Comorbidity of schizophrenia and prelingual deafness: its impact on social network structures.

BACKGROUND: Prelingually deaf persons usually gain only a rudimentary command of speech and prefer sign language to communicate within the deaf community without the handicap they experience in the hearing world. Maintaining social contact within this rather scattered community, however, requires higher degrees of social initiative and mobility. The aim of the present paper was to study the quantity and quality of social integration among a group of prelingually deaf schizophrenic patients (n = 49) and two control groups comprising prelingually deaf psychiatric but non-psychotic patients (n = 38) and hearing schizophrenic patients (n = 30), with account being taken of the special socialisation conditions of deaf persons and of their cultural standards and values. METHOD: Data were collected with the help of semi-structured interviews; with the deaf patients these were conducted in German sign language. Using rating procedures we assessed seven social support components, selected items from a history schedule for schizophrenia, and the probands' visual and verbal language skills. RESULTS: The social networks of the two deaf groups were found to have larger gaps than those of the hearing schizophrenic patients, with significant differences being registered most clearly in the comparison between deaf schizophrenic and hearing schizophrenic patients. Comparison of the verbal and visual language skills of the two deaf groups revealed a substantial deficit among the deaf schizophrenics. Visual language skills were found to correlate more strongly than verbal language skills with the social support components. CONCLUSION: Prelingual deafness has a strong impact on the course of schizophrenia. In the long run, many of these patients belong to a "minority within a minority".

Hallucinatory modalities in prelingually deaf schizophrenic patients: a retrospective analysis of 67 cases.

In order to examine the effect of congenital or early acquired deafness on hallucinatory modalities in schizophrenia, we interviewed 67 prelingually deaf schizophrenic patients (using sign language) about their hallucinatory experiences over the entire course of their illness. We also analysed the clinical records of our subjects' previous hospitalizations. In our deaf sample, visual and tactile hallucinations were plainly over-represented as hallucinatory modalities in comparison with hearing schizophrenic samples. Although some patients reported visual hallucinatory perceptions of sign language messages, the hallucinatory reception of meaningful information in deaf patients seems also to remain affiliated to the 'auditory' modality. It was concluded that the different representation of hallucinatory modalities reflects in particular the influence of 'the deaf way' of sensory experience on imagery processes.

[Schizophrenic prelingual deaf and hearing patients. A comparison of premorbid and current data after several years of progression]. / Schizophrenien prälingual gehörloser und hörender Patienten. Eine Vergleichsuntersuchung prämorbider und aktueller Daten nach mehrjährigem Krankheitsverlauf.

Prelingually deaf persons belonging to a linguistic and cultural minority have to cope with a particular sociocultural situation. The present study endeavours to analyse possible effects of this situation in the course and outcome of schizophrenia. Two samples, one comprising 27 prelingually deaf and one 27 hearing patients, all with schizophrenic psychoses, were parallelised on the basis of gender, age, duration of illness and number of previous hospitalisations. Data were then collected on the premorbid and current social situation and on the psychopathometric outcome after an (on the average) ten-year course. The prelingually deaf patients were much more profoundly impaired with regard to the rating of their residual symptoms and their social situation than those of the hearing control group. Only with respect to vocational rehabilitation did the prelingually deaf patients record a slightly more favourable situation than the hearing patients, as a greater proportion of them had regular employment, in most cases in workshops for the disabled.