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Objective Evidence suggests relationships between abnormalities in various cortical and subcortical brain structures and language dysfunction in individuals with schizophrenia, and to some extent in those with increased genetic risk for this diagnosis. The topological features of the structural brain network at the systems-level and their impact on language function in schizophrenia and in those at high genetic risk has been less well studied. Method Single-subject morphological brain network was constructed in a total of 71 subjects (20 patients with schizophrenia, 19 individuals at high genetic risk for schizophrenia, and 32 controls). Among these 71 subjects, 56 were involved in our previous neuroimaging studies. Graphic Theoretical Techniques was applied to calculate the global and nodal topological characteristics of the morphological brain network of each participant. Index scores for five language-related cognitive tests were also attained from each participant. Results Significantly smaller nodal degree in bilateral superior occipital gyri (SOG) were observed in individuals with schizophrenia, as compared to the controls and those at high risk; while significantly reduced nodal betweenness centrality (quantifying the level of a node in connecting other nodes in the network) in right middle frontal gyrus (MFG) was found in the high-risk group, relative to controls. The right MFG nodal efficiency and hub capacity (represented by both nodal degree and betweenness centrality) of the morphological brain network were negatively associated with the wide range achievement test (WRAT) standard performance score; while the right SOG nodal degree was positively associated with the WRAT standard performance score, in the entire study sample. Conclusions These findings enhance the understanding of structural brain abnormalities at the systems-level in individuals with schizophrenia and those at high genetic risk, which may serve as critical neural substrates for the origin of the language-related impairments and symptom manifestations of schizophrenia.

Objective. Schizophrenia’s first characteristics invokes the notion of disordered thought and language. Accordingly one of several diagnostic characteristics of schizophrenia is an impairment of verbal communication. To determine the detailed nature of language impairments taking into consideration these problems the aim of the present study was to analyze nominal and verbal predicate use produced by schizophrenic patients and control group during their speech as both predicates require different processings. Materials & Methods. Fifty patients with schizophrenia diagnosed according to DSM-IV criteria were included into the study and compared to fifty healthy subjects matched for age, sex and education level with the patients participated in the study. The subjects’ speech was evaluated by using picture description test, picture story telling test, subject-based narration test and free verbal narration test. The data consisted of 8–10 minute recorded interviews. The recordings were transcribed based on Du Bois’ Discourse Transcription Symbols and analyzed statistically and linguistically. Results. The results showed that the number of nominal and verbal predicates used by the patients with schizophrenia differed from the control group. Schizophrenia patients preferred nominal predicates more than control group in all tests. However, control group used significantly more verbal predicates in all tests. Conclusions. In this study it was hypothesized that language used by the patients with schizophrenia plays a central role in the this disease than commonly supposed and the phenomena of schizophrenic language can be regarded as reflections of a more basic disturbance of thought. At the end of the study based on this hypothesis patients were concluded to have simplified speech in addition to the disorganized speech defined in the field. The reason for this simplification is thought to be because of the predicate processing in the brain. The complement of a verb is always a noun phrase, which can be simple or complex, the patients tended to use nominal predicates more as it did not require any constituents and thus they simlified their speech because of their language and thought disorders.

Executive dysfunction and language impairment are the most prominent neuropsychological models of formal thought disorder (FTD) in schizophrenia. However, available studies have provided contradictory findings regarding the accuracy of these models. Furthermore, specific neurocognitive underpinnings of positive FTD (PosFTD) and negative FTD (NegFTD) are not clear. Following the systematic review of schizophrenia studies, a random-effects meta-analysis of the relationship between FTD and neurocognition/language in schizophrenia was conducted in 52 reports including 2805 patients. Neurocognition was significantly associated with both PosFTD (r = -0.21, CI = -0.14 to -0.27) and NegFTD (r = -0.24, CI = -0.18 to -0.30). Both PosFTD (r = ranged from -0.18 to -0.27) and NegFTD (r = ranged from -0.19 to -0.23) were significantly correlated with verbal memory, visual memory, attention, and processing speed. In meta-analyses of executive functions, PosFTD was significantly associated with working memory (r = -0.21). planning (r = -0.19), and inhibition (r = -0.21) and NegFTD was significantly associated with planning (r = -0.27), fluency (r = -0.27). and working memory (r = -0.24). In meta-analyses of linguistic variables, PosFTD was associated with deficits in syntactic comprehension ( r = -0.27) and semantic processing (r = -0.18). In contrast, NegFTD was associated only with semantic comprehension (r = -0.21). Both PosFTD and NegFTD were significantly associated with executive dysfunction, neurocognitive deficits and semantic dysfunction but syntactic deficits were more specific to PosFTD. There were also some distinct patterns of relationships between the pattern of executive dysfunction and types of FTD. Fluency deficit was associated more strongly with NegFTD and poor inhibition was more specifically related to PosFTD. Current findings suggest that neurocognitive and linguistic correlates of PosFTD and NegFTD might be partly different. (C) 2019 Elsevier B.V. All rights reserved.

