Example of clang association

Lyrics and poems Near rhymes Phrase rhymes Synonyms / Related Phrases Example sentences Descriptive words Definitions Homophones Similar sound Same consonants

Words and phrases that rhyme with manic: (189 results)

2 syllables:
anneke, annick, anoche, banach, banak, banick, banik, bannick, bannock, brannick, brannock, cannock, canuk, cranach, danek, fanuc, franek, ganic, hannoch, hanoch, janak, janick, janicke, janik, jannock, kanak, lanac, manak, manik, manuk, nanak, nanuk, panek, panic, panick, panik, panique, rannoch, sanac, stanek, stannic, tanach, tanak, tannic, vanoc, wrannock, yanick, yanik, yannick, zanuck
3 syllables:
atlantic, atlantik, botanic, brahmanic, britannic, britannique, brittanic, chovanec, chutzpanik, cyanic, galvanic, gananoque, germanic, gigantic, hispanic, hovanec, iranic, itanic, koranic, manganic, mazanec, mechanic, melanic, midlantic, montanic, nirvanic, organic, paganic, paiwanic, puranic, quranic, rhodanic, romanic, romanik, satanic, shamanic, stefanic, stefanik, sudanic, sultanic, szczepanik, tetanic, titanic, tympanic, tyrannic, uranic, urbanik, volcanic, vulcanic
4 syllables:
alcoranic, aldermanic, alemannic, alkoranic, allemannic, alloxanic, amphisbaenic, asianic, assapanic, bioorganic, brachycranic, caffetannic, charlatanic, chrysophanic, councilmanic, diaphanic, east germanic, epiphanic, ferrocyanic, gallotannic, gentianic, geobotanic, hennotannic, homorganic, hydrocyanic, hypomanic, inorganic, lexiphanic, magellanic, marcomannic, medianic, messianic, metastannic, mimotannic, monorganic, morintannic, mussulmanic, nonorganic, noropianic, north germanic, oceanic, opianic, ossianic, pan-germanic, parabanic, permanganic, pontianak, pozzolanic, puritanic, pyocyanic, quercitannic, rappahannock, rubianic, shop mechanic, subvolcanic, sulphostannic, talismanic, theophanic, transatlantic, transuranic, urocanic, urophanic, uroxanic, west germanic
5 syllables:
antitetanic, dolichocranic, epitympanic, ferricyanic, hydrogalvanic, indo-germanic, intratympanic, isocyanic, megalomanic, metallorganic, metalorganic, metatitanic, polysemantic, sulphocyanic, superorganic, telemecanique, telemechanic, teleorganic, transoceanic
6 syllables:
hydroferrocyanic, paleobotanic, persulphocyanic
7 syllables:
automobile mechanic, caroticotympanic, hydroferricyanic, isosulphocyanic


Words and phrases that almost rhyme †: (59&nbspresults)

2 syllables:
antic, attic, cannon, classic, frantic, gamic, granite, graphic, haemic, hammock, havoc, janet, janice, magic, manac, manis, mantic, matic, paddock, panicked, panics, phallic, planet, static, tadic, traffic, tragic
3 syllables:
agamic, asthmatic, atlantic, ceramic, dramatic, dynamic, ecstatic, emphatic, erratic, fanatic, gigantic, icelandic, mechanics, metallic, pedantic, romantic, semantic, sporadic, syllabic
4 syllables:
adynamic, apogamic, automatic, enigmatic, panoramic, pornographic, problematic, systematic
5 syllables:
aerodynamic, hydrodynamic, hypothalamic, isodynamic, thermodynamic
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Lyrics and poems Near rhymes Phrase rhymes Synonyms / Related Phrases Example sentences Descriptive words Definitions Similar sound

Words and phrases that rhyme with manic: (48 results)

