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Love S, Kannis-Dymand L, Armstrong K. Development and validation of a Disorganised Thoughts Scale: a new measure to assess thinking difficulties in the general population. BMC Psychol 2024; 12:492. [PMID: 39300589 PMCID: PMC11412006 DOI: 10.1186/s40359-024-01988-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 09/06/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Disordered thinking is a condition that can manifest in not only clinical cases (e.g., psychotic disorders), but also the wider general population. However, there is no current method to measure the specific cognitive processes experienced during such a condition. Therefore, this study aimed to develop a new self-report measure, the Disorganised Thoughts Scale (DTS), that can assess disorganised thinking in the general population. METHODS To achieve this aim, a survey was developed and shared online with four independent samples, including a sample of Australians in the general population (N = 321) and three samples (N = 200 each) that were controlled for their substance use (i.e., frequent alcohol and cannabis use; non-frequent substance use). Exploratory and confirmatory factor analyses, and reliability analyses, were used to test the internal validity, whilst correlational analyses were implemented to examine the external validity. RESULTS The exploratory factor analysis revealed a two-factor structure (10 items each) measuring Positive thought disorder (i.e., accelerated, uncontrollable, and incongruent thinking) and Negative thought disorder (i.e., inhibited, disjointed, and disorientated thinking). This internal structure was confirmed with subsequent confirmatory factor and reliability analyses (α = 0.90 to 0.97) in the three substance-controlled groups. Concurrent validity was also supported, as the DTS exhibited strong correlations with established measures of general cognitive difficulties, specific self-regulatory dysfunctions, and psychopathological symptomology. Finally, the measure was also shown to be significantly higher in cohorts who exhibited a higher degree of psychological distress and who frequently used substances (i.e., alcohol and cannabis). CONCLUSIONS Overall, this study provided preliminary evidence to suggest that the DTS is a sound measure of disorganised thought that is linked to psychopathology and substance use in non-clinical populations. The measure could be used in future research which seeks to better understand how thinking effects, and is affected by, various psychological conditions.
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Affiliation(s)
- Steven Love
- MAIC/UniSC Road Safety Research Collaboration, School of Law and Society, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland, 4556, Australia.
| | - Lee Kannis-Dymand
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland, 4556, Australia
| | - Kerry Armstrong
- MAIC/UniSC Road Safety Research Collaboration, School of Law and Society, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland, 4556, Australia
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Kizilay E, Arslan B, Verim B, Demirlek C, Demir M, Cesim E, Eyuboglu MS, Uzman Ozbek S, Sut E, Yalincetin B, Bora E. Automated linguistic analysis in youth at clinical high risk for psychosis. Schizophr Res 2024; 274:121-128. [PMID: 39293249 DOI: 10.1016/j.schres.2024.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 08/26/2024] [Accepted: 09/06/2024] [Indexed: 09/20/2024]
Abstract
Identifying individuals at clinical high risk for psychosis (CHRP) is crucial for preventing psychosis and improving the prognosis for schizophrenia. Individuals at CHR-P may exhibit mild forms of formal thought disorder (FTD), making it possible to identify them using natural language processing (NLP) methods. In this study, speech samples of 62 CHR-P individuals and 45 healthy controls (HCs) were elicited using Thematic Apperception Test images. The evaluation involved various NLP measures such as semantic similarity, generic, and part-of-speech (POS) features. The CHR-P group demonstrated higher sentence-level semantic similarity and reduced mean image-to-text similarity. Regarding generic analysis, they demonstrated reduced verbosity and produced shorter sentences with shorter words. The POS analysis revealed a decrease in the utilization of adverbs, conjunctions, and first-person singular pronouns, alongside an increase in the utilization of adjectives in the CHR-P group compared to HC. In addition, we developed a machine-learning model based on 30 NLP-derived features to distinguish between the CHR-P and HC groups. The model demonstrated an accuracy of 79.6 % and an AUC-ROC of 0.86. Overall, these findings suggest that automated language analysis of speech could provide valuable information for characterizing FTD during the clinical high-risk phase and has the potential to be applied objectively for early intervention for psychosis.
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Affiliation(s)
- Elif Kizilay
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey.
| | - Berat Arslan
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Burcu Verim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Cemal Demirlek
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - Muhammed Demir
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Ezgi Cesim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Merve Sumeyye Eyuboglu
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Simge Uzman Ozbek
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ekin Sut
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Berna Yalincetin
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - Emre Bora
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia
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3
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Skiba RM, Chinchani AM, Menon M, Lepage M, Lavigne KM, Malla A, Joober R, Goldberg JO, Heinrichs RW, Castle DJ, Burns A, Best MW, Rossell SL, Walther S, Woodward TS. Overlap between individual differences in cognition and symptoms of schizophrenia. Schizophr Res 2024; 270:220-228. [PMID: 38924940 DOI: 10.1016/j.schres.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Neurocognitive impairment is a core feature of schizophrenia spectrum disorders (SSDs), and the relationship between cognition and symptoms in SSDs has been widely researched. Negative symptoms are related to a wide range of cognitive impairments; however, the aspects of negative symptoms that underpin this relationship have yet to be specified. STUDY DESIGN We used iterative Constrained Principal Component Analysis (iCPCA) to explore the relationship between 18 cognitive measures (including processing speed, attention, working, spatial and verbal memory and executive functions) and 46 symptoms in schizophrenia at the individual item level while minimizing the risk of Type I errors. ICPCA was conducted on a sample of SSD patients in the early stages of psychiatric treatment (n = 121) to determine the components of cognition overlapping with symptoms measured by the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS). RESULTS We found that a verbal memory component was associated with items from SANS and SAPS related to impoverished and disorganized emotional communication, language, and thought. In contrast, a working memory component was associated with SANS items related to motor system impoverishment. CONCLUSIONS The iCPCA allowed us to explore the associations between individual items, optimized to understand the overlap between symptoms and cognition. The specific symptoms linked to verbal and working memory impairments imply distinct brain networks, which further investigation may lead to our deeper understanding of the illness and the development of treatment methods.