Negative symptoms represent the main cause of disability in schizophrenia, having recently been grouped into two general dimensions: avolition and diminished emotional expression, which includes affective flattening and alogia. The aim of this study was to explore the response of these two symptoms to a set of behavioral interventions based on contingency management, performed in an interdisciplinary context.Behaviors of interest were monitored and evaluations before and after the treatment were performed on 9 schizophrenic inpatients with persistent negative symptoms. The program included 12 group double sessions aimed at developing facial expression and verbal communication, and a nursing care plan to generalize and strengthen these behaviors synergistically.there were appreciable differences in facial expression, which were less clear for alogia. The clinical evaluation using PANSS-N did not find notable differences at group level, but the nursing assessment using NOC indicators did.although difficult to modify, negative symptoms are not insensitive to the influence of behavioral interventions. Specific psychological interventions that address negative symptoms as a priority focus of attention and care need to be promoted and developed, particularly when considering the crucial role of context in their progression.

This work aims to develop some considerations on an extremely interesting topic for linguistic investigation, namely indirect speech during dialogue. In particular, we will consider ten dialogues between a therapist and schizophrenic patients, starting from a corpus of pathological speech (CIPPS – Corpus di Italiano Parlato Patologico Schizofrenico, in Dovetto and Gemelli, 2013). The focus of our investigation is on the cases of indirect speech produced both by the patient and by the therapist during the therapeutic session. In the cases of indirect speech we can observe a position on the part of the speaker in which what matters is not so much what is reported but the way, from a metalinguistic point of view, in which this is formulated. In indirect speech the message passes through the filter of the speakers so that they feel relatively free from duties of fidelity and can express, from an illocutionary point of view, their personal attitude through the mediation made possible by language devices.

Objectives Social cognition and metacognition have been identified as important cognitive domains in schizophrenia, which are separable from general neurocognition and predictive of functional and treatment outcomes. However, one challenge to improved models of schizophrenia has been the conceptual overlap between the two. One tool used in previous research to develop cognitive models of psychopathology is language analysis. In this article we aimed to clarify distinctions between social cognition and metacognition in schizophrenia using computerized language software. Methods Fifty-eight (n = 58) individuals with schizophrenia completed the Metacognitive Assessment Scale Abbreviated and measures of social cognition using the Hinting, Eyes, BLERT and Picture Arrangement test. A lexical analysis of participants’ speech using Language Inquiry and Word Count software was conducted to examine relative frequencies of word types. Lexical characteristics were examined for their relationships to social cognition and metacognition. Results We found that lexical characteristics indicative of cognitive complexity were significantly related to level of metacognitive capacity while social cognition was related to second-person pronoun use, articles, and prepositions, and pronoun use overall. The relationships between lexical variables and metacognition persisted after controlling for demographics, verbal intelligence, and overall word count, but the same was not true for social cognition. Conclusions Our findings provided support for the view that metacognition requires more synthetic and complex verbal and linguistic operations, while social cognition is associated with the representation and clear identification of others.

Category fluency is a widely used task that relies on multiple neurocognitive processes and is a sensitive assay of cortical dysfunction, including in schizophrenia. The test requires naming of as many words belonging to a certain category (e.g., animals) as possible within a short period of time. The core metrics are the overall number of words produced and the number of errors, namely non-members generated for a target category. We combine a computational linguistic approach with a candidate gene approach to examine the genetic architecture of this traditional fluency measure.In addition to the standard metric of overall word count, we applied a computational approach to semantics, Latent Semantic Analysis (LSA), to analyse the clustering pattern of the categories generated, as it likely reflects the search in memory for meanings. Also, since fluency performance probably also recruits verbal learning and recall processes, we included two standard measures of this cognitive process: the Wechsler Memory Scale and California Verbal Learning Test (CVLT). To explore the genetic architecture of traditional and LSA-derived fluency measures we employed a candidate gene approach focused on SNPs with known function that were available from a recent genome-wide association study (GWAS) of schizophrenia. The selected candidate genes were associated with language and speech, verbal learning and recall processes, and processing speed. A total of 39 coding SNPs were included for analysis in 665 subjects.Given the modest sample size, the results should be regarded as exploratory and preliminary. Nevertheless, the data clearly illustrate how extracting the meaning from participants' responses, by analysing the actual content of words, generates useful and neurocognitively viable metrics. We discuss three replicated SNPs in the genes ZNF804A, DISC1 and KIAA0319, as well as the potential for computational analyses of linguistic and textual data in other genomics tasks.

