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© Borgis - Postępy Nauk Medycznych 1/2020, s. 19-27 | DOI: 10.25121/PNM.2019.33.1.19
Klaudia Sowa1, Anna Lobaczuk-Sitnik1, *Emilia Duchnowska1, Bozena Kosztyla-Hojna1, Jerzy Robert Ladny2
Voice disorders as a result of psychological disturbances
Zaburzenia głosu i mowy uwarunkowane psychogennie
1Department of Clinical Phonoaudiology and Speech Therapy, Medical University of Bialystok, Poland
2Department of Emergency Medicine, Medical University of Bialystok, Poland
Streszczenie
Głos jest narzędziem pracy wielu grup zawodowych. Dla dzieci możliwość komunikacji odgrywa fundamentalną rolę w procesie nauki, rozwoju oraz poznawania świata. Podjęcie odpowiednich działań terapeutycznych może dać pacjentowi szansę na osiągnięcie sukcesów w komunikacji społecznej, a co za tym idzie w społeczności szkolnej lub miejscu pracy. Wydolność i jakość głosu są odzwierciedleniem problemów zdrowotnych człowieka zarówno ze sfery somatycznej, jak i psychicznej, dlatego bardzo duże znaczenie ma objęcie terapią psychologiczną pacjentów z psychogennymi zaburzeniami głosu i mowy.
Summary
Voice is a work tool for many professional groups. For children, the ability to communicate plays a fundamental role in learning, developing and exploring the world. Taking appropriate therapeutic measures may give the patient a chance to achieve success in social communication, and thus in the school community or workplace. Voice efficiency and quality reflect human health problems both in the somatic and mental spheres, therefore it is very important to include psychological therapy in patients with psychogenic voice and speech disorders.
Introduction
Voice and speech are the basis of interpersonal communication. It is also a tool for many professional groups. Voice efficiency and quality reflect human health problems, both, in the somatic and mental aspect. Psychogenic voice disorders are referred to as Phononeurosis (1). The causes of voice quality disorders include: professional problems, frequent conflicts in social relationships, especially family relationships, and permanent anxiety. There are several classifications presenting psychogenic-related voice quality disorders (1-3).
In the classification of speech disorders, Styczek distinguished intrinsic speech disorders (also called endogenous). The group of these disorders includes: speech neuroses (logoneuroses), and also: stuttering, mutism, dysphonia, aphonia, disturbances in strength, modulation and pitch, as well as disturbances in speech rate (1, 4).
Zalewski includes mutism and aphonia to the group of speech neuroses, similarly to Styczek, he adds, among others, fear of speaking – logophobia, logosthenia (reduced speaking competence), hysterical speech disorders (the main form of these disorders is logorea) (1, 5).
On the other hand, Czernikiewicz and Woźniak include schizophasia, some forms of stuttering, logoneurosis and speech disorders accompanying the autism spectrum among psychogenic voice disorders (1, 4, 5).
Autism
In 1943, Leo Kanner described autism as a pervasive development disorder of a child appearing approximately at 30 months of age (1, 4, 5).
Speech and communication disorders are one of the most characteristic symptoms of autism. Linguistic development is delayed and problems with the use of acquired skills in order to communicate with other people (5-8).
The etiology of ASD – Autism Spectrum Disorder – is not clearly defined. There is no evidence that a particular factor, gene, or specific brain change causes autism. This is due to the fact that the occurrence of autism is correlated with the presence of other disorders, which makes the formulation of an unambiguous thesis difficult (5, 9, 10).
The first symptoms of autism may be observed in early infancy, where the child manifests an aversion to physical contact with the parents and eye contact is limited or absent. Many children struggling with autism acquire developmental skills such as crawling, walking or speech at the same time as their peers, however, in a large percentage of children with autism, speech is delayed to a varying degree or we observe its regression (10, 11).
Characteristic for persons with autism are stereotypical movements in 3 areas: hands, whole body as well as posture and gait. Hand movement stereotypes are represented by waving hands, clapping, and constantly rotating objects. Movement stereotypes within the body are manifested by swaying, spinning around its axis, forward and backward bending. Gait and posture stereotypes are represented by tiptoeing or frequent jumping. Patients often show fixation on objects or sequences of movements, e.g. on constantly turning off and on the light. Various types of sensory integration disorders are often observed in children with ASD (5, 11).
Characteristic features of speech of children with autism include delay of its development in relation to their peers or, in extreme cases, a complete lack of speech development. Children who speak have difficulty initiating or continuing a conversation. Speech is stereotypical, characterized by numerous repetitions of the same words or phrases. Speech intensity, intonation, pace, rhythm and accent disturbances may also occur (9-11).