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Affiliation(s)
- Rafal M Skiba
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Abhijit M Chinchani
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada; Department of Bioinformatics, University of British Columbia, Vancouver, Canada
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, McGill University, Montreal, Qc, Canada; Department of Psychiatry, McGill University, Montreal, Qc, Canada
| | - Katie M Lavigne
- Douglas Mental Health University Institute, McGill University, Montreal, Qc, Canada; Department of Psychiatry, McGill University, Montreal, Qc, Canada
| | - Ashok Malla
- Douglas Mental Health University Institute, McGill University, Montreal, Qc, Canada; Department of Psychiatry, McGill University, Montreal, Qc, Canada
| | - Ridha Joober
- Douglas Mental Health University Institute, McGill University, Montreal, Qc, Canada; Department of Psychiatry, McGill University, Montreal, Qc, Canada
| | - Joel O Goldberg
- Department of Psychology, York University, Toronto, ON, Canada
| | | | - David J Castle
- Department of Psychiatry, University of Tasmania, Hobart, TAS, Australia
| | - Amy Burns
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Michael W Best
- Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Todd S Woodward
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada; Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
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Peng Z, Li Q, Liu X, Zhang H, Luosang-Zhuoma, Ran M, Liu M, Tan X, Stein MJ. A new schizophrenia screening instrument based on evaluating the patient's writing. Schizophr Res 2024; 266:127-135. [PMID: 38401411 DOI: 10.1016/j.schres.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 01/18/2024] [Accepted: 02/10/2024] [Indexed: 02/26/2024]
Abstract
Formal Thought Disorder (FTD) is a defining feature of schizophrenia, which is often assessed through patients' speech. Meanwhile, the written language is less studied. The aim of the present study is to establish and validate a comprehensive clinical screening scale, capturing the full variety of empirical characteristics of writing in patients with schizophrenia. The 16-item Screening Instrument for Schizophrenic Features in Writing (SISFiW) is derived from detailed literature review and a "brainstorming" discussion on 30 samples written by patients with schizophrenia. One hundred and fifty-seven participants (114 patients with an ICD-10 diagnoses of schizophrenia; 43 healthy control subjects) were interviewed and symptoms assessed with the Positive and Negative Syndrome Scale (PANSS) and the Scale for the Assessment of Thought, Language, and Communication (TLC). Article samples written by each participant were rated with the SISFiW. Results demonstrated significant difference of the SISFiW-total between the patient group and healthy controls [(3.61 ± 1.72) vs. (0.49 ± 0.63), t = 16.64, p<0.001]. The inter-rater reliability (weighted kappa = 0.72) and the internal consistency (Cronbach's alpha coefficient = 0.613) were acceptable, but correlations with the criterion (PANSS and TLC) were unremarkable. The ROC analysis indicated a cutoff point at 2 with the maximal sensitivity (93.0 %)/specificity (93.0 %). Discriminant analysis of the SISFiW items yielded 8 classifiers that discriminated between the diagnostic groups at a perfect overall performance (with 90.4 % of original and 88.5 % cross-validated grouped cases classified correctly). This instrument appears to be practicable and reliable, with relatively robust discriminatory power, and may serve as a complementary tool to existing FTD rating scales.
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Affiliation(s)
- Zulai Peng
- Chongqing Mental Health Center, Chongqing, China; Affiliated Hospital of Southwest University, Chongqing, China
| | - Qingjun Li
- Chongqing Mental Health Center, Chongqing, China; Affiliated Hospital of Southwest University, Chongqing, China
| | - Xinglan Liu
- Chongqing Mental Health Center, Chongqing, China; Affiliated Hospital of Southwest University, Chongqing, China
| | - Huangzhiheng Zhang
- Chongqing Mental Health Center, Chongqing, China; Affiliated Hospital of Southwest University, Chongqing, China
| | - Luosang-Zhuoma
- Chongqing Mental Health Center, Chongqing, China; Affiliated Hospital of Southwest University, Chongqing, China
| | - Manli Ran
- Chongqing Mental Health Center, Chongqing, China; Affiliated Hospital of Southwest University, Chongqing, China
| | - Maohang Liu
- Chongqing Mental Health Center, Chongqing, China; Affiliated Hospital of Southwest University, Chongqing, China
| | - Xiaolin Tan
- Chongqing Mental Health Center, Chongqing, China; Affiliated Hospital of Southwest University, Chongqing, China.
| | - Mark J Stein
- Chongqing Mental Health Center, Chongqing, China; Affiliated Hospital of Southwest University, Chongqing, China
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Zamperoni G, Tan EJ, Rossell SL, Meyer D, Sumner PJ. Evidence for the factor structure of formal thought disorder: A systematic review. Schizophr Res 2024; 264:424-434. [PMID: 38244319 DOI: 10.1016/j.schres.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/14/2023] [Accepted: 01/01/2024] [Indexed: 01/22/2024]
Abstract
Disorganised speech, or, formal thought disorder (FTD), is considered one of the core features of psychosis, yet its factor structure remains debated. This systematic review aimed to identify the core dimensions of FTD. In line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), a systematic review was conducted on the FTD factor analytic literature. Sixteen studies were identified from PsycINFO, PubMed and Web of Science between October 1971 and January 2023. Across the 39 factor analyses investigated, findings demonstrated the prominence of a three-factor structure. Broad agreement was found for two factors within the three-factor model, which were typically referred to as disorganisation and negative, with the exact nature of the third dimension requiring further clarification. The quality assessment revealed some methodological challenges relating to the assessment of FTD and conducted factor analyses. Future research should clarify the exact nature of the third dimension across different patient groups and methodologies to determine whether a consistent transdiagnostic concept of FTD can be elucidated.
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Affiliation(s)
- Georgia Zamperoni
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, VIC 3122, Australia.
| | - Eric J Tan
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, VIC 3122, Australia; Memory Ageing & Cognition Centre, National University Health System, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Susan L Rossell
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, VIC 3122, Australia; Department of Psychiatry, St Vincent's Hospital, VIC 3065, Australia
| | - Denny Meyer
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, VIC 3122, Australia; Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, VIC 3122, Australia
| | - Philip J Sumner
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, VIC 3122, Australia
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6
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Pilon F, Boisvert M, Potvin S. Losing the chain of thought: A meta-analysis of functional neuroimaging studies using verbal tasks in schizophrenia. J Psychiatr Res 2024; 169:238-246. [PMID: 38048673 DOI: 10.1016/j.jpsychires.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 10/30/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Disorganization symptoms are a main feature of schizophrenia, which include illogical and incoherent thinking, circumstantiality, tangentiality and loose associations. As these symptoms entail language deficits, several functional neuroimaging studies have been performed in schizophrenia using verbal tasks, producing somewhat heterogenous results. Hence, we performed a meta-analysis seeking to identify the most reliable neural alterations observed in schizophrenia patients during such tasks. METHODS Web of Sciences, PubMed, and EMBASE were searched for functional neuroimaging studies during verbal tasks (e.g. verbal fluency and semantic processing) in schizophrenia. Out of 795 screened articles, 33 were eligible for this meta-analysis. A coordinated-based meta-analysis was performed with the activation likelihood estimation (ALE) approach, using the cluster-level family-wise error (FWE) correction set at p < 0.05. RESULTS In schizophrenia, hyperactivations were observed in the left inferior frontal gyrus (IFG) and middle frontal gyrus (MFG) and hypoactivations were observed in the right IFG, the precentral gyrus and the left caudate nucleus. Another analysis pooling hyper- and hypoactivations revealed altered activations, firstly, in the left IFG and MFG, secondly, in the left precentral gyrus, IFG and insula, and, thirdly, in the left angular gyrus and precuneus. In the light of these results, not only classic language-related regions are abnormally activated during verbal tasks in schizophrenia, but also brain regions involved in executive functions, autobiographical memory and, unexpectedly, in motor functions. Further functional neuroimaging studies are needed to investigate the role of the striatum in linguistic sequencing in schizophrenia.