Many cortical disorders are associated with memory problems. In schizophrenia, verbal memory deficits are a hallmark feature. However, the exact nature of this deficit remains elusive. Modeling aspects of language features used in memory recall have the potential to provide means for measuring these verbal processes. We employ computational language approaches to assess time-varying semantic and sequential properties of prose recall at various retrieval intervals (immediate, 30 min and 24 h later) in patients with schizophrenia, unaffected siblings and healthy unrelated control participants. First, we model the recall data to quantify the degradation of performance with increasing retrieval interval and the effect of diagnosis (i.e., group membership) on performance. Next we model the human scoring of recall performance using an n-gram language sequence technique, and then with a semantic feature based on Latent Semantic Analysis. These models show that automated analyses of the recalls can produce scores that accurately mimic human scoring. The final analysis addresses the validity of this approach by ascertaining the ability to predict group membership from models built on the two classes of language features. Taken individually, the semantic feature is most predictive, while a model combining the features improves accuracy of group membership prediction slightly above the semantic feature alone as well as over the human rating approach. We discuss the implications for cognitive neuroscience of such a computational approach in exploring the mechanisms of prose recall.

Numerous cortical disorders affect language. We explore the connection between the observed language behavior and the underlying substrates by adopting a neurocomputational approach. To represent the observed trajectories of the discourse in patients with disorganized speech and in healthy participants, we design a graphical representation for the discourse as a trajectory that allows us to visualize and measure the degree of order in the discourse as a function of the disorder of the trajectories. Our work assumes that many of the properties of language production and comprehension can be understood in terms of the dynamics of modular networks of neural associative memories. Based upon this assumption, we connect three theoretical and empirical domains: (1) neural models of language processing and production, (2) statistical methods used in the construction of functional brain images, and (3) corpus linguistic tools, such as Latent Semantic Analysis (henceforth LSA), that are used to discover the topic organization of language. We show how the neurocomputational models intertwine with LSA and the mathematical basis of functional neuroimaging. Within this framework we describe the properties of a context-dependent neural model, based on matrix associative memories, that performs goal-oriented linguistic behavior. We link these matrix associative memory models with the mathematics that underlie functional neuroimaging techniques and present the "functional brain images" emerging from the model. This provides us with a completely "transparent box" with which to analyze the implication of some statistical images. Finally, we use these models to explore the possibility that functional synaptic disconnection can lead to an increase in connectivity between the representations of concepts that could explain some of the alterations in discourse displayed by patients with schizophrenia.

A poster-sized piece of embroidery, completed in the 1960s, hangs in the Glore Psychiatric Museum, a testament to the daily experience of a woman who rarely spoke and was diagnosed with schizophrenia. The embroidery document was analyzed by three researchers who came to agreement on themes via triangulation and constant comparison. The woman’s lived experience was considered. The analysis found that although the patient was silent, she was connected in interesting ways to the environment around her. Implications for nursing care include awareness of the importance of milieu to patients, that silence should not be inferred to be detachment, and nurses should continue to develop creative ways to engage patients who may communicate in nontraditional ways.

Background Disorganized speech, manifested as derailment, tangentiality, incoherence and loss of goal, occurs commonly in schizophrenia. Studies of language processing have demonstrated that semantic activation in schizophrenia is often disordered and, moreover, the ability to use contextual cues is impaired. Aims To reconstruct the origins and most plausible intended meanings of disorganized discourse sequences in a clinical interview with a patient with thought-disordered schizophrenia. Methods & Procedures We assessed the so-called pragmatic felicity of every turn using a novel tool called the Overall Comprehensibility of Turn (OCT) Scale. In addition to felicity analysis, all topics and referents of turns were registered. Three most disorganized discourse sequences from the transcribed interview were chosen for the thematic and semantic analysis, in which we attempted to reconstruct the structure and meaning of those sequences utilizing (1) the notion of discourse model extending up to contextual background knowledge, (2) the (re)occurrence of topical items, together with (3) the knowledge from findings of disordered semantic activation in schizophrenia. Outcomes & Results The linguistic analyses showed that the disrupted sequences were characterized by (1) unexpected, seemingly irrelevant topic intrusion, (2) pragmatically inappropriate chain of topic extensions, and (3) fuzzy reference together with disturbed ordering of propositions. The underlying causes seemed to be, respectively, (1) long-term semantic activation of topics, which popped out sporadically along the conversation, (2) overreliance on lexical–semantic associations, and (3) the inability to sequence the utterances and link them together using explicit or implicit bridging assumptions necessary to a coherent and cohesive message. All scrutinized passages violated the expectations of the addressee in on-line conversation. However, the post-hoc analysis showed that they contained items which were relevant to the global topic. Conclusions & Implications Latent sources, motivations and even meanings, at least to some extent, of seemingly disorganized utterances can become analysable through linguistic analyses. The results suggest that continuity in the treatment is essential, because a practitioner who shares background knowledge with the patient has better opportunities to capture the relevance of the superficially disorganized utterances. Moreover, especially the most disorganized sequences should warrant thorough attention because they can convey, beneath their unexpected or obscure surface structure, items which are psychologically important to the patient. The results of this study should be taken into account in the training of interactional skills of professionals who work with schizophrenia patients.

