, never returning to the original topic of conversation. With logorrhea, which is closer to word salad, it may not even be clear that the speaker had a particular idea or point in the first place.

Symptoms

A person afflicted with circumstantiality has slowed thinking and invariably talks at length about irrelevant and trivial details (i.e. circumstances).^[4] Eliciting information from such a person can be difficult since circumstantiality makes it hard for the individual to stay on topic. In most instances however, the relevant details are eventually achieved.
The disorder is often associated with schizophrenia and obsessive-compulsive disorder.^[2]

Example

An example of circumstantial speech is that when asked about the age of a person's mother at death, the speaker responds by talking at length about accidents and how too many people die in accidents, then eventually says what the mother's age was at death.^[1]

Similarly, a patient afflicted with this condition, for example, when asked about a certain recipe, could give minute details about going to the grocery store, the shopping experience, people there, and so on.

Treatment

Treatment often involves the use of behavioral modification and anticonvulsants, antidepressants and anxiolytics.^[5]

References

^ ^a ^b Problem-Based Psychiatry by Ben Green 2009 ISBN 1-84619-042-8 page 15
^ ^a ^b "Merck Source Library". Dorland's Medical Dictionary found on Merck Source's website. 2002–2009. Retrieved June 1, 2010. ^{[dead link]}
^ Crash Course: Psychiatry by Julius Bourke, Matthew Castle, Alasdair D. Cameron 2008 ISBN 0-7234-3476-X page 255
^ "A definition of circumstantiality". Retrieved November 6, 2009.
^ Svobada, William (April 5, 2004). Childhood Epilepsy: Language, Learning And Behavioural Complications. Cambridge University Press. p. 672. ISBN 0-521-82338-2.

UpToDate Contents

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1. 統合失調症：臨床症状、経過、評価、および診断 schizophrenia clinical manifestations course assessment and diagnosis
2. 短期精神病性障害 brief psychotic disorder
3. 成人における精神病に対する臨床症状、鑑別診断および初期マネージメント clinical manifestations differential diagnosis and initial management of psychosis in adults

English Journal

The German Translation and Validation of the Scale for the Assessment of Thought, Language and Communication: A Factor Analytic Study.

Nagels A, Stratmann M, Ghazi S, Schales C, Frauenheim M, Turner L, Fährmann P, Hornig T, Katzev M, Müller-Isberner R, Krug A, Kircher T.SourceDepartment of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany.
Psychopathology.Psychopathology.2013 Feb 13. [Epub ahead of print]
The Scale for the Assessment of Thought, Language and Communication (TLC) represents an instrument for the assessment of formal thought disorder (FTD). The factorial dimensionality of the TLC has yielded ambiguous results for a distinction between positive (e.g. circumstantiality) and negative (e.g.
PMID 23407056

Cognitive profile difference between normally intelligent children with Asperger's disorder and those with pervasive developmental disorder not otherwise specified.

Koyama T, Kurita H.SourceDepartment of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan. tomok@ncnp.go.jp
Psychiatry and clinical neurosciences.Psychiatry Clin Neurosci.2008 Dec;62(6):691-6. doi: 10.1111/j.1440-1819.2008.01871.x.
AIM: Asperger's disorder (Asperger syndrome, AS) and pervasive developmental disorder not otherwise specified (PDD-NOS) are different subtypes of mild pervasive developmental disorders (PDD).METHODS: Using the Japanese version of the Wechsler Intelligence Scale for Children-Third Edition (WISC-III),
PMID 19068006

Interrater reliability and coding guide for nonpsychotic formal thought disorder.

