Higher order language impairments can predict the transition of ultrahigh risk state to psychosis-An empirical study.

communication conversion to schizophrenia pragmatic language transition to psychosis ultrahigh risk state

Journal

Early intervention in psychiatry
ISSN: 1751-7893
Titre abrégé: Early Interv Psychiatry
Pays: Australia
ID NLM: 101320027

Informations de publication

Date de publication:
04 2021
Historique:
received: 04 07 2019
revised: 23 11 2019
accepted: 27 01 2020
pubmed: 14 2 2020
medline: 26 10 2021
entrez: 14 2 2020
Statut: ppublish

Résumé

Higher order language skills, for example, non-literal language, humour, prosody deal with 'what is meant' and they are necessary for communicative exchange and relationships; No study has investigated their link with conversion to psychosis. The purpose of this study was to determine whether such skills could act as predictors of the onset of psychosis, and compare those of individuals converting and non-converting to psychosis with control of cognitive functions. Seventy-three patients, aged 15 to 32 years, fulfilling ultrahigh risk criteria took part: 14% of whom were receiving antipsychotic drugs. The study was observational, prospective and longitudinal in nature, and scheduled for 60 months. Pragmatic language skills were evaluated using the Polish version of the right hemisphere language battery. The ultrahigh risk (UHR) criteria were evaluated with Comprehensive Assessment of At-Risk Mental States; attention, intelligence and verbal fluency were controlled. The conversion rate was 25%; converters demonstrated impaired humour comprehension and metaphor explanation abilities; composite score of pragmatic language was associated with a hazard ratio of 6.0 (95% CI 1.8-20.5) and AUC of .73. Verbal fluency was an independent predictor of conversion, but attention and intelligence were not; pragmatic language skills were associated with social function but not with prodromal symptoms. The results suggest that deficits in humour comprehension and metaphor explanation could predict conversion to psychosis. These findings could improve diagnosis and create implications for speech and language therapy in UHR groups. Further studies on the mechanisms of pragmatic skills should analyze their relationship with abstract measures and semantic coherence.

Identifiants

pubmed: 32052573
doi: 10.1111/eip.12943
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

314-327

Informations de copyright

© 2020 John Wiley & Sons Australia, Ltd.

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Auteurs

Agnieszka Pawełczyk (A)

Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland.

Emilia Łojek (E)

Department of Cognitive Neuropsychology, University of Warsaw, Warsaw, Poland.

Natalia Żurner (N)

Child and Adolescent Psychiatry, Central Clinical Hospital of Medical University of Łódź, Łódź, Poland.

Magdalena Kotlicka-Antczak (M)

Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland.

Tomasz Pawełczyk (T)

Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland.

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