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Affiliation(s)
- Florence Pilon
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Mélanie Boisvert
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Stéphane Potvin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
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7
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Xiang LS, Zhang Y, Xie F, Fei X, Wang Y, Shi Y. Reliability and validity of the Cognitive Assessment for Stroke Patients (Chinese version) for patients with nonaphasic stroke. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 38104350 DOI: 10.1080/23279095.2023.2292236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
This study aimed to preliminarily explore the reliability and validity of the Chinese version of the Cognitive Assessment for Stroke Patients (CASP) in patients with nonaphasic stroke and provide a reliable basis for its clinical application in China. The original French version of the CASP was translated into Mandarin Chinese. The study enrolled 58 patients in the neurological center. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and CASP were used to evaluate cognitive function. Content validity, structural validity, and concurrent validity, internal consistency, interrater consistency, and retesting reliability were used to evaluate the results. The Spearman correlation coefficient of each item and the total CASP score was between 0.320 and 0.905 (p < .05), showing good content validity. Two initial factors were extracted using principal component analysis and the orthogonal rotation method, with a cumulative contribution rate of 70.100%. Except for the subitem reproducing a copy of a cube, the factor loading of all subitems was >0.5, indicating good construct validity. The total CASP score significantly correlated with the total MMSE (r = 0.796, p < .001) and total MoCA (r = 0.816, p < .001) scores, indicating good concurrent validity. Cronbach's α of the CASP was 0.812, showing good internal consistency. The interrater consistency (ICC > 0.85) and retesting reliability (ICC = 0.7-0.951) were good. The Chinese version of the CASP has good reliability and validity and can play a good auxiliary role in evaluating cognitive dysfunction in patients with stroke.
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Affiliation(s)
- Li-Sha Xiang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Department of Rehabilitation Medicine, School of Clinical Medicine, Soochow University, Soochow, China
| | - Yi Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Fan Xie
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiao Fei
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ya Wang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yue Shi
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
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Liebenthal E, Ennis M, Rahimi-Eichi H, Lin E, Chung Y, Baker JT. Linguistic and non-linguistic markers of disorganization in psychotic illness. Schizophr Res 2023; 259:111-120. [PMID: 36564239 PMCID: PMC10282106 DOI: 10.1016/j.schres.2022.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Disorganization, presenting as impairment in thought, language and goal-directed behavior, is a core multidimensional syndrome of psychotic disorders. This study examined whether scalable computational measures of spoken language, and smartphone usage pattern, could serve as digital biomarkers of clinical disorganization symptoms. METHODS We examined in a longitudinal cohort of adults with a psychotic disorder, the associations between clinical measures of disorganization and computational measures of 1) spoken language derived from monthly, semi-structured, recorded clinical interviews; and 2) smartphone usage pattern derived via passive sensing technologies over the month prior to the interview. The language features included speech quantity, rate, fluency, and semantic regularity. The smartphone features included data missingness and phone usage during sleep time. The clinical measures consisted of the Positive and Negative Symptom Scale (PANSS) conceptual disorganization, difficulty in abstract thinking, and poor attention, items. Mixed linear regression analyses were used to estimate both fixed and random effects. RESULTS Greater severity of clinical symptoms of conceptual disorganization was associated with greater verbosity and more disfluent speech. Greater severity of conceptual disorganization was also associated with greater missingness of smartphone data, and greater smartphone usage during sleep time. While the observed associations were significant across the group, there was also significant variation between individuals. CONCLUSIONS The findings suggest that digital measures of speech disfluency may serve as scalable markers of conceptual disorganization. The findings warrant further investigation into the use of recorded interviews and passive sensing technologies to assist in the characterization and tracking of psychotic illness.
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Affiliation(s)
- Einat Liebenthal
- McLean Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Michaela Ennis
- McLean Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; Division of Medical Sciences, Harvard Medical School, Boston, MA, USA
| | - Habiballah Rahimi-Eichi
- McLean Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Eric Lin
- McLean Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; Medical Informatics, Veterans Affairs Boston, Boston, MA, USA
| | - Yoonho Chung
- McLean Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Justin T Baker
- McLean Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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9
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Schneider K, Leinweber K, Jamalabadi H, Teutenberg L, Brosch K, Pfarr JK, Thomas-Odenthal F, Usemann P, Wroblewski A, Straube B, Alexander N, Nenadić I, Jansen A, Krug A, Dannlowski U, Kircher T, Nagels A, Stein F. Syntactic complexity and diversity of spontaneous speech production in schizophrenia spectrum and major depressive disorders. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:35. [PMID: 37248240 DOI: 10.1038/s41537-023-00359-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/25/2023] [Indexed: 05/31/2023]
Abstract
Syntax, the grammatical structure of sentences, is a fundamental aspect of language. It remains debated whether reduced syntactic complexity is unique to schizophrenia spectrum disorder (SSD) or whether it is also present in major depressive disorder (MDD). Furthermore, the association of syntax (including syntactic complexity and diversity) with language-related neuropsychology and psychopathological symptoms across disorders remains unclear. Thirty-four SSD patients and thirty-eight MDD patients diagnosed according to DSM-IV-TR as well as forty healthy controls (HC) were included and tasked with describing four pictures from the Thematic Apperception Test. We analyzed the produced speech regarding its syntax delineating measures for syntactic complexity (the total number of main clauses embedding subordinate clauses) and diversity (number of different types of complex sentences). We performed cluster analysis to identify clusters based on syntax and investigated associations of syntactic, to language-related neuropsychological (verbal fluency and verbal episodic memory), and psychopathological measures (positive and negative formal thought disorder) using network analyses. Syntax in SSD was significantly reduced in comparison to MDD and HC, whereas the comparison of HC and MDD revealed no significant differences. No associations were present between speech measures and current medication, duration and severity of illness, age or sex; the single association accounted for was education. A cluster analysis resulted in four clusters with different degrees of syntax across diagnoses. Subjects with less syntax exhibited pronounced positive and negative symptoms and displayed poorer performance in executive functioning, global functioning, and verbal episodic memory. All cluster-based networks indicated varying degrees of domain-specific and cross-domain connections. Measures of syntactic complexity were closely related while syntactic diversity appeared to be a separate node outside of the syntactic network. Cross-domain associations were more salient in more complex syntactic production.
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Affiliation(s)
- Katharina Schneider
- Department of English and Linguistics, General Linguistics, University of Mainz, Mainz, Germany.
| | - Katrin Leinweber
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Hamidreza Jamalabadi
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Lea Teutenberg
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Florian Thomas-Odenthal
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Paula Usemann
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Nina Alexander
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Arne Nagels
- Department of English and Linguistics, General Linguistics, University of Mainz, Mainz, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
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10
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Bora E, Verim B, Akgul O, Ildız A, Ceylan D, Alptekin K, Özerdem A, Akdede BB. Clinical and developmental characteristics of cognitive subgroups in a transdiagnostic sample of schizophrenia spectrum disorders and bipolar disorder. Eur Neuropsychopharmacol 2023; 68:47-56. [PMID: 36640733 DOI: 10.1016/j.euroneuro.2022.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023]
Abstract
Evidence suggests that neurocognitive dysfunction is a transdiagnostic feature of individuals across the continuum between schizophrenia and bipolar disorder. However, there is significant heterogeneity of neuropsychological and social-cognitive abilities in schizophrenia, schizoaffective disorder, and bipolar disorder. The current study aimed to investigate the clinical and developmental characteristics of cognitive subgroups within the schizo-bipolar spectrum. 147 clinically stable patients with schizophrenia, schizoaffective or bipolar disorder were assessed using clinical rating scales for current psychotic and affective symptoms, and a comprehensive neuropsychological battery including measures of social cognition (Hinting and Reading the mind from the Eyes (RMET) task)). Developmental history and premorbid academic functioning were also evaluated. The study also included 36 healthy controls. Neurocognitive subgroups were investigated using latent class analysis (LCA). The optimal number of clusters was determined based on the Bayesian information criterion. A logistic regression analysis was conducted to investigate the predictors of membership to the globally impaired subgroup. LCA revealed two neurocognitive clusters including globally impaired (n = 89, 60.5%) and near-normal cognitive functioning (n = 58, 39.5%) subgroups. The near-normal cognitive functioning subgroup was not significantly different from healthy controls. The globally impaired subgroup had a higher score of developmental abnormalities (p<0.001), poorer premorbid academic functioning, mothers who were less educated and more severe disorganized speech (p = 0.001) and negative symptoms (p = 0.004) compared to the near-normal cognitive functioning group. History of developmental abnormalities and persistent disorganization rather than diagnosis are significant predictors of the subgroup of individuals with global cognitive impairment in the schizophrenia-bipolar disorder continuum.