North CS, Kienstra DM, Osborne VA, Dokucu ME, Vassilenko M, Hong B, Wetzel RD, Spitznagel EL.SourceDepartment of Psychiatry, UT Southwestern Medical Center at Dallas,VAMC 6363 Forest Park Rd., Suite 651, Dallas, TX 75390-8828, USA. carol.north@utsouthwestern.edu
Perceptual and motor skills.Percept Mot Skills.2006 Oct;103(2):395-411.
Reliable and valid assessment of abnormal speech patterns may enable earlier recognition of nonpsychotic disorders through characteristic speech patterns. This study sought to establish interrater reliability using a standardized guide for scoring. A scoring guide defining 27 elements (e.g., inappro
PMID 17165403

Japanese Journal

「まわりくどい話が止まらない」脳外傷の一例 : 談話障害についての考察

山里道彦,佐藤晋爾,池嶋千秋,朝田隆
高次脳機能研究 : 日本高次脳機能障害学会誌 = Higher brain function research 26(2), 200-208, 2006-06-30
NAID 10017633106

「まわりくどい話が止まらない」脳外傷の一例―談話障害についての考察―

山里道彦,佐藤晋爾,池嶋千秋,朝田隆
高次脳機能研究（旧失語症研究） 26(2), 200-208, 2006
Ponsford の提唱した「談話障害」に該当する症例を経験した。症例は 37 歳男性で，脳外傷慢性期に，注意障害と記憶障害，遂行機能障害がみられた。脳外傷の部位は，両側前頭前野背内側部，右側頭葉外側部および右扁桃体であった。当症例の発言の特徴は a) 話がまわりくどい，b) 場にそぐわない話題を選ぶ，c) 自分のことを一方的に延々と話し続ける，d) 聞き手の不快感を考慮しないことの 4 …
NAID 130004467565

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英: circumstantiality
関: 冗長思考
関: 思路障害

[BG-1] Problem-Based Psychiatry by Ben Green 2009 ISBN 1-84619-042-8 page 15

[Dorlands-2] "Merck Source Library". Dorland's Medical Dictionary found on Merck Source's website. 2002–2009. Retrieved June 1, 2010. ^{[dead link]}

[3] Crash Course: Psychiatry by Julius Bourke, Matthew Castle, Alasdair D. Cameron 2008 ISBN 0-7234-3476-X page 255

[4] "A definition of circumstantiality". Retrieved November 6, 2009.

[5] Svobada, William (April 5, 2004). Childhood Epilepsy: Language, Learning And Behavioural Complications. Cambridge University Press. p. 672. ISBN 0-521-82338-2.

v t e Symptoms and signs: Speech and voice / Symptoms involving head and neck (R47–R49, 784)

Aphasias	Acute Aphasias Expressive aphasia Receptive aphasia Conduction aphasia Anomic aphasia Global aphasia Transcortical sensory aphasia Transcortical motor aphasia Mixed transcortical aphasia Progressive Aphasias Progressive nonfluent aphasia Semantic dementia Logopenic progressive aphasia Speech disturbances Speech disorder Developmental verbal dyspraxia/‎Apraxia of speech Auditory verbal agnosia Dysarthria Schizophasia Aprosodia/Dysprosody Specific language impairment Thought disorder Pressure of speech Derailment Clanging Circumstantiality

Communication disorders	Developmental dyslexia/Alexia Agnosia Astereognosis Prosopagnosia Visual agnosia Gerstmann syndrome Developmental coordination disorder/Apraxia Ideomotor apraxia Dyscalculia/Acalculia Agraphia

Voice disturbances	Dysphonia/Aphonia Bogart–Bacall syndrome

Nose	Post-nasal drip Epistaxis

Mouth	Orofacial pain Toothache Galvanic pain Barodontalgia Fremitus Tooth mobility Bruxism Trismus Ageusia Hypogeusia Dysgeusia Parageusia Hypergeusia Xerostomia Halitosis Drooling Hypersalivation

Neck	Neck mass Cervical lymphadenopathy

Other	Headache Auditory processing disorder Otalgia Velopharyngeal inadequacy Velopharyngeal insufficiency Hypersensitive gag reflex Jaw claudication

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circumstantiality