Статья предлагает анализ стилистики постмодернистского мышления, его цели, средства их достижения и результатов. Яркий представитель постмодернизма Жиль Делез конструирует способ интенсивного философствования, который осуществляется через интеллектуальную диагностику времени. Философ-стилист достигает цели посредством шизофренического языка. Увлеченность формой стиля девальвирует смысл текста и множит безрезультативные рассуждения иногда безупречные с точки зрения эстетики.

Background: Schizophrenic patients generate fewer words than healthy controls during verbal fluency tasks. The structure of output may explain why patients generate fewer exemplars. Methods: Twenty-four healthy controls and 24 patients with schizophrenia participated in six, 3 min semantic fluency tasks. In a subsequent session, participants were given cards, each printed with one of their own words generated from previous fluency tasks. Participants were to sort the cards into categories (e.g. subcategories of 'animals'), thus defining their own semantic subcategories of words, and thereby eliminating experimenter assumptions about word relatedness. These clusters were matched with fluency output of each participant. The time spend searching through semantic networks within clusters and switching to other clusters when locating and producing associated words were measured. Results: Patients produced fewer words and spent more time switching to words within clusters and to different clusters than controls, but otherwise response profiles were similar. Although controls returned more frequently to clusters and consequently made more switches between these clusters than patients, this group difference disappeared when the total number of words produced was covaried. Conclusions: Consistent with previous literature, patients produced fewer words and made more errors than controls. The absence of a group difference in number of different clusters or mean number of items per cluster suggests that patients are similar to controls with respect to number of ideas in their semantic network. Patients' longer between-cluster switching times indicate a general slowness that may be attributed to difficulties finding new words within a semantic field.

The communicative efficacy of the speech of schizophrenia patients is compromised by the presence of references for which there are no referents. There is evidence that this kind of error is positively associated with the genetic substrate of schizophrenia. The present study was an effort to identify a cognitive process source of these errors by looking at their association with performance on an internal source memory task assessing the ability to remember what one has said out loud versus only thought. Their relationship to psychotic symptoms also was examined. A sample of 110 schizophrenic/schizoaffective outpatients, and 23 nonpsychiatric controls provided 10-min speech samples and completed a battery of memory tests. Patients' symptoms also were rated for severity. Patients performed more poorly than controls on the memory tests, and their speech contained much more frequent references without referents. Frequency of missing referents was associated with scores on the test of internal source memory, even after scores on tests of immediate memory, working memory, and external source memory were regressed out. Missing referents were also related to severity of hallucinations and delusions, and internal source memory performance was related to hallucinations. The findings of this study support the idea that missing referents, hallucinations, and delusions have some common process underpinnings. Impairment in internal source memory appears to be one such process.

Several psychiatric and neurological conditions affect the semantic organization and content of a patient's speech. Specifically, the discourse of patients with schizophrenia is frequently characterized as lacking coherence. The evaluation of disturbances in discourse is often used in diagnosis and in assessing treatment efficacy, and is an important factor in prognosis. Measuring these deviations, such as “loss of meaning” and incoherence, is difficult and requires substantial human effort. Computational procedures can be employed to characterize the nature of the anomalies in discourse. We present a set of new tools derived from network theory and information science that may assist in empirical and clinical studies of communication patterns in patients, and provide the foundation for future automatic procedures. First we review information science and complex network approaches to measuring semantic coherence, and then we introduce a representation of discourse that allows for the computation of measures of disorganization. Finally we apply these tools to speech transcriptions from patients and a healthy participant, illustrating the implications and potential of this novel framework.

This paper offers a biosemiotic account of the poetic aspects of gesture and speech in schizophrenia. The argument is that speech and gesture are not the mere expression of pre-verbal thoughts. Instead, meaning is enacted by the temporal and semantic coordination of speech and gesture. The bodily basis of language is highlighted by the fact that, failing to create language that is organized around topics, individuals with schizophrenia often rely on poetic associations in directing their utterances. Accordingly, the analysis of schizophrenic speech and gesture based on McNeill’s Growth Point theory is enriched with reference to both Cowley’s (2007b) views on language as distributed social coordination, and Alexander’s (Biosemiotics 2(1):77–100, 2009) description of formal causes in nature. Schizophrenic language can be seen as a hypertrophied manifestation of the discourse-scaffolding function of poetic associations in speech and gesture. The analysis of schizophrenic language shows that language behavior need not be built on pre-verbal thoughts and important aspects of schizophrenic language, such as metalinguistic awareness and semiotic agency, can be clarified by applying concepts from biosemiotics.

