Coprolalia is considered a neurological-psychiatric disorder that manifests itself by uttering foul language from the anal area. It is usually a symptom of an underlying mental illness, such as Tourettes syndrome. However, other psychiatric disorders may also present with this symptom.
What is coprolalia?
Coprolalia is characterized by a tendency to utter obscene and indecent words from fecal language. Coprolalia is characterized by the tendency to pronounce obscene and indecent words from fecal language. This results in inappropriate name-calling and insults to bystanders without cause or basis. The affected person, however, cannot control his verbal attacks and in no way means what he expresses in these expletives. It is a verbal tic disorder triggered by an impulsive compulsion. Often the swear words are uttered without context of meaning within normal speech. While uttering the swear words, voice pitch and tone also change. The consequence of coprolalia is often social isolation of the patient. The term coprolalia comes from Greek and means fecal language. The first syllable of the word coprolalia can be translated as feces, dung, or fecal matter, with the second syllable meaning “speech” or “I speak.”
Cause
The cause of coprolalia is not clearly known. However, it has been found to occur frequently in association with certain psychiatric disorders. The best known is the occurrence of coprolalia in the so-called Tourettes syndrome. Therefore, Tourette’s syndrome is used almost as a synonym for coprolalia. However, Tourette’s syndrome cannot be reduced to coprolalia. It is a tic disorder that has many motor and verbal tics. In addition, Tourette’s syndrome may be associated with various obsessive-compulsive disorders. Symptoms of ADHD, Asperger syndrome, or restless legs syndrome are also common. The intelligence of the patients is not affected. There is sometimes overactive signaling in the brain, which manifests itself in sudden bursts. However, coprolalia occurs in Tourette’s syndrome in only about 30 percent of cases. Other conditions that can develop coprolalia include brain inflammation, brain tumors, dementia, or traumatic brain injury. Coprolalia can also occur in the context of aphasia (a special form of speech disorder). However, to this day, experts puzzle over why it is that foul and aggressive expressions are uttered during a seizure. According to one hypothesis, there are two separate areas in the brain for speech. While in the right cerebral cortex contentful expressions are formulated, emotional vocalizations occur in a second area. This area is thought to be located in the limbic system. Thus, with the increased activation of this area by various diseases, coprolalia can occur.
Diseases associated with this symptom
- ADHD
- Dementia
- Concussion
- Asperger’s Syndrome
- Brain tumor
- Speech disorders
- Restless legs syndrome (Restless legs).
- Brain inflammation
- Tic and Tourette syndrome
Diagnosis and course of the disease
For affected patients, coprolalia is very unpleasant and embarrassing. They are aware of their oral slips, but are unable to stop them. As the disorder progresses, social exclusion is common. Some forms of coprolalia take place only in the thoughts of the affected person. Although no foul verbal expressions are produced, uncontrolled obscene gestures such as raised middle finger (stinky finger) or masturbation gestures are often shown. This form of coprolalia is also called copropraxia. However, in order to effectively treat coprolalia, it is also necessary to diagnose the underlying condition. In most cases, coprolalia is due to Tourette’s syndrome. Other causes include brain inflammation or brain tumors. Special forms of dementia can also lead to coprolalia. This applies, for example, to the so-called Pick syndrome. This form of dementia does not begin with forgetfulness, but with personality changes that often initially manifest themselves in irritability, aggressiveness and restlessness. It is not uncommon for coprolalia to develop in the process.
Complications
Coprolalia, or the compulsive tendency to use fecal language, is most often associated with Tourette syndrome, a psychiatric disorder characterized by tics that the affected person constantly performs involuntarily. Since fecal words are not looked upon favorably in society, the environment of the affected person usually feels harassed and ostracizes him. Often it can also come to fisticuffs due to the misunderstanding and the affected person is hurt for no reason. Likewise, the unconscious use of the obscene words leads to a certain feeling of shame in the affected person, so that he isolates himself socially. In the worst cases, this can lead to depression and the development of addiction. Also, the exercise of some professions is restricted, especially those that involve a lot of social contact. In Tourette’s syndrome, about one third of those affected in childhood carry on the disease in adulthood, which can be even more severe. Accordingly, the quality of life continues to be severely impaired. Coprolalia can also be a symptom of Pick’s syndrome. This is a form of dementia that can lead to severe personality and behavioral changes as it progresses. In addition, speech and thinking skills may be impaired. Affected persons appear neglected and listless, as well as in need of care. In addition, opposite effects such as euphoria or aggressiveness may also appear.