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Affiliation(s)
- Emre Bora
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey.
| | - Burcu Verim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Ozge Akgul
- Department of Psychology, İzmir Demokrasi University, İzmir, Turkey
| | - Ayşegül Ildız
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Deniz Ceylan
- Department of Psychiatry and Psychology, Koc University, Istanbul, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Ayşegül Özerdem
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
| | - Berna Binnur Akdede
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
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11
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Myers EJ, Abel DB, Hardin KL, Bettis RJ, Beard AM, Salyers MP, Lysaker PH, Minor KS. Mild vs. moderate: How behavioral speech measures predict metacognitive capacity across different levels of formal thought disorder. J Psychiatr Res 2023; 157:43-49. [PMID: 36436427 PMCID: PMC9898140 DOI: 10.1016/j.jpsychires.2022.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/21/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
Disorganized speech is a key component of formal thought disorder (FTD) in schizophrenia. Recent work has tied disorganized speech to deficits in metacognition, or one's ability to integrate experiences to form complex mental representations. The level of FTD at which differences in metacognitive capacity emerge remains unclear. Across two studies, using different cut scores to form FTD groups, we aimed to 1) explore the relationship between disorganized speech and metacognition and 2) compare trained rater and automated analysis methods. Clinical interviews were coded for disorganized speech and metacognition using the Communication Disturbances Index (CDI), Coh-Metrix multidimensional indices, and Metacognition Assessment Scale. In Study 1, we examined CDI and Coh-Metrix's ability to predict metacognition in FTD (n = 16) and non-FTD (n = 29) groups. We hypothesized the FTD group would have lower metacognition and that both CDI and Coh-Metrix would account for significant variance in metacognition. In Study 2, we conducted the same analyses with an independent sample using more stringent FTD cut scores (FTD: n = 23; non-FTD: n = 23). Analyses indicated that at a moderate but not mild cutoff: 1) automated methods differentiated FTD and non-FTD groups, 2) differences in metacognition emerged, and 3) behavioral measures accounted for significant variance (34%) in metacognition. Results emphasize the importance of setting the FTD cutoff at a moderate level and using samples that contain high levels of FTD. Findings extend research linking FTD and metacognition and demonstrate the benefit of pairing trained rater and automated speech measures.
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Affiliation(s)
- Evan J Myers
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, United States.
| | - Danielle B Abel
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, United States.
| | - Kathryn L Hardin
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, United States.
| | - Robert J Bettis
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, United States.
| | - Ashlynn M Beard
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, United States.
| | - Michelle P Salyers
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, United States.
| | - Paul H Lysaker
- Richard L. Roudebush VA Medical Center, Department of Psychiatry, Indianapolis, IN, United States; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States.
| | - Kyle S Minor
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, United States.
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12
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Chang X, Zhao W, Kang J, Xiang S, Xie C, Corona-Hernández H, Palaniyappan L, Feng J. Language abnormalities in schizophrenia: binding core symptoms through contemporary empirical evidence. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:95. [PMID: 36371445 PMCID: PMC9653408 DOI: 10.1038/s41537-022-00308-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Both the ability to speak and to infer complex linguistic messages from sounds have been claimed as uniquely human phenomena. In schizophrenia, formal thought disorder (FTD) and auditory verbal hallucinations (AVHs) are manifestations respectively relating to concrete disruptions of those abilities. From an evolutionary perspective, Crow (1997) proposed that "schizophrenia is the price that Homo sapiens pays for the faculty of language". Epidemiological and experimental evidence points to an overlap between FTD and AVHs, yet a thorough investigation examining their shared neural mechanism in schizophrenia is lacking. In this review, we synthesize observations from three key domains. First, neuroanatomical evidence indicates substantial shared abnormalities in language-processing regions between FTD and AVHs, even in the early phases of schizophrenia. Second, neurochemical studies point to a glutamate-related dysfunction in these language-processing brain regions, contributing to verbal production deficits. Third, genetic findings further show how genes that overlap between schizophrenia and language disorders influence neurodevelopment and neurotransmission. We argue that these observations converge into the possibility that a glutamatergic dysfunction in language-processing brain regions might be a shared neural basis of both FTD and AVHs. Investigations of language pathology in schizophrenia could facilitate the development of diagnostic tools and treatments, so we call for multilevel confirmatory analyses focused on modulations of the language network as a therapeutic goal in schizophrenia.
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Affiliation(s)
- Xiao Chang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Wei Zhao
- MOE-LCSM, School of Mathematics and Statistics, Hunan Normal University, Changsha, PR China
| | - Jujiao Kang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- Shanghai Center for Mathematical Sciences, Shanghai, China
| | - Shitong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Chao Xie
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Hugo Corona-Hernández
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada.
- Lawson Health Research Institute, London, Ontario, Canada.
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Zhangjiang Fudan International Innovation Center, Shanghai, China.
- Shanghai Center for Mathematical Sciences, Shanghai, China.
- Department of Computer Science, University of Warwick, Coventry, UK.
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13
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Positiv psychotische Symptome in Kindheit und Jugend. Prax Kinderpsychol Kinderpsychiatr 2022; 71:640-657. [DOI: 10.13109/prkk.2022.71.7.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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14
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Zhang J, Yang H, Li W, Li Y, Qin J, He L. Automatic Schizophrenia Detection Using Multimodality Media via a Text Reading Task. Front Neurosci 2022; 16:933049. [PMID: 35911987 PMCID: PMC9331283 DOI: 10.3389/fnins.2022.933049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Schizophrenia is a crippling chronic mental disease that affects people worldwide. In this work, an automatic schizophrenia detection algorithm is proposed based on the reading deficit of schizophrenic patients. From speech and video modalities, the automatic schizophrenia detection algorithm illustrates abnormal speech, head movement, and reading fluency during the reading task. In the speech modality, an acoustic model of speech emotional flatness in schizophrenia is established to reflect the emotional expression flatness of schizophrenic speech from the perspective of speech production and perception. In the video modality, the head-movement-related features are proposed to illustrate the spontaneous head movement caused by repeated reading and unconscious movement, and the reading-fluency-related features are proposed to convey the damaged degree of schizophrenic patients' reading fluency. The experimental data of this work are 160 segments of speech and video data recorded by 40 participants (20 schizophrenic patients and 20 normal controls). Combined with support vector machines and random forest, the accuracy of the proposed acoustic model, the head-movement-related features, and the reading-fluency-related features range from 94.38 to 96.50%, 73.38 to 83.38%, and 79.50 to 83.63%, respectively. The average accuracy of the proposed automatic schizophrenia detection algorithm reaches 97.50%. The experimental results indicate the effectiveness of the proposed automatic detection algorithm as an auxiliary diagnostic method for schizophrenia.
