Background Remote assessment of acoustic alterations in speech holds promise to increase scalability and validity in research across the psychosis spectrum. A feasible first step in establishing a procedure for online assessments is to assess acoustic alterations in psychometric schizotypy. However, to date, the complex relationship between alterations in speech related to schizotypy and those related to comorbid conditions such as symptoms of depression and anxiety has not been investigated. This study tested whether (1) depression, generalized anxiety and high psychometric schizotypy have similar voice characteristics, (2) which acoustic markers of online collected speech are the strongest predictors of psychometric schizotypy, (3) whether controlling for generalized anxiety and depression symptoms can improve the prediction of schizotypy. Methods We collected cross-sectional, online-recorded speech data from 441 participants, assessing demographics, symptoms of depression, generalized anxiety and psychometric schizotypy. Results Speech samples collected online could predict psychometric schizotypy, depression, and anxiety symptoms, however, most influential features of these models largely overlapped. The predictive power of speech marker-based models of schizotypy significantly improved after controlling for symptoms of depression and generalized anxiety (from R2 = 0.296 to R2 = 0. 436). Conclusions Acoustic features of online collected speech are predictive of psychometric schizotypy as well as generalized anxiety and depression symptoms. The acoustic characteristics of schizotypy, depression and anxiety symptoms significantly overlap. Speech models that are designed to predict schizotypy or symptoms of the schizophrenia spectrum might therefore benefit from controlling for symptoms of depression and anxiety.

Background and Hypothesis Mapping a patient’s speech as a network has proved to be a useful way of understanding formal thought disorder in psychosis. However, to date, graph theory tools have not explicitly modelled the semantic content of speech, which is altered in psychosis. Study Design We developed an algorithm, “netts,” to map the semantic content of speech as a network, then applied netts to construct semantic speech networks for a general population sample (N = 436), and a clinical sample comprising patients with first episode psychosis (FEP), people at clinical high risk of psychosis (CHR-P), and healthy controls (total N = 53). Study Results Semantic speech networks from the general population were more connected than size-matched randomized networks, with fewer and larger connected components, reflecting the nonrandom nature of speech. Networks from FEP patients were smaller than from healthy participants, for a picture description task but not a story recall task. For the former task, FEP networks were also more fragmented than those from controls; showing more connected components, which tended to include fewer nodes on average. CHR-P networks showed fragmentation values in-between FEP patients and controls. A clustering analysis suggested that semantic speech networks captured novel signals not already described by existing NLP measures. Network features were also related to negative symptom scores and scores on the Thought and Language Index, although these relationships did not survive correcting for multiple comparisons. Conclusions Overall, these data suggest that semantic networks can enable deeper phenotyping of formal thought disorder in psychosis. Whilst here we focus on network fragmentation, the semantic speech networks created by Netts also contain other, rich information which could be extracted to shed further light on formal thought disorder. We are releasing Netts as an open Python package alongside this manuscript.

Mapping a patient's speech as a network has proved to be a useful way of understanding formal thought disorder in psychosis. However, to date, graph theory tools have not incorporated the semantic content of speech, which is altered in psychosis. We developed an algorithm, netts, to map the semantic content of speech as a network, then applied netts to construct semantic speech networks for a general population sample, and a clinical sample comprising patients with first episode psychosis (FEP), people at clinical high risk of psychosis (CHR-P), and healthy controls. Semantic speech networks from the general population were more connected than size-matched randomised networks, with fewer and larger connected components, reflecting the non-random nature of speech. Networks from FEP patients were smaller than from healthy participants, for a picture description task but not a story recall task. For the former task, FEP networks were also more fragmented than those from controls; showing more, smaller connected components. CHR-P networks showed fragmentation values in-between FEP patients and controls. A clustering analysis suggested that semantic speech networks captured novel signal not already described by existing NLP measures. Network features were also related to negative symptom scores and scores on the Thought and Language Index, although these relationships did not survive correcting for multiple comparisons. Overall, these data suggest that semantic networks can enable deeper phenotyping of formal thought disorder in psychosis. We are releasing Netts as an open Python package upon publication of this manuscript.

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Automatically extracted measures of speech constitute a promising marker of psychosis as disorganized speech is associated with psychotic symptoms and predictive of psychosis-onset. The potential of speech markers is, however, hampered by (i) lengthy assessments in laboratory settings and (ii) manual transcriptions. We investigated whether a short, scalable data collection (online) and processing (automated transcription) procedure would provide data of sufficient quality to extract previously validated speech measures. To evaluate the fit of our approach for purpose, we assessed speech in relation to psychotic-like experiences in the general population. Participants completed an 8-minutes long speech task online. Sample 1 included measures of psychometric schizotypy and delusional ideation (N = 446). Sample 2 included a low and high psychometric schizotypy group (N = 144). Recordings were transcribed both automatically and manually, and connectivity, semantic and syntactic speech measures were extracted for both type of transcripts. 73%/86% participants in sample 1/2 completed the experiment. Nineteen out of 25 speech measures were strongly (r > 0.7) and significantly correlated between automated and manual transcripts in both samples. Amongst the 14 connectivity measures, 11 showed a significant relationship with delusional ideation. For the semantic and syntactic measures, On Topic score and the Frequency of personal pronouns were negatively correlated with both schizotypy and delusional ideation. Combined with demographic information, the speech markers could explain 11–14% of the variation of delusional ideation and schizotypy in Sample 1 and could discriminate between high-low schizotypy with high accuracy (0.72 − 0.70, AUC = 0.78–0.79) in Sample 2. The moderate to high retention rate, strong correlation of speech measures across manual and automated transcripts and sensitivity to psychotic-like experiences provides initial evidence that online collected speech in combination with automatic transcription is a feasible approach to increase accessibility and scalability of speech-based assessment of psychosis.