When should you go to the doctor?
Coprolalia is a problem for those affected primarily in that it can put a strain on social relationships. However, it does not represent an organic condition and therefore does not require diagnosis, let alone treatment, at this level. Coprolalia can be perceived as stressful in different ways. As an occasional tic disorder, it represents an impairment that does not require a discussion with a psychologist or therapist. However, if the affected person feels that he or she is losing control of his or her verbal behavior, it may be advisable to consult a psychologically and logopedically trained specialist. Even if, in addition to the coprolalia, other symptoms of obsessive-compulsive disorder and Tourette’s syndrome develop, a doctor must be consulted. Only in this way can the certainty about one’s own condition and, if necessary, therapy remain possible. In the case that the obsessive-compulsive disorder restricts the affected person in his attitude to life to such an extent that he shows the symptoms of depression, a psychiatrist or psychologist must be consulted without fail.
Treatment and therapy
Various medications are available for the treatment of vocal and motor tics. These are so-called neuroleptics, which act on the central nervous system. In Germany, tiapride is mainly used. However, the drugs risperidone, pimozide and haloperidol are also effective against coprolalia and copropraxia, respectively. Haloperidol in particular works very well, but causes considerable side effects. The dose of medication varies from person to person and must be adjusted to individual circumstances. In milder cases, the tics can be well controlled. In severe cases, other treatment methods may have to be used. In the meantime, deep brain stimulation is used as a surgical method for Tourette’s syndrome in Germany. This involves a so-called brain pacemaker, which promises good success in combating the disease. Other therapies include relaxation techniques such as autogenic training, stress reduction training and other behavioral therapies. Although these do not eliminate the cause of coprolalia, they can reduce triggering stress factors. Behavioral therapies may include improving the patient’s self-control. For example, he can learn to counter the tic with a generally accepted alternative behavior. In the case of other causes of coprolalia, such as brain tumors or brain inflammation, even the underlying condition can often be successfully addressed. Therefore, when a sudden personality change occurs, it is very important to take extensive diagnostic measures to determine its cause.
Outlook and prognosis
Due to coprolalia, the patient’s daily life becomes extremely limited.Unfortunately, the disease often leads to a lack of understanding, because other people from everyday life are not informed about the disease. Coprolalia can therefore lead to social exclusion. Especially children are sometimes bullied or teased because of the symptom, so that it can lead to psychological problems and depression. Obscene gestures can, in the worst case, also lead to violence by other people, so that injuries can result. The affected person often appears irritable, aggressive and changes his personality. The family or the partner of the affected person sometimes also suffer extremely from coprolalia. Treatment is possible with the help of medication or through surgery. Since the surgery is performed on the brain, there may be complications in the course of the surgery and healing. Likewise, training by a speech coach or a psychologist is possible to limit coprolalia. The patient’s self-control can be restored in behavioral therapies. However, complete cure of coprolalia occurs only in rare cases. Since stress has a negative effect on coprolalia, it should be avoided at all costs so as not to strengthen the symptom.
Prevention
There is no prevention from coprolalia. The psychological changes can be due to many causes. However, a healthy lifestyle with little stress is always recommended. There is often a hereditary component underlying the condition.
What you can do yourself
Coprolalia can only be treated at home to a very limited extent. In most cases, contact with other people or taking medication is necessary. The affected person should in any case be educated and also tell his friends, acquaintances and partner about the symptom. In this way, unpleasant and, above all, misunderstood situations can be avoided. In general, the affected person must take care to avoid stressful situations and discussions or arguments. This can greatly limit the coprolalia. In any case, the people around must understand that the words are not personal insults. In many cases coprolalia can be treated with the help of music. In this case, not only listening to music helps, but also directly playing music on an instrument. Practicing the sense of time and scales can be very effective. The patient can choose an instrument of his choice, in this case there are no preferred musical instruments. In any case, relaxation helps with coprolalia. This should be done not only on the physical level, but also on the psychological level. In general, a healthy lifestyle has a positive effect on coprolalia. Sports activities can also limit coprolalia.