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Affiliation(s)
- Jing Zhang
- College of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Hui Yang
- College of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Wen Li
- College of Biomedical Engineering, Sichuan University, Chengdu, China
| | - Yuanyuan Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Qin
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Ling He
- College of Biomedical Engineering, Sichuan University, Chengdu, China
- *Correspondence: Ling He
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15
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Semantic processing features and schizotypal traits: A test-retest study. Int J Psychophysiol 2022; 178:1-8. [DOI: 10.1016/j.ijpsycho.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022]
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16
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Morán-Kneer J, Ríos U, Costa-Cordella S, Barría C, Carvajal V, Valenzuela K, Wasserman D. Childhood Trauma and Social Cognition in participants with Bipolar Disorder: The Moderating Role of Attachment. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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17
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Schultze-Lutter F, Kindler J, Ambarini TK, Michel C. Positive psychotic symptoms in childhood and adolescence. Curr Opin Psychol 2021; 45:101287. [PMID: 35016089 DOI: 10.1016/j.copsyc.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/21/2021] [Accepted: 11/24/2021] [Indexed: 11/30/2022]
Abstract
Based on the assumption of a universal neurodevelopmental model of psychosis, especially of the schizophrenia spectrum, the diagnosis (and treatment) of psychosis in minors commonly follows those in adults. Yet, as our review demonstrates, recent years have seen an emergence of studies of minors indicating that developmental aspects may play a crucial role in the prevalence and appraisal of diagnostically relevant positive psychotic symptoms in their full-blown and subthreshold forms, including neurobiogenetic and other risk factors, such as migration. Thus, caution is advised to not overpathologize potentially transient and clinically irrelevant occurrence of (subthreshold) positive psychotic symptoms in the diagnosis and treatment of psychotic disorders and their clinical high-risk states in minors. More studies on developmental aspects are urgently needed.
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Affiliation(s)
- Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, Bergische Landstraße 2, 40470 Düsseldorf, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstr, 111, 3000 Bern 60, Switzerland; Department of Psychology, Faculty of Psychology, Airlangga University, Airlangga 4-6, Surabaya 60286, Indonesia.
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstr, 111, 3000 Bern 60, Switzerland
| | - Tri Kurniati Ambarini
- Department of Psychology, Faculty of Psychology, Airlangga University, Airlangga 4-6, Surabaya 60286, Indonesia
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstr, 111, 3000 Bern 60, Switzerland
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18
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Tan EJ, Meyer D, Neill E, Rossell SL. Investigating the diagnostic utility of speech patterns in schizophrenia and their symptom associations. Schizophr Res 2021; 238:91-98. [PMID: 34649084 DOI: 10.1016/j.schres.2021.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 09/19/2021] [Accepted: 10/03/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Speech disturbances are a recognised aspect of schizophrenia that may have potential utility as a diagnostic indicator. Recent advances in quantitative speech assessment methods have led to more reproducible and precise metrics making this possible. The current study sought firstly to characterise the speech profile of schizophrenia patients using quantitative speech measures, then examine the diagnostic utility of these measures and explore their relationship to symptoms. METHODS Speech recordings from 43 schizophrenia/schizoaffective disorder (SZ) patients and 46 healthy controls (HC) were obtained and transcribed. Cognitive and symptom measures were also administered. RESULTS Compared to HCs, SZ patients had higher incidences of aberrance across five types of quantitative speech variables: utterances, single words, time/speaking rate, turns and formulation errors, but not pauses. Based on two machine learning algorithms, 21 speech variables across the same five speech variable types (again not including pauses) were identified as significant classifiers for a schizophrenia diagnosis with 90-100% specificity and 80-90% sensitivity for both models. Selective relationships were also observed between these speech variables and only positive, disorganisation, excitement and formal thought disorder symptoms. CONCLUSIONS The findings support pervasive speech impairments in schizophrenia patients relative to HCs, and the potential diagnostic utility of these speech disturbances. Continued work is needed to build the evidence base for quantitative speech assessment as a future objective diagnostic tool for schizophrenia. It holds the promise of improved diagnostic accuracy leading to increased treatment efficacy and better patient outcomes.
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Affiliation(s)
- Eric J Tan
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia; Department of Psychiatry, St. Vincent's Hospital, Melbourne, Australia.
| | - Denny Meyer
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Erica Neill
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia; Department of Psychiatry, St. Vincent's Hospital, Melbourne, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia; Department of Psychiatry, St. Vincent's Hospital, Melbourne, Australia
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19
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Fuentes-Claramonte P, López-Araquistain L, Sarró S, Sans-Sansa B, Ortiz-Gil J, Maristany T, Salvador R, McKenna PJ, Pomarol-Clotet E. Brain functional correlates of formal thought disorder in schizophrenia: examining the frontal/dysexecutive hypothesis. Psychol Med 2021; 51:2446-2453. [PMID: 32338241 DOI: 10.1017/s0033291720001063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND One hypothesis proposed to underlie formal thought disorder (FTD), the incoherent speech is seen in some patients with schizophrenia, is that it reflects impairment in frontal/executive function. While this proposal has received support in neuropsychological studies, it has been relatively little tested using functional imaging. This study aimed to examine brain activations associated with FTD, and its two main factor-analytically derived subsyndromes, during the performance of a working memory task. METHODS Seventy patients with schizophrenia showing a full range of FTD scores and 70 matched healthy controls underwent fMRI during the performance of the 2-back version of the n-back task. Whole-brain corrected, voxel-based correlations with FTD scores were examined in the patient group. RESULTS During 2-back performance the patients showed clusters of significant inverse correlation with FTD scores in the inferior frontal cortex and dorsolateral prefrontal cortex bilaterally, the left temporal cortex and subcortically in the basal ganglia and thalamus. Further analysis revealed that these correlations reflected an association only with 'alogia' (poverty of speech, poverty of content of speech and perseveration) and not with the 'fluent disorganization' component of FTD. CONCLUSIONS This study provides functional imaging support for the view that FTD in schizophrenia may involve impaired executive/frontal function. However, the relationship appears to be exclusively with alogia and not with the variables contributing to fluent disorganization.