Stuttering
Stuttering (alalia syllabaris) is a disorder commonly observed in world population that affects all cultural, religious and socio-economic groups. Disorder of fluency in the form of stuttering is a complex phenomenon, it has a multifaceted etiology and varied symptomatology. The first symptoms of stuttering are noticeable in early childhood, they occur in the period of intensive speech development between 2 and 4 years old. Some patients develop stuttering gradually and progressively, while others – suddenly. Scientific research (1) shows that 1% of the general population stutters, in the early school age there is one girl for 3 boys who stutter, and at approximately 10 years of age this ratio changes and there is 1 girl for every 6 boys who stutter. The above studies show that male gender is a factor that increases the risk of stuttering. Physiological factors, environmental factors, linguistic factors related to speech and language, and psychological factors inducing stuttering have also been identified. Among the physiological factors, we may distinguish:
– genetic predispositions,
– neurological factors in the form of structural and functional differences in the brain in adults who stutter,
– male gender,
– differences in motor skills related to the production of speech.
Linguistic factors:
– delayed speech development or above-average language skills,
– inharmonious development of speech.
Environmental factors:
– family relationships, especially in the parent-child aspect,
– great anxiety of the parent,
– negative reactions from the environment, especially from the peer group.
Psychological factors:
• child temperament (more active, impulsive, less flexible, more reactive, sensitive, withdrawn, introverted, fearful, shy),
• awareness of the problem in the child. The child sees that he has a problem with speaking, which creates a lack of acceptance by his peers. The patient feels insecure when speaking, becomes stressed, which intensifies the stuttering (2, 8, 12).
Szamburski points that a strong positive or traumatic event in the patient’s life may be a factor that triggers stuttering in the presence of other factors that predispose to this disorder (2, 8).
Alalia syllabaris, or stuttering, is a disorder of fluency of speech characterized by frequent repetitions or extensions of words, syllables and sounds. Patients also struggle with pauses that disrupt the rhythmic flow of speech, bradillalia (slow speaking) and tachylalia (fast speaking). The main cause of stuttering is excessive tension in the respiratory, articulation and phonation muscles. There are 3 types of stuttering: clonic, tonic and clonic-tonic. The main disturbances include the pace of speech, duration of sounds, rhythm and melody of speech (1, 8, 13, 14).
The psychogenic aspect is of great importance in the etiology of stuttering, the severity of the disorder and in speech therapy (8).
Schizophasia

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Piśmiennictwo
1. Krajewska M: Psychiatria w logopedii – problem zaburzeń somatoformicznych i nerwic mowy. Neurolingwistyka Praktyczna 2018; 4: 32-42.
2. Maniecka-Aleksandrowicz B, Domaniecka-Kołodziej A: Rehabilitacja w afonii psychogennej. Audiofonologia 2004; 25: 53-56.
3. Andersson K, Schalèn L: Etiology and treatment of psychogenic voice disorder: results of a follow-up study of thirty patients. J Voice 1998; 12(1): 96-106.
4. Aronson EA: Clinical voice disorders. George Thieme Verlag Stuttgart, New York 1985.
5. Bader CA, Schick B: Psychogenic aphonia. A challenging diagnosis? HNO 2013; 61: 678-682.
6. Baker J: Persistent dysphonia in two performers affecting the singing and projected speaking voice: a report on a collaborative approach to management. Logoped Phoniatr Vocol 2002; 27: 179-187.
7. Baker J: Psychogenic voice disorders and traumatic stress experience: a discussion paper with two case reports. J Voice 2003; 17(3): 303-318.
8. Kelman E, Nicholas A: Praktyczna interwencja w jąkaniu wczesnodziecięcym. Harmonia, Gdańsk 2008.
9. Boone D: The voice and voice therapy. Prentice-Hall Inc. Englewood Clifts, New York 1971: 222-233.
10. Kosztyła-Hojna B, Moskal D, Kuryliszyn-Moskal A et al.: Morphological changes of the vocal fold mucosa in hyperfunctional dysphonia diagnosed by psychoacoustic and videostroboscopic methods. Adv Med Sci 2011; 56(2): 343-351.
11. Kosztyła-Hojna B, Moskal D, Rogowski M et al.: The usage of modern physioterapeutic methods of rehabilitation in treatment of chosen kinds of dysphonia. Otolaryngol Pol 2012; 66(5): 328-336.
