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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Speech disturbances are well-known symptoms contributing to the diagnosis of schizophrenia. Subanesthetic doses of the N-methyl-D-aspartate (NMDA) antagonist ketamine have been reported to produce positive and negative symptoms and cognitive impairments consistent with those seen in schizophrenia. Insofar as this is true, it constitutes evidence that the NMDA system is involved in schizophrenia. It is therefore of interest to know whether ketamine produces speech disturbances like those of schizophrenia. Quantitative computer-aided analysis of apparently normal speech can detect clinically relevant changes and differences that are not noticeable to the human observer. Accordingly, in this study, speech samples were analysed for repetitiousness, idea density, and verb density using software developed by the authors. The samples came from two experiments, a within-subjects study of healthy volunteers given intravenous ketamine versus placebo, and a between-groups study of patients diagnosed with schizophrenia and comparable healthy controls.Our primary hypothesis was that in both schizophrenia and ketamine, repetitiousness would increase, since perserverative speech is a well-known symptom of schizophrenia. Our secondary hypotheses were that in both schizophrenia and ketamine, idea density and verb density would decrease as indicators of cognitive impairment. The primary hypothesis was confirmed in the schizophrenia experiment (between groups) and the ketamine experiment (within subjects). The secondary hypotheses were disconfirmed except that in the ketamine experiment, verb density was significantly lowered. Reduced use of verbs apparently reflects a cognitive impairment of a different type than repetitiousness, and further investigation is needed to determine whether this impairment occurs in psychosis.
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PMID:Does ketamine mimic aspects of schizophrenic speech? 1856 22

Speech disturbances (SD) are a pernicious symptom of schizophrenia that increase when negative emotion is elicited. This increase is referred to as affective reactivity (AR). Although considerable research has examined SD in schizophrenia, few studies have investigated this symptom in individuals at risk for the disorder, who demonstrate schizophrenia-like, or schizotypic, traits. In the present study, we examined: (1) SD severity in schizotypy, (2) how SD varies as a function of stress reactivity in schizotypy, and (3) the relationship between SD/AR with Quality of Life (QOL). Individuals with psychometrically-defined schizotypy (n=83) and controls (n=22) completed a laboratory procedure in which they produced speech while viewing pleasant and stressful photographs. This speech was analyzed for subtle speech disorder using a well-validated measure. We found that the schizotypy group demonstrated significant increases in SD across both baseline and stressful conditions compared to the control group. AR was not significantly different between the groups. Within the schizotypy group, severity of disorganized schizotypy symptoms was associated with high levels of SD and AR while interpersonal schizotypy was associated with low levels of SD and AR. AR was also related to increased objective QOL in the schizotypy group. This study highlights the role of stress reactivity across the schizophrenia-spectrum. Moreover, the incongruous relationships between disorganized and interpersonal symptoms with SD underscore the marked heterogeneity in processes across schizotypy.
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PMID:Affective reactivity of speech disturbances in schizotypy. 1961 90

Speech disturbances in schizophrenia impact on the individual's communicative ability. Although they are considered a core feature of schizophrenia, comparatively little work has been done to examine their impact on the life experiences of patients. This study aimed to examine the relationship between schizophrenia speech disturbances, including those traditionally known as formal thought disorder (TD), and quality of life (QoL). It assessed effects on functioning (objective QoL) and satisfaction (subjective QoL) concurrently, while controlling for the influence of neurocognition and depression. Fifty-four patients with schizophrenia/schizoaffective disorder were administered the MATRICS Consensus Cognitive Battery (MCCB), the PANSS, MADRS (with separate ratings for negative TD [verbal underproductivity] and positive TD [verbal disorganisation and pressured speech]) and Lehman's QOLI assessing both objective and subjective QoL. Ratings of positive and negative TD, depression, and general neurocognition were entered into hierarchical regressions to explore their relationship with both life functioning and satisfaction. Verbal underproductivity was a significant predictor of objective QoL, while pressured speech had a trend association with subjective QoL. This suggests a differential relationship between speech disturbances and QoL. Verbal underproductivity seems to affect daily functioning and relations with others, while pressured speech is predictive of satisfaction with life. The impact of verbal underproductivity on QoL suggests it to be an important target for rehabilitation in schizophrenia.
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PMID:Speech disturbances and quality of life in schizophrenia: differential impacts on functioning and life satisfaction. 2431 17

Speech disturbances are prevalent in psychosis. These may arise in part from executive function impairment, as research suggests that inhibition and monitoring are associated with production of cohesive discourse. However, it is not yet understood how linguistic and executive function impairments in psychosis interact with disrupted metacognition, or deficits in the ability to integrate information to form a complex sense of oneself and others and use that synthesis to respond to psychosocial challenges. Whereas discourse studies have historically employed manual hand-coding techniques, automated computational tools can characterize deep semantic structures that may be closely linked with metacognition. In the present study, we examined whether higher executive functioning promotes metacognition by way of altering linguistic cohesion. Ninety-four individuals with schizophrenia-spectrum disorders provided illness narratives and completed an executive function task battery (Delis-Kaplan Executive Function System). We assessed the narratives for linguistic cohesion (Coh-Metrix 3.0) and metacognitive capacity (Metacognition Assessment Scale - Abbreviated). Selected linguistic indices measured the frequency of connections between causal and intentional content (deep cohesion), word and theme overlap (referential cohesion), and unique word usage (lexical diversity). In path analyses using bootstrapped confidence intervals, we found that deep cohesion and lexical diversity independently mediated the relationship between executive functioning and metacognitive capacity. Findings suggest that executive control abilities support integration of mental experiences by way of increasing causal, goal-driven speech and word expression in individuals with schizophrenia. Metacognitive-based therapeutic interventions for psychosis may promote insight and recovery in part by scaffolding use of language that links ideas together.
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PMID:Piecing together fragments: Linguistic cohesion mediates the relationship between executive function and metacognition in schizophrenia. 3178 37