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Affiliation(s)
- P Fuentes-Claramonte
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Spain
| | | | - S Sarró
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Spain
| | - B Sans-Sansa
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - J Ortiz-Gil
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Spain
- Hospital de Granollers, Spain
| | | | - R Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Spain
| | - P J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Spain
| | - E Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- CIBERSAM, Spain
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20
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Implications for Early Diagnosis and Treatment in Schizophrenia Due to Correlation between Auditory Perceptual Deficits and Cognitive Impairment. J Clin Med 2021; 10:jcm10194557. [PMID: 34640571 PMCID: PMC8509531 DOI: 10.3390/jcm10194557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
It is indicated that auditory perception deficits are present in schizophrenia and related to formal thought disorder. The purpose of the present study was to investigate the association of auditory deficits with cognitive impairment in schizophrenia. An experimental group of 50 schizophrenia patients completed a battery of auditory processing evaluation and a neuropsychological battery of tests. Correlations between neuropsychological battery scores and auditory processing scores were examined. Cognitive impairment was correlated with auditory processing deficits in schizophrenia patients. All neuropsychological test scores were significantly correlated with at least one auditory processing test score. Our findings support the coexistence of auditory processing disorder, severe cognitive impairment, and formal thought disorder in a subgroup of schizophrenia patients. This may have important implications in schizophrenia research, as well as in early diagnosis and nonpharmacological treatment of the disorder.
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21
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Palaniyappan L. Dissecting the neurobiology of linguistic disorganisation and impoverishment in schizophrenia. Semin Cell Dev Biol 2021; 129:47-60. [PMID: 34507903 DOI: 10.1016/j.semcdb.2021.08.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/13/2021] [Accepted: 05/06/2021] [Indexed: 12/16/2022]
Abstract
Schizophrenia provides a quintessential disease model of how disturbances in the molecular mechanisms of neurodevelopment lead to disruptions in the emergence of cognition. The central and often persistent feature of this illness is the disorganisation and impoverishment of language and related expressive behaviours. Though clinically more prominent, the periodic perceptual distortions characterised as psychosis are non-specific and often episodic. While several insights into psychosis have been gained based on study of the dopaminergic system, the mechanistic basis of linguistic disorganisation and impoverishment is still elusive. Key findings from cellular to systems-level studies highlight the role of ubiquitous, inhibitory processes in language production. Dysregulation of these processes at critical time periods, in key brain areas, provides a surprisingly parsimonious account of linguistic disorganisation and impoverishment in schizophrenia. This review links the notion of excitatory/inhibitory (E/I) imbalance at cortical microcircuits to the expression of language behaviour characteristic of schizophrenia, through the building blocks of neurochemistry, neurophysiology, and neurocognition.
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Affiliation(s)
- Lena Palaniyappan
- Department of Psychiatry,University of Western Ontario, London, Ontario, Canada; Robarts Research Institute,University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
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22
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Mutlu E, Abaoğlu H, Barışkın E, Gürel ŞC, Ertuğrul A, Yazıcı MK, Akı E, Yağcıoğlu AEA. The cognitive aspect of formal thought disorder and its relationship with global social functioning and the quality of life in schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1399-1410. [PMID: 33458782 DOI: 10.1007/s00127-021-02024-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 01/06/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE It was expected that using a comprehensive scale like the Thought and Language Disorder Scale (TALD) for measurement of FTD would enable assessing its heterogeneity and its associations with cognitive impairment and functionality. This study has aimed to analyze the relationship between formal thought disorder (FTD) and cognitive functions, functionality, and quality of life in schizophrenia. METHODS This cross-sectional exploratory study included 46 clinical participants meeting the DSM-5 diagnostic criteria for schizophrenia and 35 healthy individuals as the control groups. Data were acquired by means of the Turkish language version of the TALD, the Positive and Negative Syndrome Scale, the Clinical Global Impression Scale, the Functioning Assessment Short Test, the Social Functioning Scale, the World Health Organization Quality of Life Instrument-Short Form, and a neuropsychological test battery on executive functions, working memory, verbal fluency, abstract thinking, and response inhibition. Correlation analyses were conducted to detect significant relationships. RESULTS The clinical group scored failures in all cognitive tests. The objective positive FTD was associated with deficits in executive functions and social functioning. The objective negative FTD was associated with poor performance in all cognitive domains, physical quality of life, and social and global functioning. The subjective negative FTD was negatively correlated with psychological quality of life. CONCLUSION This study demonstrated that objective FTD factors reflect different underlying cognitive deficits and correlate with different functioning domains. Significant correlation was determined between subjective negative FTD and psychological quality of life. Given the close relationship of FTD with functioning and quality of life, the FTD-related cognitive deficits should be the key treatment goal in schizophrenia.
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Affiliation(s)
- Emre Mutlu
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey. .,Psychiatry Clinic, Etimesgut Şehit Sait Ertürk State Hospital, Ankara, Turkey.
| | - Hatice Abaoğlu
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Elif Barışkın
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ş Can Gürel
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aygün Ertuğrul
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - M Kazım Yazıcı
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Esra Akı
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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23
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Deyo C, Langdon R. Cognitive correlates of 'Formal Thought Disorder' in a non-clinical sample with elevated schizotypal traits. Psychiatry Res 2021; 302:113971. [PMID: 34182311 DOI: 10.1016/j.psychres.2021.113971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 04/24/2021] [Indexed: 11/28/2022]
Abstract
Different dimensions of formal thought disorder (FTD) are distinguished by different patterns of cognitive dysfunction in patients with schizophrenia; however, inconsistent findings may relate to patient-related confounds. To avoid these confounds, we examined relationships between FTD dimensions and cognitive domains in a non-clinical sample with attenuated schizophrenia-like traits, or schizotypal traits, on the Schizotypal Personality Questionnaire (N = 91). To our knowledge, no study has done this. FTD dimension scores were derived following principal component analysis of the Scale for the Assessment of Thought, Language and Communication (TLC dimensions: Disorganisation, Verbosity, Emptiness) and the Thought and Language Index (TLI dimensions: Negative, Idiosyncratic). The sample completed a comprehensive neuropsychological battery. Findings indicate that higher-order reasoning, executive function (set shift and generative ability) and language/semantic functioning are the primary drivers of FTD in our non-clinical sample with elevated schizotypal traits, in line with schizophrenia research. FTD may have shared aetiology along the schizophrenia spectrum.
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Affiliation(s)
- Cliff Deyo
- Department of Psychology, Macquarie University, NSW, Australia.
| | - Robyn Langdon
- ARC Centre of Excellence in Cognition and Its Disorders and Department of Cognitive Science, Macquarie University, NSW, Australia
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Ucok A, Karakaş B, Şahin OŞ. Formal thought disorder in patients with first-episode schizophrenia: Results of a one-year follow-up study. Psychiatry Res 2021; 301:113972. [PMID: 33979765 DOI: 10.1016/j.psychres.2021.113972] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 04/24/2021] [Indexed: 11/19/2022]
Abstract
Formal thought disorder (FTD) refers to abnormal speech patterns that can be characterized by deficiencies in thought organization and direction. The present study aimed to assess the factor structure of FTD and to examine its relationship with cognition and clinical features at first admission in patients with first-episode schizophrenia. We also examined the course of FTD during the twelve months after first admission. We assessed FTD using the alogia items of the Scale for the Assessment of Negative Symptoms and FTD items of the Scale for the Assessment of Positive Symptoms in 160 drug-naïve patients. A three-factor structure as a disorganization factor, poverty factor, and verbosity factor were found in principal component analysis. The poverty factor was correlated negatively with executive functions, attention, and global cognition. The poverty factor was also correlated with global functioning. Admission FTD factor scores were not related to global functioning and work/study status at one year. The positive-FTD score decreased from admission to the third month, but no change occurred from the third to the twelfth month. The negative-FTD score did not differ throughout the follow-up. Our findings showed that FTD had three factors. Each factor had a different relationship with cognition and functioning.