At doses lower than those needed to stimulate prolactin release directly, TRH almost completely antagonizes the inhibitory effect of dopamine on prolactin release. We have previously reported that prolactin response to administration of 12.5 microg TRH i.v. correlates with prolactin response to 0.5 mg i.m. haloperidol and negatively with 24-h urinary excretion of HVA in normal subjects, suggesting that the response reflects dopamine activity. An association between central dopamine hyperactivity and SANS scores relating to poverty of content of speech and inattention has been suggested by studies utilizing methylphenidate administration in patients with first-episode schizophrenia. The hypothesis that small plasma prolactin responses to administration of 12.5 microg TRH i.v. (Delta prolactin) correlate with SANS scores for these symptoms was tested in 19 drug-naïve patients with first-episode schizophrenia. Significant negative correlations were found between the response and scores relating to poverty of content of speech (r = - 0.55, p = 0.014) and inattention (r = - 0.52, p = 0.022), supporting the hypothesis of increased dopamine activity in association with disorganization symptoms. A significant positive correlation between basal prolactin levels and prolactin response to stimulation by 12.5 microg TRH was also found (r = + 0.61, p = 0.0058). Our previous study in normal subjects found a similar positive correlation between basal prolactin levels and prolactin response to stimulation by 200 microg TRH i.v., but not by 12.5 microg TRH i.v. As far as we know, this is the first study to report an abnormality in TRH-induced prolactin release in acute schizophrenia.

Performance-based measures of the ability to perform social and everyday living skills are being more widely used to assess functional capacity in people with serious mental illnesses such as schizophrenia and bipolar disorder. Since they are also being used as outcome measures in pharmacological and cognitive remediation studies aimed at cognitive impairments in schizophrenia, understanding their measurement properties and potential sensitivity to change is important. In this study, the test-retest reliability, practice effects, and reliable change indices of two different performance-based functional capacity measures, the UCSD Performance-based skills assessment (UPSA) and Social skills performance assessment (SSPA) were examined over several different retest intervals in two different samples of people with schizophrenia (n’s=238 and 116) and a healthy comparison sample (n=109). These psychometric properties were compared to those of a neuropsychological assessment battery. Test-retest reliabilities of the long form of the UPSA ranged from r=.63 to r=.80 over follow-up periods up to 36 months in people with schizophrenia, while brief UPSA reliabilities ranged from r=.66 to r=.81. Test-retest reliability of the NP performance scores ranged from r=.77 to r=.79. Test-retest reliabilities of the UPSA were lower in healthy controls, while NP performance was slightly more reliable. SSPA test-retest reliability was lower. Practice effect sizes ranged from .05 to .16 for the UPSA and .07 to .19 for the NP assessment in patients, with HC having more practice effects. Reliable change intervals were consistent across NP and both FC measures, indicating equal potential for detection of change. These performance-based measures of functional capacity appear to have similar potential to be sensitive to change compared to NP performance in people with schizophrenia.

Verbal fluency is impaired in patients with schizophrenia, but the association with other cognitive domains remains unclear. Forty-seven patients with schizophrenia (DSM-IV) and 47 controls matched by age, gender, years of education, and vocabulary (Wechsler Adult Intelligence Scale-III) were assessed in terms of sociodemographic, clinical, and cognitive variables. Healthy controls performed significantly better than patients with schizophrenia in all cognitive measures. However, the way these cognitive domains were related differed across groups. Semantic fluency (SF) and phonological fluency (PF) were predicted by working memory (WM) in patients with schizophrenia, whereas the predictor in the healthy controls was processing speed (PS). Moreover, after dividing the sample of patients according to their performance on fluency tests, we found that a worse performance on SF or PF was predicted by WM. However, for patients with a better performance on fluency, the pattern was similar to that of healthy controls. Cognition may show a different pattern of interaction in schizophrenia, with less impaired patients showing a closer pattern to healthy controls. Therefore, we suggest that, depending on the severity of cognitive deficits, performance on neuropsychological tests may not reflect the same underlying mechanisms.

We tested the hypothesis that the level of reduced laterality in language is correlated with the degrees of schizotypal personality in healthy individuals and with their performance in the remote-associate task (RAT). A total of 53 healthy participants completed a schizotypal personality measure of the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE; a questionnaire measuring the level of psychotic proneness), a consonant–vowel–consonant (CVC; requiring the identification of letter trigrams presented tachistoscopically in the left/right visual fields or both), measuring reduced language laterality and a remote-associate task (RAT; requiring to report a word, weakly associated with three cue words). Analysis revealed correlations between CVC and O-LIFE, as well as between CVC and RAT performance. The results suggest that reduced language lateralisation (reduced hemispheric integration) may play a role in schizophrenic language disorganization, as reflected in highly schizotypal individuals, and that hemispheric integration plays a role in the remote-associate task.

