Prosodic deficits and interpersonal difficulties in patients with schizophrenia.

The present study examines the use of receptive emotional and linguistic prosody in patients with schizophrenia; particularly, its aim was to evaluate the type and number of errors made when comprehending the emotions and modes implied by meaningless utterances. Seventy-eight participants were enrolled to the study, i.e. two groups (patients with schizophrenia and healthy controls) consisting of 39 subjects. The severity of illness was evaluated with the Positive and Negative Syndrome Scale; comprehension of emotional and linguistic prosody was assessed by the subtests of the Polish Version of the Right Hemisphere Language Battery. Neither emotional nor linguistic prosody comprehension both correlated with schizophrenia symptoms. The study group experienced more difficulties in distinguishing between happiness and anger, and were more likely to misunderstand imperative utterances, confusing them with interrogative or affirmative ones. Such impairments are significant as they may affect the ability to form and sustain relationships with other people, achieve success in the work environment, and integrate in the community. They may also be a trait mark of the illness independent of psychotic symptoms. Further research is needed to translate this knowledge into meaningful and therapeutic interventions to improve quality of life, both for affected individuals and for their communication partners.

The correlation between white matter integrity and pragmatic language processing in first episode schizophrenia.

OBJECTIVE: Higher-order language disturbances could be the result of white matter tract abnormalities. The study explores the relationship between white matter and pragmatic skills in first-episode schizophrenia. METHODS: Thirty-four first-episode patients with schizophrenia and 32 healthy subjects participated in a pragmatic language and Diffusion Tensor Imaging study, where fractional anisotropy of the arcuate fasciculus, corpus callosum and cingulum was correlated with the Polish version of the Right Hemisphere Language Battery. RESULTS: The patients showed reduced fractional anisotropy in the right arcuate fasciculus, left anterior cingulum bundle and left forceps minor. Among the first episode patients, reduced understanding of written metaphors correlated with reduced fractional anisotropy of left forceps minor, and greater explanation of written and picture metaphors correlated with reduced fractional anisotropy of the left anterior cingulum. CONCLUSIONS: The white matter dysfunctions may underlie the pragmatic language impairment in schizophrenia. Our results shed further light on the functional neuroanatomical basis of pragmatic language use by patients with schizophrenia.

Preliminary study of higher-order language and extralinguistic impairments in individuals with high clinical risk of psychosis and first episode of schizophrenia.

AIM: Higher-order language functions are associated with understanding indirect speech acts, lexical-semantic processes, the understanding and production of prosody, discourse production and comprehension. Only a few studies imply that language abnormalities may be present in individuals at ultra-high risk for psychosis (UHR) and first-episode of schizophrenia (FE). The purpose of this study was to test the presence of higher-order language dysfunctions in UHR and FE subjects using a standardized comprehensive test battery. METHODS: Twenty patients experiencing FE schizophrenia, 33 UHR individuals and 20 healthy controls (HC) took part in the study. Higher-order language and extralinguistic abilities were evaluated using the Right Hemisphere Language Battery (RHLB-PL). The battery consisted of tests covering the comprehension of implicit information, lexico-semantic processing, understanding humour, making inappropriate remarks and comments, understanding and explaining metaphors, understanding prosody and appropriateness of behaviour in communication settings. RESULTS: The UHR patients scored lower than HC when comprehending implicit information, discourse and in areas associated with the effectiveness of interpersonal communication; however, they scored higher than the FE participants in explanation of metaphors and processing language information in the context of general knowledge. The FE participants scored lower than healthy controls in comprehension of implicit information, explanation of metaphors, discourse understanding, processing language information in the context of general knowledge and effectiveness of interpersonal communication. CONCLUSIONS: The higher-order language dysfunctions mediated by the right hemisphere appear to be present in subjects at UHR of schizophrenia and those experiencing their FE. The results may play a crucial role in diagnostic processes.

Higher-order language dysfunctions as a possible neurolinguistic endophenotype for schizophrenia: Evidence from patients and their unaffected first degree relatives.