2 syllables:
bannock, panic, stannic, tanach, tannic
3 syllables:
atlantic, botanic, britannic, brittanic, cyanic, galvanic, germanic, gigantic, hispanic, koranic, manganic, mechanic, melanic, organic, paiwanic, puranic, romanic, satanic, tetanic, titanic, tympanic, tyrannic, uranic, volcanic
4 syllables:
aldermanic, alemannic, brachycranic, east germanic, inorganic, messianic, north germanic, oceanic, puritanic, shop mechanic, talismanic, transatlantic, transuranic, west germanic
5 syllables:
dolichocranic, indo-germanic, megalomanic, transoceanic
7 syllables:
automobile mechanic


Words and phrases that almost rhyme †: (55&nbspresults)

2 syllables:
antic, attic, cannon, classic, frantic, gamic, granite, graphic, haemic, hammock, havoc, janet, janice, magic, manis, mantic, paddock, panicked, phallic, planet, static, traffic, tragic
3 syllables:
agamic, asthmatic, atlantic, ceramic, dramatic, dynamic, ecstatic, emphatic, erratic, fanatic, gigantic, icelandic, mechanics, metallic, pedantic, romantic, semantic, sporadic, syllabic
4 syllables:
adynamic, apogamic, automatic, enigmatic, panoramic, pornographic, problematic, systematic
5 syllables:
aerodynamic, hydrodynamic, hypothalamic, isodynamic, thermodynamic
More ideas:
— Try the advanced search interface for more ideas (New!)
— Search for words ending with “nic”
— Nouns for manic: depression, episode, episodes, patients, phase, symptoms, depressive, states, state, patient, psychosis, more…
— People also search for: maniacal, frenetic, demented, spastic, psychotic, neurotic, hyperactive, unhinged, loopy, hyperkinetic, zany, more…
— Invent new words related to manic
Commonly used words are shown in bold. Rare words are dimmed.
Click on a word above to view its definition.

Organize by: Letters Show rare words: Show phrases:

Clang Associations in Bipolar Disorder

Linking words together based on similar sounds rather than coherent meaning is a symptom of psychosis in people with bipolar disorder. Such bipolar symptoms occur during psychotic episodes in the manic phase, but can also occur with depressive psychosis.

“This speech pattern is characteristic of disorganized thinking in psychotic disorders,” explains psychiatrist Michael Peterson, MD, PhD, an assistant professor in the department of psychiatry at the University of Wisconsin School of Medicine and Public Health in Madison. Dr. Peterson offers these examples of clang associations: “that boat hope floats” or “the train brain rained on me.” The words involved often have a rhyming, near-rhyming, or punning (choosing words based on double meanings) quality to them.

There are other types of language changes that may be present with bipolar symptoms in addition to clang associations, including:

  • Word salad. A jumble of words that are not apparently linked and may be hard to understand.
  • Disorganization. Jumping from one idea to another without transition.
  • Neologism. Making up words that have no meaning to anyone but the speaker.
  • Echolalia. Repeating others’ words or phrases.

Typically, if you spend time with a person who is becoming psychotic, you will notice that his language gets less sensible and understandable as his psychosis gets worse. He may not be aware that he is not making sense as he strings together clang associations or other unusual language associations. Eventually he may become totally incoherent or appear to be “speaking in tongues.” Rationalizing with him or trying to talk to him about what he is saying is not going to get you any clear answers. Instead, start seeking treatment for his bipolar symptoms as soon as you notice that his language is starting to fall apart.

Other Signs of Bipolar Psychosis

Clang associations and other language changes may be accompanied by other symptoms of psychosis, which include:

  • Hallucinations
  • Paranoia
  • Delusions
  • Disordered thinking or speaking
  • Being excessively responsive to stimulation in the environment
  • Difficulty determining what is real and what is not
  • Problems completing ordinary tasks (problems may be related to memory, concentration, clear thinking, etc)

Bipolar psychosis looks a lot like symptoms of schizophrenia, which can result in a misdiagnosis for some patients with manic depression or other psychiatric illnesses. About half of people with bipolar disorder will have a psychotic episode at some point in their lives. Psychosis is usually temporary, but it is important to get treatment immediately.

