Linguistic determinants of formal thought disorder in first episode psychosis
Linguistic determinants of formal thought disorder in first episode psychosis
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DOI：
10.1111/eip.12948
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发表时间：
2020-03-03
影响因子：
2
通讯作者：
Palaniyappan, Lena
中科院分区：
文献类型：
--
作者：
Mackinley, Michael;Chan, Jenny;Palaniyappan, Lena
目的 思维障碍是精神分裂症的核心特征，但对思维障碍的评估具有挑战性，这可能导致人们对早期精神病中的混乱缺乏机械性的理解。我们在未经治疗的首发精神病 (FEP) 和健康对照 (HC) 中使用自动言语分析，研究了与临床量化思维障碍维度相关的语言连接词的使用。方法 招募了 39 名未接受治疗的活动性精神病 FEP 和 23 组匹配的 HC。根据主题统觉测试的照片诱发三个一分钟的语音样本，并使用 COH-METRIX 软件对语音进行分析。使用主成分分析减少了 Coh-Metrix 软件中的五个连接词变量，从而产生了两个语言连接词因子。使用思维语言指数 (TLI) 和 PANSS-8 评估思维障碍。结果 连接因素预测混乱，但不预测贫困，表明连接词的异常使用是积极思维障碍所特有的。比较低和高混乱度 FEP 的独立 t 检验显示，与低混乱度 FEP 相比，高混乱度 FEP 中的因果时间连接词负载更高（高与低混乱度 FEP 的平均 [SD] = 0.64 (1.1) vs -0.37 (1.02)；t = 2.91，P = .006）。非因果-时间连接词与症状或认知的严重程度无关，表明连接词的使用是思维混乱的特定指标，而不是整体疾病状态。结论对精神病混乱的临床评估可能与连接词的异常使用导致直觉上的不连贯感有关。在早期精神病中，可以使用自动语法分析可靠地量化思维障碍。
Aim Thought disorder is a core feature of schizophrenia but assessment of disordered thinking is challenging, which may contribute to the paucity of mechanistic understanding of disorganization in early psychosis. We studied the use of linguistic connectives in relation to clinically quantified dimensions of thought disorder using automated speech analysis in untreated, first episode psychosis (FEPs) and healthy controls (HCs).Methods 39 treatment-naive, actively psychotic FEPs and 23 group matched HCs were recruited. Three one-minute speech samples were induced in response to photographs from the Thematic Apperception Test and speech was analysed using COH-METRIX software. Five connectives variables from the Coh-Metrix software were reduced using principle component analysis, resulting in two linguistic connectives factors. Thought disorder was assessed using the Thought Language Index (TLI) and the PANSS-8.Results Connective factors predicted disorganization, but not impoverishment suggesting aberrant use of connectives is specific to positive thought disorder. An independent t test comparing low and high disorganization FEPs showed higher load of acausal temporal connectives in high disorganization FEPs compared to low disorganization FEPs (mean [SD] in high vs low disorganization FEPs = 0.64 (1.1) vs -0.37 (1.02); t = 2.91, P = .006). Acausal-temporal connectives were not correlated with severity of symptoms or cognition suggesting connective use is a specific index of disorganized thinking rather than overall illness status.Conclusions Clinical assessment of disorganization in psychosis is likely linked to the aberrant use of connectives resulting in an intuitive sense of incoherence. In early psychosis, thought disorder may be reliably quantifiable using automated syntax analysis.