clanging

Clanging, or clang associations, is a phenomenon in speech and thought disorders in which words are chosen for their sound rather than their meaning. The utterances tend to form chains linked by rhyme, alliteration, or other phonetic similarities, with little regard for semantic connection. This can yield disjointed, rhythmically driven speech that is hard to follow.

Clanging is most commonly observed in psychiatric contexts, particularly during acute episodes of schizophrenia and mood disorders such as mania or bipolar disorder. It can also appear in delirium, dementia, and other neurological conditions, as well as under the influence of substances that impair thought processes. It is a form of loosening of associations and differs from other linguistic disturbances like word salad (which is more incoherent) or neologisms (creation of new words).

Examples of clang speech illustrate phonological linking rather than logical content. A patient might say, for instance, “The light is bright, the night is tight, I might bite a kite,” or produce sequences where words rhyme or start with the same sound without a clear semantic progression. Such patterns are more prominent when the underlying condition affects thought organization.

Diagnosis and management focus on the underlying disorder. Clanging is usually documented as a feature of a broader language and thought disturbance rather than as a separate diagnosis. Treatment aims to address the primary condition with appropriate pharmacological and psychotherapeutic approaches, and, when possible, speech-language therapy may help improve communication and cognitive organization. Prognosis depends on the underlying illness and response to treatment.