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Affiliation(s)
- Alp Ucok
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Begüm Karakaş
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Olcay Şenay Şahin
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Silva A, Limongi R, MacKinley M, Palaniyappan L. Small Words That Matter: Linguistic Style and Conceptual Disorganization in Untreated First-Episode Schizophrenia. SCHIZOPHRENIA BULLETIN OPEN 2021; 2:sgab010. [PMID: 33937775 PMCID: PMC8072135 DOI: 10.1093/schizbullopen/sgab010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study aimed to shed light on the linguistic style affecting the communication discourse in first-episode schizophrenia (FES) by investigating the analytic thinking index in relation to clinical scores of conceptual and thought disorganization (Positive and Negative Syndrome Scale, PANSS-P2 and Thought and Language Index, TLI). Using robust Bayesian modeling, we report three major findings: (1) FES subjects showed reduced analytic thinking, exhibiting a less categorical linguistic style than healthy control (HC) subjects (Bayes factor, BF10 > 1000), despite using the same proportion of function and content words as HCs; (2) the lower the analytic thinking score, the higher the symptoms scores of conceptual disorganization (PANSS-P2, BF = 22.66) and global disorganization of thinking (TLI, BF10 = 112.73); (3) the linguistic style is a better predictor of conceptual disorganization than the cognitive measure of processing speed in schizophrenia (SZ). These findings provide an objectively detectable linguistic style with a focus on Natural Language Processing Analytics of transcribed speech samples of patients with SZ that require no clinical judgment. These findings also offer a crucial insight into the primacy of linguistic structural disruption in clinically ascertained disorganized thinking in SZ. Our work contributes to an emerging body of literature on the psychopathology of SZ using a first-order lexeme-level analysis and a hypothesis-driven approach. At a utilitarian level, this has implications for improving educational and social outcomes in patients with SZ.
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Affiliation(s)
| | - Roberto Limongi
- Robarts Research Institute, London, ON, Canada
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
| | - Michael MacKinley
- Robarts Research Institute, London, ON, Canada
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Lena Palaniyappan
- Robarts Research Institute, London, ON, Canada
- Department of Psychiatry, University of Western Ontario, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- Department of Medical Biophysics, University of Western Ontario, London, ON, Canada
- The Brain and Mind Institute, University of Western Ontario, London, ON, Canada
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26
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Solot CB, Moore TM, Crowley TB, Gerdes M, Moss E, McGinn DE, Emanuel BS, Zackai EH, Gallagher S, Calkins ME, Ruparel K, Gur RC, McDonald-McGinn D, Gur RE. Early language measures associated with later psychosis features in 22q11.2 deletion syndrome. Am J Med Genet B Neuropsychiatr Genet 2020; 183:392-400. [PMID: 32715620 PMCID: PMC8050829 DOI: 10.1002/ajmg.b.32812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 02/18/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022]
Abstract
The 22q11.2 deletion syndrome (22q11DS) is associated with impaired cognitive functions and increased risk for schizophrenia spectrum disorders. Speech and language deficits are prominent, with evidence of decline anteceding emergence of psychosis. There is paucity of data examining language function in children with 22q11DS with follow-up assessment of psychosis spectrum (PS) symptoms. We examined the association between early language measures, obtained clinically, and PS status, obtained on average 10.1 years later, in 166 youths with 22q11DS, with repeated language testing in 48. Participants were administered the Preschool Language Scale (receptive/expressive), and/or, for school aged children, the Clinical Evaluation of Language Fundamentals (receptive/expressive), and age appropriate IQ tests. The structured interview for prodromal syndromes (SIPS) assessed PS symptoms. We found that performance on all preschool measures showed age associated decline, and males performed more poorly on core composite (receptive/expressive) and receptive language measures. For language assessment later in childhood, poorer performance was consistently associated with subsequent PS status. Furthermore, steeper age-related decline was seen in the PS group across language measures and marginally for full-scale IQ. These findings suggest that while preschool language testing is useful in characterizing performance decline in individuals with 22q11DS, it does not robustly differentiate those with subsequent PS from those without. However, language testing in the school age population can help identify individuals with 22q11DS who are at risk for psychosis. Such data are needed for elucidating a lifespan trajectory for affected individuals and may help understand pathways to psychosis applicable to the general population.
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Affiliation(s)
- Cynthia B. Solot
- Department of Speech-Language Pathology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tyler M. Moore
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - T. Blaine Crowley
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Marsha Gerdes
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Edward Moss
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Daniel E. McGinn
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Beverly S. Emanuel
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elaine H. Zackai
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sean Gallagher
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Monica E. Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kosha Ruparel
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Donna McDonald-McGinn
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raquel E. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia
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Palaniyappan L, Al-Radaideh A, Gowland PA, Liddle PF. Cortical thickness and formal thought disorder in schizophrenia: An ultra high-field network-based morphometry study. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109911. [PMID: 32151693 DOI: 10.1016/j.pnpbp.2020.109911] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/17/2020] [Accepted: 03/05/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Persistent formal thought disorder (FTD) is a core feature of schizophrenia. Recent cognitive and neuroimaging studies indicate a distinct mechanistic pathway underlying the persistent positive FTD (pFTD or disorganized thinking), though its structural determinants are still elusive. Using network-based cortical thickness estimates from ultra-high field 7-Tesla Magnetic Resonance Imaging (7T MRI), we investigated the structural correlates of pFTD. METHODS We obtained speech samples and 7T MRI anatomical scans from medicated clinically stable patients with schizophrenia (n = 19) and healthy controls (n = 20). Network-based morphometry was used to estimate the mean cortical thickness of 17 functional networks covering the entire cortical surface from each subject. We also quantified the vertexwise variability of thickness within each network to quantify the spatial coherence of the 17 networks, estimated patients vs. controls differences, and related the thickness of the affected networks to the severity of pFTD. RESULTS Patients had reduced thickness of the frontoparietal and default mode networks, and reduced spatial coherence affecting the salience and the frontoparietal control network. A higher burden of positive FTD related to reduced frontoparietal thickness and reduced spatial coherence of the salience network. The presence of positive FTD, but not its severity, related to the reduced thickness of the language network comprising of the superior temporal cortex. CONCLUSIONS These results suggest that cortical thickness of both cognitive control and language networks underlie the positive FTD in schizophrenia. The structural integrity of cognitive control networks is a critical determinant of the expressed severity of persistent FTD in schizophrenia.
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Affiliation(s)
- Lena Palaniyappan
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; Department of Psychiatry, University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
| | - Ali Al-Radaideh
- Department of Medical Imaging, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan.; Sir Peter Mansfield Imaging Centre (SPMIC), School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Penny A Gowland
- Sir Peter Mansfield Imaging Centre (SPMIC), School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Peter F Liddle
- Translational Neuroimaging for Mental Health, Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
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Schultze-Lutter F, Schimmelmann BG, Flückiger R, Michel C. Effects of age and sex on clinical high-risk for psychosis in the community. World J Psychiatry 2020; 10:101-124. [PMID: 32477906 PMCID: PMC7243619 DOI: 10.5498/wjp.v10.i5.101] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/23/2020] [Accepted: 03/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Recent reports of both heightened prevalence rates and limited clinical relevance of clinical high-risk (CHR) criteria and their relevant symptoms in children and adolescents indicate an important role of neurodevelopment in the early detection of psychoses. Furthermore, sex effects in CHR symptoms have been reported, though studies were inconclusive. As sex also impacts on neurodevelopment, we expected that sex might have an additional contribution to age in the prevalence and clinical relevance of CHR symptoms and criteria.