Schizophrenia is a severe mental disorder with substantial genetic vulnerability. This review discusses recent neuroimaging studies reporting on impairment in brain functioning relevant to language processing in individuals with schizophrenia and those who are at a genetic risk for its development.Studies have shown that schizophrenia is associated with deficits in language function, as well as structural and functional abnormalities in brain regions that are involved with language perception and processing. Individuals who are at genetic high risk for schizophrenia also have structural and functional deficits in brain pathways for language processing. These studies consistently suggest that the normal pattern of left hemisphere dominance of language processing is significantly disturbed.This review suggests that future studies should examine the underlying mechanism for producing this disturbance in language processing and that prospective studies should be carried out that aim to follow individuals over time to determine whether these anomalies eventually lead to clinical symptoms of schizophrenia.

Patients with schizophrenia exhibit a decrease or loss of normal anatomical brain asymmetry that also extends to functional levels. We applied functional magnetic resonance imaging (fMRI) to investigate language lateralization in patients with schizophrenia during their first episode of illness, thus excluding effects of chronic illness and treatment. Brain regions activated during language tasks of verb generation and passive music listening were explored in 12 first-episode patients with schizophrenia and 17 healthy controls. Regions of interest corresponded to Broca's area in the inferior frontal gyrus (IFG) and Wernicke's area in the superior temporal sulcus (STS). Patients with schizophrenia had significantly smaller lateralization indices in language-related regions than controls. A similar effect was observed in their IFG and STS regions. There was no difference between the groups in the auditory cortex for the music task. Patients with schizophrenia demonstrated greater activation than the controls in temporal regions: the difference was larger in patients with more severe positive symptom subscores. In conclusion, patients with schizophrenia demonstrated loss of normal functional brain asymmetry, as reflected in diminished lateralization of language-related activation in frontal and temporal regions. This phenomenon was already present during their first episode of psychosis, possibly reflecting developmental brain abnormalities of the illness.

Background: Information provided by patients with schizophrenia and their respective carers is used to study the descriptive psychopathology and neuropsychology of formal thought disorder (FTD). Sampling and Methods: Relatively intellectually preserved schizophrenia patients (n = 31) exhibiting from no to severe positive FTD completed a self-report scale of FTD, a scale of insight as well as several tests of executive and semantic function. The patients’ carers completed another scale of FTD to assess the patients’ speech. Results: FTD as self-reported by patients was significantly associated with the synonyms test performance and severity of the reality distortion dimension. FTD as assessed by a clinician and by the patients’ carers was significantly associated with executive test performance and performance in a test of associative semantics. Overall insight was significantly associated with severity of the reality distortion dimension and graded naming test performance, but was not associated with self-reported FTD or severity of FTD as assessed by the clinician or carers. Conclusions: The self-reported experience of FTD has different clinical and neuropsychological correlates from those of FTD as assessed by clinicians and carers. The assessment of FTD by patients and carers used along with the clinician’s assessment may further the study of this group of symptoms.

Even though a large body of data suggests the presence of various types of cognitive deficits in the unaffected relatives of schizophrenia patients, more study is needed to clarify the comparative sensitivities of specific cognitive measures for relative-control differences. In this study, the authors compared the cognitive profiles of unaffected siblings of schizophrenia patients and those of patients and normal controls, and attempted to identify cognitive markers that might be associated with genetic liability to schizophrenia. Eighty-eight clinically stable schizophrenia patients, 44 healthy patient siblings, and 100 normal controls were evaluated using comprehensive neuropsychological tests. The domain structure of the MATRICS consensus cognitive battery was adopted, and both domain scores and individual test scores were used in the analysis. Performances of the sibling group were intermediate between those of patients and controls on most measures. A significant difference between the sibling and control groups was observed only in the Category Fluency Test. This cognitive deficit might be caused by familial predisposition to schizophrenia and could be a candidate of endophenotype for schizophrenia.

The purpose of the present study was to determine if there is evidence to support the hypothesis that schizophrenia is a human-specific disorder associated with the need for highly complex central nervous system (CNS) development. A review was therefore undertaken of published literature relevant to the identification of human-specific CNS development. There was no clear evidence found at the macroscopic, microscopic or molecular level that suggests unique changes have occurred in the evolution of the human CNS. Rather, highly significant changes in the size of the frontal lobe, increases in numbers of specific cell types, changes in gene expression and changes in genome sequence all seem to be involved in the evolution of the human CNS. Human-specific changes in CNS development are wide ranging. The modification in CNS structure and function that has resulted from these changes affects many pathways and behaviours that appear to be also affected in subjects with schizophrenia. Therefore there is evidence to support the hypothesis that schizophrenia is a disease that develops because of derangements to human-specific CNS functions that have emerged since our species diverged from non-human primates.