The purpose of the study was to examine the presence of pragmatic dysfunctions in first episode (FE) subjects and their healthy first degree relatives as a potential endophenotype for schizophrenia. Thirty-four FE patients, 34 parents of the patients (REL) and 32 healthy controls (HC) took part in the study. Pragmatic language functions were evaluated with the Right Hemisphere Language Battery, attention and executive functions were controlled, as well as age and education level. The parents differed from HC but not from their FE offspring with regard to overall level of language and communication and the general knowledge component of language processing. The FE participants differed from HC in comprehension of inferred meaning, emotional prosody, discourse dimensions, overall level of language and communication, language processing with regard to general knowledge and communication competences. The FE participants differed from REL regarding discourse dimensions. Our findings suggest that pragmatic dysfunctions may act as vulnerability markers of schizophrenia; their assessment may help in the diagnosis of early stages of the illness and in understanding its pathophysiology. In future research the adoptive and biological parents of schizophrenia patients should be compared to elucidate which language failures reflect genetic vulnerability and which ones environmental factors.

Schizophrenia patients have higher-order language and extralinguistic impairments.

INTRODUCTION: The extralinguistic and paralinguistic aspects of the language refer to higher-order language functions such as lexical-semantic processes, prosody, indirect speech acts or discourse comprehension and production. Studies suggest that these processes are mediated by the Right Hemisphere (RH) and there is also some evidence of RH dysfunctions in schizophrenia. The aim of the paper is to investigate the extralinguistic and paralinguistic processing mediated by Right Hemisphere in schizophrenia patients using a validated and standardized battery of tests. METHODS: Two groups of participants were examined: a schizophrenia sample (40 participants) and a control group (39 participants). Extralinguistic and paralinguistic processing was assessed in all subjects by the Polish version of the Right Hemisphere Language Battery (RHLB-PL), which measures comprehension of implicit information, naming, understanding humor, inappropriate remarks and comments, explanation and understanding of metaphors, understanding emotional and language prosody and discourse understanding. RESULTS: Schizophrenia patients scored significantly lower than controls in subtests measuring comprehension of implicit information, interpretation of humor, explanation of metaphors, inappropriate remarks and comments, discernment of emotional and language prosody and comprehension of discourse. No differences were observed in naming, understanding metaphors or in processing visuo-spatial information. CONCLUSIONS: Extralinguistic and paralinguistic dysfunctions appear to be present in schizophrenia patients and they suggest that RH processing may be disturbed in that group of patients. As the disturbances of higher-order language processes mediated by the RH may cause serious impairments in the social communication of patients, it is worth evaluating them during clinical examination.

Figural fluency and immediate visual memory in patients with at-risk mental state for psychosis: empirical study.

AIM: Although a number of cognitive functions have been assessed in the ultra-high risk (UHR) population, only one study has reported on figural fluency. Visual memory was measured by different tests providing inconsistent results. The aim of the present study was to compare figural fluency and visual immediate memory performance in UHR patients and normal subjects. METHODS: The UHR sample consisted of 55 help-seeking individuals meeting CAARMS criteria. The control group consisted of 65 subjects. They were matched as a group by age, gender and education level. Figural fluency (RFFT) and immediate visual memory (BVRT) were assessed within 2 weeks after inclusion in the study in the UHR patient group. RESULTS: Significant differences were obtained in RFFT and BVRT results. In BVRT, UHR patients scored lower in number of correct designs (P < 0.001) and higher in number of errors (P < 0.0001), especially omissions (P < 0.001) and distortions (P < 0.0001). UHR subjects accurately recalled fewer designs, omitted and distorted more test figures. In RFFT, they scored lower in production of novel designs (P < 0.0001) and higher in the error ratio index (P < 0.008). They produced fewer novel designs and made more preservative errors. CONCLUSIONS: The current study concerns non-verbal cognitive functions in UHR samples. Our results suggest that figural fluency and visual immediate memory are impaired in help-seeking UHR individuals as compared with matched controls.