12. Perello J: Functional dysphonias. Phonoponosis and phononeurosis. Folia Phoniatr (Basel) 1962; 14: 150-205.
13. Kosztyła-Hojna B, Moskal D, Falkowski D et al.: High-speed digital imaging in the diagnosis of voice pathologies. Pol Merkur Lekarski 2016; 41(241): 26-31.
14. Kosztyła-Hojna B, Moskal D, Kuryliszyn-Moskal A et al.: Usefulness of high-speed digital imaging (HSDI) in the diagnosis of oedematous – hypertrophic changes of the larynx in people using voice occupationally. Otolaryngol Pol 2017; 71(4): 19-25.
15. Roy N, Bless DM, Heisey D: Personality and voice disorders: a multitrait-multidisorder analysis. J Voice 2000; 14(4): 521-548.
16. Czernikiewicz A: Przewodnik po zaburzeniach językowych w schizofrenii. Wyd. IPiN, Warszawa 2004.
17. Woźniak T: Narracja w schizofrenii. Wyd. UMCS, Lublin 2005.
18. Andreasen N: Thought, language, and communication disorders. II. Diagnostic significance. Arch Gen Psychiatry 1979; 36: 1325-1330.
19. Toomey R, Kremen W, Simpson J et al.: Revisiting the factor structure for positive and negative symptoms: Evidence from large heterogeneous group of psychiatric patients. Am J Psychiatry 1997; 154: 371-377.
20. Thomas P, Kerney G, Napier E et al.: Speech and language in first onset psychosis: differences between people with schizophrenia, mania, and controls. Br J Psychiatr 1996; 168: 337-343.
21. Morice R, Ingram J: Language complexity and age of onset of schizophrenia. Psychiatry Res 1982; 9: 233-242.
22. Liddle P: Syndromes in schizophrenia and their neuropsychological and neuroanatomical correlates. [In:] Pantelis C, Nelson H, Barnes T (eds.): Schizophrenia: A neuropschological perspective. Wiley, Chichester 1996: 299-316.
23. Peralta V, De Leon J, Cuesta M: Are the more than two syndromes in schizophrenia? A critique of the positive-negative dychotomy. Br J Psychiatry 1992; 161: 335-343.
24. Schmand B, Brand N, Kuipers T: Procedural learning of cognitive and motor skills in psychotic patients. Schizophr Res 1992; 8: 157-170.
25. Nemr K, Somoes-Zenari M, Marques SF et al.: Psychogenic dysphonia associated to other diseases: a challenge for speech therapy. ProFono 2010; 22(3): 359-361.
26. Bystrzanowska M: Mutyzm wybiórczy. Poradnik dla rodziców, nauczycieli i specjalistów. Oficyna Wydawnicza „Impuls”, Kraków 2017.
27. Bawolska A: Dziecko z mutyzmem wybiórczym – charakterystyka zjawiska. 2011. Niepełnosprawność 2019; 33(2019): 204-212.
28. Cabała M, Leoniak-Stępień A, Szot R, Szyszka K: Mutyzm wybiórczy. Trzy spojrzenia. Oficyna Wydawnicza „Impuls”, Kraków 2016.
29. Bryńska A: Zaburzenia lękowe i zaburzenia obsesyjno-kompulsywne. [W:] Wolańczyk T, Komender J (red.): Zaburzenia emocjonalne i behawioralne u dzieci. Wydawnictwo Lekarskie PZWL, Warszawa 2005; 148-174.
30. Tarkowski Z: Dzieci z zaburzeniami zachowania, emocji i mowy. Harmonia, Gdańsk 2015.
31. Gerrig RJ, Zimbardo GP: Psychologia i życie. Wydawnictwo Naukowe PWN, Warszawa 2012.
32. Paul BC, Chen S, Sridharan S et al.: Diagnostic accuracy of history, laryngoscopy, and stroboscopy. Laryngoscope 2013; 123(1): 215-219.
33. Pruszewicz A: Foniatria kliniczna. Wydawnictwo Lekarskie PZWL, Warszawa 1992.
34. Andreasen N, Grove W: Thought, language, and communication in schizophrenia: Diagnosis and prognosis. Schizophr Bull 1986; 12: 348-358.
otrzymano: 2020-01-13
zaakceptowano do druku: 2020-02-03

Adres do korespondencji:
*Emilia Duchnowska
Zakład Fonoaudiologii Klinicznej i Logopedii Wydział Nauk o Zdrowiu Uniwersytet Medyczny w Białymstoku
ul. Szpitalna 37, 15-273 Białystok
tel.: +48 603-330-294
emilia.duchnowska@umb.edu.pl

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