Management of Clang Associations

Because clang associations are a symptom of psychosis, managing them requires treatment of the psychosis.

“They are managed primarily using antipsychotic medications. The goal in treating bipolar episodes with psychosis is to resolve the acute symptoms and to stabilize mood. Antipsychotic medication for bipolar disorder may be used either during the psychotic episode only, or as longer-term mood-stabilizing medications,” says Peterson.

As worrying as clang associations and other language problems may be, effective treatments exist that can get your loved one back on track.

By The Recovery Village Editor Renee Deveney Reviewer Dr. Karen Vieira Updated on11/22/19

Clang association involves the use of words in speech that sound similar but have no connection or meaning. Words with similar sounds or that rhyme are grouped together. This type of speech is often seen in those with bipolar disorder and schizophrenia. This illogical form of communication is referred to as disorganized thinking and is a sign of acute psychosis present in both manic and depressive episodes.

What Are Clang Associations?

The word clang is associated with sound, such as bells or metal ringing. In contrast, speech produces sounds and words with the effect of communicating thoughts and ideas. A person who speaks using clang associations uses actual words, but the effect is only sound and no real communication. The rhyming words do not convey any clear thoughts or ideas. Therefore clang association can be defined as words based on sounds without logical communication.

Mood disorders can have a variety of symptoms and behavioral characteristics. Clang association is a symptom related to disordered thoughts seen in bipolar disorder and schizophrenia. It is a reflection of disorganized thought processes. Instead of a person’s thinking and speech being directed based on meaning, in clang association, a person’s thinking and speech is driven by the sound of words. A person can associate words based on rhyming quality and punning.

Examples of clang association include:

  • “I wrote the boat overload showed my goat float tote.”
  • “He rained the train brain strain gain the crane.”

While the rhyming may have similar qualities to music such as rap, clang association is situationally inappropriate and interferes with the ability to clearly communicate.

Cognitive dysfunction is a major component in serious mental health conditions and can include changes in thinking, memory, motivation, perception, skilled movements and language. Thought disorder is a key feature of cognitive dysfunction. Although bipolar is recognized as a mood disorder with cycling highs and lows, thought disorder is a symptom of bipolar as well.

Often seen during manic phases of bipolar disorder, thought disorder can manifest as cognitive deficits prior to acute mood symptoms. Some thought disorder symptoms could include racing thoughts, difficulty with word retrieval, attention and retention problems and accelerated thought processes. This acceleration of thought makes it difficult for a person with bipolar to focus on specific thoughts, and in a matter of minutes, they can lose clarity and awareness of their own thoughts. Processing such a rapid emergence of thoughts is nearly impossible and affects responses to situations and others.

During an acute manic episode in bipolar disorder, clang association can emerge as the person is trying to communicate but unable to make any sense. In addition to clang association, a person may speak in jumbled words or phrases, have speech that rapidly changes direction, use made-up words and be generally incoherent.

Clanging in Schizophrenia

Clang association was originally associated with schizophrenia, a mental health disorder characterized by psychotic symptoms including delusions, hallucinations and thought disorder. As previously discussed, thought disorder can affect one’s thought processes, language and ability to communicate. During a phase of acute psychosis in schizophrenia, a person may display several breaks in communication related to thought disorder, including, but not limited to:

  • Poverty of speech: brief responses
  • Pressure of speech: loud, fast-paced speech that is difficult to interrupt
  • Loosening of associations: speech that is spontaneous with changing topics
  • Schizophasia: severe lack of coherence and sentence structure
  • Neologism: making up new words
  • Echolalia: repeating words or phrases of another person during a conversation
  • Clang association: speech governed by word sound rather than the meaning

Changes in language and speech are common symptoms of schizophrenia, and clang association can be seen during acute psychosis when a person is distracted by their own speech and subsequently uses similar sounding words that rhyme. Although not all individuals with schizophrenia will have impairments with language, many do experience these abnormalities in language. Researchers are unable to definitively determine whether these language deficits are related to language itself or deficits in cognition as a whole.