ObjectiveThe main aim of this study was to explore whether specific groups of patients with first episode non-affective psychosis could be identified on a psychopathological basis and, then, whether such identified groups could be validated by exploring their correlation with a variety of neurodevelopmental markers.MethodEighty-seven patients with a first episode of non-affective psychotic disorder were consecutively recruited. We assessed psychopathology and neurological soft signs using the PANSS and the Neurological Evaluation Scale, respectively. We collected information on obstetric complications, premorbid adjustment and family history.ResultsAll PANSS symptoms were analysed using principal component analysis and four factors were obtained (negative, disorganization, positive and paranoid). Subsequently, the four factors were subjected to a cluster analysis where three groups emerged: “paranoid” (n = 40), “low score” (n = 29) and “negative” (n = 18) subtype. After adjusting by sex and age, we found that the “negative group” had poorer social premorbid adjustment, worse verbal fluency and higher prevalence of both obstetric complications and neurological soft signs, when compared with the “low score” group. Similarly, the “negative group” showed significantly poorer social premorbid adjustment and higher number of neurological soft signs than the “paranoid group”.ConclusionsOur results support that, among non-affective first onset psychotic patients, those with predominant negative symptoms are more likely to correlate with higher presence of neurodevelopmental markers.

Previous small-sample studies have shown altered frontotemporal activity in schizophrenia patients with auditory hallucinations and impaired monitoring of self-generated speech. We examined a large cohort of patients with schizophrenia (n = 63) and a representative group of healthy controls (n = 20) to disentangle performance, illness, and symptom-related effects in functional magnetic resonance imaging-detected brain abnormalities during monitoring of self- and externally generated speech in schizophrenia. Our results revealed activation of the thalamus (medial geniculate nucleus, MGN) and frontotemporal regions with accurate monitoring across all participants. Less activation of the thalamus (MGN, pulvinar) and superior-middle temporal and inferior frontal gyri occurred in poorly performing patients (1 standard deviation below controls' mean; n = 36), relative to the combined group of controls and well-performing patients. In patients, (1) greater deactivation of the ventral striatum and hypothalamus to own voice, combined with nonsignificant activation of the same regions to others' voice, associated positively with negative symptoms (blunted affect, emotional withdrawal, poor rapport, passive social avoidance) regardless of performance and (2) exaggerated activation of the right superior-middle temporal gyrus during undistorted, relative to distorted, feedback associated with both positive symptoms (hallucinations, persecution) and poor performance. A further thalamic abnormality characterized schizophrenia patients regardless of performance and symptoms. We conclude that hypoactivation of a neural network comprised of the thalamus and frontotemporal regions underlies impaired speech monitoring in schizophrenia. Positive symptoms and poor monitoring share a common activation abnormality in the right superior temporal gyrus during processing of degraded speech. Altered striatal and hypothalamic modulation to own and others' voice characterizes emotionally withdrawn and socially avoidant patients.

Introduction The genetic region coding for d -amino acid oxidase activator ( DAOA ) is considered an intriguing susceptibility locus for schizophrenia. However, association studies have often resulted in conflicting findings, and the risk-conferring variants and their biological impact remain elusive. Our aim in this study was to investigate the relationship between DAOA variation and schizophrenia, and the influence of DAOA on cognitive performance. Methods We analyzed block structure and association patterns of a ~ 173 kb region on chromosome 13q33, applying genotype data of 55 SNPs derived from Caucasian North American sample (178 cases, 144 healthy controls). Haplotypes were assigned using the program PHASE and frequencies compared between cases and controls. We applied MANOVA to investigate the relationship between the identified risk haplotype on cognitive performance. Results We identified multiple haplotypes within the region containing the DAOA gene. Of these, one was significantly associated with schizophrenia, being over-represented in schizophrenia versus healthy controls. This haplotype was also associated with one aspect of cognitive performance, semantic fluency. Carriers of the risk haplotype showed better semantic fluency than non-carriers. Conclusions We report a significant effect of DAOA variation on risk for schizophrenia. Moreover, we identified a relationship between DAOA genetic variation and specific aspects of neurocognitive function. As the identified DAOA risk haplotype was associated with better performance on a semantic fluency measure, further work is required to identify the mechanism of DAOA action on CNS function, including the possibility of a role for balanced selection at this locus.

Three chronic schizophrenics who were mild to severely mentally retarded were treated for a wide range of vocalisations characteristic of psychotic persons. Relevance of responses, speech duration, making nonsense statements, and changing the subject were among the behaviours treated in two experiments. Treatment consisted of instructions, performance feedback via audiotapes, modelling and speech rehearsal provided in twenty-five minute training sessions held each day on a one-to-one basis with a therapist. In all cases, treatment resulted in rapid changes of target behaviours in desired directions. Results were particularly significant since all three subjects displayed active hallucinations and delusions while taking large maintenance dosages of antipsychotic medications. Changes generalised across settings and were maintained over two months follow-up.