AIM To investigate age and sex effects on CHR criteria and symptoms and their association with psychosocial impairment and mental disorder.
METHODS In this cross-sectional cohort study, n = 2916 8- to 40-year-olds, randomly drawn from the population register of the Swiss canton Bern, were assessed in semi-structured interviews by phone or face-to-face for CHR symptoms and criteria using the Structured Interview for Psychosis-Risk Syndromes and the Schizophrenia Proneness Instrument in its child and youth, and adult version, respectively. Furthermore, social and occupational functioning and DSM-IV axis I disorders were assessed. Simple and interaction effects of age and sex on CHR symptoms and criteria, and interaction effects of age, sex, and CHR symptoms and criteria on presentation of functional impairment and of non-psychotic disorder were investigated using logistic regression analyses.
RESULTS Altogether, 542 (18.6%) participants reported any CHR symptom; of these, 261 (9.0%) participants reported any one of the 11 criteria relevant cognitive and perceptual basic symptoms, and 381 (13.1%) any one of the five attenuated or transient psychotic symptoms (attenuated psychotic symptoms/brief intermittent psychotic symptoms). Fewer participants met any one of the CHR criteria (n = 82, 2.8%) or any one of the three recently recommended CHR criteria (n = 38, 1.3%). Both age and sex were significantly (P < 0.05) associated with CHR symptoms and criteria, mostly by younger age and female sex. Though slightly differing between symptom groups, age thresholds were detected around the turn from adolescence to adulthood; they were highest for cognitive basic symptoms and CHR criteria. With the exception of the infrequent speech disorganization attenuated psychotic symptom, the interaction of age with CHR symptoms and criteria predicted functional impairment; whereas, independent of each other, sex and CHR symptoms mostly predicted mental disorders.
CONCLUSION Age and sex differentially impact on CHR symptoms and criteria; these differences may support better understanding of causal pathways. Thus, future CHR studies should consider effects of sex and age.
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Affiliation(s)
- Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf 40692, Germany
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern 3000, Switzerland
- University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Rahel Flückiger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern 3000, Switzerland
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern 3000, Switzerland
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Little B, Gallagher P, Zimmerer V, Varley R, Douglas M, Spencer H, Çokal D, Deamer F, Turkington D, Ferrier IN, Hinzen W, Watson S. Language in schizophrenia and aphasia: the relationship with non-verbal cognition and thought disorder. Cogn Neuropsychiatry 2019; 24:389-405. [PMID: 31550981 DOI: 10.1080/13546805.2019.1668758] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: To determine the relationship between language abnormalities and broader cognitive impairment and thought disorder by examining language and cognition in schizophrenia and aphasia (a primary language disorder).Methods: Cognitive and linguistic profiles were measured with a battery of standardised tests, and compared in a clinical population of n = 50 (n = 30 with schizophrenia and n = 20 with aphasia) and n = 61 non-clinical comparisons (n = 45 healthy controls and n = 16 non-affected first-degree relatives of patients with schizophrenia).Results: Both clinical groups showed linguistic deficits. Verbal impairment was more severe in participants with aphasia, whereas non-verbal performance was more affected in participants with schizophrenia. In schizophrenia, but not in aphasia, verbal and non-verbal performance were associated. Formal thought disorder was associated with impairment in executive function and in grammatical, but not naming, tasks.Conclusion: While patients with schizophrenia and aphasia showed language impairments, the nature and cognitive basis of these impairments may be different; language performance disassociates from broader cognitive functioning in aphasia but may be an intrinsic expression of a broader cognitive impairment in schizophrenia. Thought disorder may represent a core malfunction of grammatical processing. Results suggests that communicative ability may be a valid target in cognitive remediation strategies in schizophrenia.
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Affiliation(s)
- Bethany Little
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Peter Gallagher
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Vitor Zimmerer
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Rosemary Varley
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Maggie Douglas
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Helen Spencer
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Derya Çokal
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,School of Electronic Engineering and Computer Science, Cognitive Science Research Group, Queen Mary University of London, London
| | - Felicity Deamer
- Department of Philosophy, Durham University, Durham, UK.,Department of English Studies, Durham University, Durham, UK
| | - Douglas Turkington
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - I Nicol Ferrier
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Wolfram Hinzen
- ICREA (Catalan Institute of Advanced Studies and Research), Universitat Pompeu Fabra, Barcelona, Spain.,Department of Translation and Language Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,FIDMAG Germanes Hospitalaries Research Foundation, Benito Menni Hospital, Barcelona, Spain
| | - Stuart Watson
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
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31
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Chang CH, Lane HY, Liu CY, Cheng PC, Chen SJ, Lin CH. C-reactive protein is associated with severity of thought and language dysfunction in patients with schizophrenia. Neuropsychiatr Dis Treat 2019; 15:2621-2627. [PMID: 31571879 PMCID: PMC6750161 DOI: 10.2147/ndt.s223278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/26/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Numerous studies have demonstrated an association between C-reactive protein (CRP) levels and schizophrenia. However, the findings on psychotic severity and cognition remain inconsistent. The relationship between CRP and formal thought disorder in subdomains remains unclear. METHODS We enrolled stable patients (defined as those who had no treatment changes during the 4-week period before evaluation) with a diagnosis of schizophrenia or schizoaffective disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We used the 30-item Thought and Language Disorder (TALD) scale to evaluate thought and language dysfunction over four subscales. We assessed psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS). We collected fasting venous blood and measured plasma CRP levels. RESULTS We enrolled 60 patients with schizophrenia. All patients received TALD and PANSS evaluation, and 33 of them had their CRP levels checked. The multivariate regression analysis indicated that CRP levels were significantly associated with the total score on the TALD (t=2.757, P=0.010) and the TALD Objective Positive subscale (t=2.749, P=0.011), after sex, age, duration of illness (in years), and use of atypical antipsychotics were adjusted for. Additionally, CRP was significantly associated with the PANSS positive subscale (t=2.102, P=0.045). A significantly positive correlation was observed between the total scores on the TALD scale and PANSS (ρ =0.751, P<0.001). CONCLUSION Our results suggest that abnormal CRP levels are significantly associated with formal thought and language dysfunction in the Objective Positive subdomain and positive psychotic symptoms.
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Affiliation(s)
- Chun-Hung Chang
- Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan.,An Nan Hospital, China Medical University, Tainan, Taiwan
| | - Hsien-Yuan Lane
- Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Chieh-Yu Liu
- Biostatistical Consulting Laboratory, Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Po-Chih Cheng
- Biostatistical Consulting Laboratory, Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shaw-Ji Chen
- Department of Psychiatry, Mackay Memorial Hospital Taitung Branch, Taitung, Taiwan.,Department of Medicine, Mackay Medical College, New Taipei, Taiwan
| | - Chieh-Hsin Lin
- Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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