Managing Clang Associations

Since clang associations are symptoms of thought disorder seen in manic or acute episodes of bipolar disorder and schizophrenia, the best form of management includes consistent treatment of the disorder. Some people may be currently receiving treatment but experience psychosis because their medication needs adjustment, or other health and situational factors may worsen their symptoms. Acute psychosis in either disorder requires immediate treatment to prevent harm to self or others. Clang association can be a good indicator that a person is close to or already experiencing psychosis.

Mental health first aid can help those close to a person with bipolar disorder or schizophrenia get the help they need. Typical treatment for bipolar disorder or schizophrenia, including the symptom of clang association, can include:

  • Psychotherapy
  • Cognitive behavioral therapy
  • Group or family therapy
  • Cognitive enhancement therapy (specific to schizophrenia)
  • Medications

If you or someone you know is struggling with bipolar disorder or schizophrenia and a co-occurring substance use disorder, contact The Recovery Village. One of our representatives can discuss a treatment plan suitable for you.

  • Sources

    Fountoulakis, Konstantinos N. “The emerging modern face of mood disorders: a didactic editorial with a detailed presentation of data and definitions.” Annals of General Psychiatry, April 12, 2010. Accessed May 25, 2019.

    Morgan, Charity; et al. “Thought Disorder in Schizophrenia and Bipolar Disorder Probands, Their Relatives, and Nonpsychiatric Controls.” Schizophrenia Bulletin, March 1, 2017. Accessed May 25, 2019.

    Rivki, Paul; Barta, Patrick. “Thought Disorder.” Johns Hopkins Psychiatry Guide, August 2, 2017. Accessed May 25, 2019.

    Covington, Michael A.; et al. “Schizophrenia and the structure of language: The linguist’s view.” Schizophrenia Research, April 2, 2005. Accessed May 25, 2019.

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DEFINITION

Formal thought disorder refers to an impaired capacity to sustain coherent discourse, and occurs in the patient’s written or spoken language.

  • Whereas delusions reflect abnormal thought content, formal thought disorder indicates a disturbance of the organization and expression of thought.
    • Indeed, the most basic assessment of thought content requires at least some degree of language competence.
  • For research purposes, scales have been developed to study the quality and severity of abnormalities in thought, language, and communication.
  • In clinical practice, formal thought disorder is assessed by engaging patients in open-ended conversation and observing their verbal responses.
  • A number of medical and surgical conditions can affect language performance; the term formal thought disorder is used when these conditions are excluded from the diagnosis.
  • The cause of formal thought disorder is not established. Research has implicated abnormalities in the semantic system in patients with schizophrenia.
  • Thought disorder is often accompanied by executive function problems and general disorganization.
  • Abnormalities in language are common in the general population, in everyday conversation. Thus, the categorical presence or absence of the following language problems is not absolutely diagnostic of any condition. However, heightened frequency and severity of these problems should be noted by the physician and accounted for in the patient’s diagnostic formulation.

Formal thought disorder descriptors (adapted from the Thought, Language, and Communication scale):