This study illustrates the use of a computer-assisted linguistic analysis technique to compare the spoken language of an adolescent, diagnosed in childhood as autistic, with that of normal and schizophrenic individuals. A distinctive profile, in keeping with accounts in the literature of autistic speech, was noted to be radically different from that found in linguistic analysis of schizophrenic speech. This distinctive profile was mirrored by her written linguistic analysis. Changes indicative of some improvement in language function were seen on re-recording after 5 years. Implications of this technique for differential diagnosis of Aspberger's syndrome and atypical psychoses are mentioned.

This article begins with an account of Beckett's translations of Surrealist texts for the September 1932 issue of This Quarter, which contained extracts from Breton and Eluard's Simulations. The essay argues that Beckett was influenced by these sketches in psychic confusion and suggests that traces of this encounter can be found in Lucky's speech in Waiting for Godot . Beckett is seen to use pathological language structures in a deliberate way and Lucky's schizophrenic language seems to correspond to the psychiatric concept of formal thought disorder. Irrational speech patterns in Watt are also examined and viewed as another deliberate sabotage of logical speech. A discussion of Worstward Ho using Deleuzean conceptions of language pathology suggests that Beckett is swayed, in the later prose, by the rhythms of pathological language in an unconscious way. Beckett's linguistic play is seen to echo, in an austere manner, the more expansive language of Finnegans Wake .

Objective: Impaired emotion perception is documented for schizophrenia, but findings have been mixed for bipolar disorder. In healthy samples females perform better than males. This study compared emotion perception in schizophrenia and bipolar disorder and investigated the effects of gender. Method: Visual (facial pictures) and auditory (sentences) emotional stimuli were presented for identification and discrimination in groups of participants with schizophrenia, bipolar disorder and healthy controls. Results: Visual emotion perception was unimpaired in both clinical groups, but the schizophrenia sample showed reduced auditory emotion perception. Healthy males and male schizophrenia subjects performed worse than their female counterparts, whereas there were no gender differences within the bipolar group. Conclusion: A disease-specific auditory emotion processing deficit was confirmed in schizophrenia, especially for males. Participants with bipolar disorder performed unimpaired.

The heterogeneity of the schizophrenia phenotype is often considered an obstacle for genetic research. We therefore aim to identify subgroups of psychosis patients with a shared symptom profile by means of a fully data-driven analysis, which may serve as an alternative phenotype. We investigated the symptoms of 1056 patients that were referred to our hospital with a psychosis. The lifetime symptoms scores were derived from the current and lifetime ratings of the comprehensive assessment of psychiatric history (CASH) interview. We used latent class analysis (LCA) to identify clusters of patients with a shared symptom profile. The five indicators in our analysis were the total number of symptoms present for each of the five factors identified in a factor analysis of lifetime symptoms. We also analysed the discriminating power of these symptom dimensions in previous LCAs. A six-cluster division of psychotic phenotypes showed substantial overlap with earlier LCA analyses and findings from genetic association studies. The results included a bipolar and a depression subgroup in psychosis and showed that mood symptoms are the best discriminators of subgroups of psychosis. The distinction of subgroups of psychosis patients, in particular those with major mood symptoms could facilitate the unravelling of the genetics of psychotic disorders.

Thought disorder is a symptom of schizophrenia expressed as disorganized or incoherent speech. Severity of thought disorder correlates with decreased left superior temporal gyrus grey matter volume and cortical activation in posterior temporal regions during the performance of language tasks. The goal of this study was to determine whether language-related activation mediates the association between thought disorder and left superior temporal lobe grey matter volume. 12 patients with schizophrenia were assessed for thought disorder. FMRI images were acquired for each subject while they listened to English speech, along with a high resolution structural image. Thought disorder was used as a covariate in the functional analysis to identify brain regions within which activation correlated with symptom severity. Voxel based morphometry was used to calculate grey matter volume of the planum temporale. A mediation model waste-tested using a four-step multiple regression approach incorporating cortical volume, functional activation and symptom severity. Thought disorder correlated with activation in a single cluster within the left posterior middle temporal gyrus during listening to speech. Grey matter volume within the planum temporale correlated significantly with severity of thought disorder and activation within the functional cluster. Regressing thought disorder on grey matter volume and BOLD response simultaneously led to a significant reduction in the correlation between grey matter volume and thought disorder. These results support the hypothesis that the association between decreased grey matter volume in the left planum temporale and severity of thought disorder is mediated by activation in the posterior temporal lobe during language processing.