  • Poverty of speech: restricted quantity of speech; brief, unelaborated responses
  • Poverty of content of speech: adequate speech quantity with prominent vagueness and inappropriate level of abstraction
  • Pressure of speech: increased rate and quantity of speech; speech may be loud and difficult to interrupt
  • Distractible speech: topic maintenance difficulties due to distraction by nearby stimulus
  • Tangentiality: Replies to questions are off-point or totally irrelevant.
  • Derailment (loosening of associations): spontaneous speech with marked impairments in topic maintenance
  • Incoherence (word salad, schizaphasia): severe lack of speech cohesion at the basic level of syntax and/or semantics within sentences
  • Illogicality: marked errors in inferential logic
  • Clanging: speech in which word choice is governed by word sound rather than meaning; word choice may show rhyming or punning associations
  • Neologism: the creation of new “words”
  • Word approximations: unconventional and idiosyncratic word use
  • Circumstantiality: excessively indirect speech; speech is liable to be overinclusive and include irrelevant detail
  • Loss of goal: difficulty in topic maintenance in reference to failure to arrive at the implicit goal of a statement
  • Perseveration: excessive repetition of words, ideas, or subjects
  • Echolalia: speech repeats words or phrases of interviewer
  • Blocking: interruption of speech while ostensibly in pursuit of a goal
  • Stilted speech: odd language use that may be excessively formal, pompous, outdated, or quaint
  • Self-reference: The patient is liable to refer the subject of conversation back to him/herself.
  • Paraphasic error (phonemic): word mispronunciation, slip of the tongue
  • Paraphasic error (semantic): substitution of an inappropriate word to make a specific statement

Psychiatric Disorders/Psychotic Disorders

Psychotic disorders include the following disorders: Schizophrenia, Schizoaffective Disorder, Schizophreniform Disorder, Delusional Disorder, Brief Psychotic Disorder, and the Secondary Psychotic Disorders (Psychotic Disorder that are due to medical conditions or to substances). The central feature of these disorders is that they cause psychosis. Psychosis can be thought of as a loss of contact with reality. A person with a psychotic disorder is unable to evaluate properly what is or is not real.

In addition to the primary psychotic disorders, a number of other psychiatric disorders can cause a person to become psychotic. These include the mood disorders, such as psychotic depression, or mania with psychosis.

Thought Disorders

Psychotic disorders represent the failure of normal thought and, hence, they can be categorized as thought disorders. Thought disorders can be divided into different types. Most commonly, they are divided into disorders of process and disorders of content.

Disorders of Thought Process

Disorders of thought process involve a disturbance in the way one formulates thought. Thought disorders are inferred from speech, and often referred to as “disorganized speech.” Historically, thought disorders have included associative loosening, illogical thinking, over inclusive thinking, and loss of the ability to engage in abstract thinking. Associative loosening includes circumstantial thought and tangential thought.

Other types of formal thought disorder include:

  • Perseveration: the patient gets stuck on one idea or one thing and cannot move on from there
  • Clanging: the connections between thoughts may be tenuous, and the patient uses rhyming and punning
  • Neologisms: words that patients make up; often a condensation of several words that are unintelligible to another person
  • Echolalia: the patient repeats back the words of other people, “parrots” people’s speech
  • Thought blocking: stopping mid-thought and being unable to continue with the thought
  • Word salad: an incomprehensible mixing of meaningless words and phrases.
  • For a larger list of thought disorders, see this article

Disorders of Thought Content

Disorders of thought content include hallucinations and delusions.

Hallucinations are perceptions without external stimuli. They are most commonly auditory, but may be any type. Auditory hallucinations are often voices, mumbled or distinct. Visual hallucinations can be simple or complex, in or outside the field of vision (ex. “in head”) and are usually of normal color rather than black and white. Olfactory and gustatory hallucinations generally occur together as unpleasant tastes and smells. Tactile or haptic hallucinations may include any sensation—for example, an electrical sensation or the feeling of bugs on skin (formication).

Delusions are fixed, false beliefs, not amendable by logic or experience. There are a variety of types. Delusions are most commonly persecutory, but may be somatic, grandiose, religious or nihilistic. No one type of delusion is specific to any particular disorder (such as schizophrenia). Hallucinations and delusions are common across all cultures and backgrounds; however, culture may influence their content. Culture and religion must be considered when evaluating whether an event is a delusion or hallucination. In this context, a good rule of thumb is that if other people endorse it, it may not be a delusion or hallucination.

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