Altered syntactic abilities in first episode patients: An inner phenomenon characterizing psychosis

Abstract

Background: Research has consistently shown that language abilities represent a core dimension of psychosis; however, to date, very little is known about syntactic comprehension performance in the early stages of psychosis. This study aims to compare the linguistic abilities involved in syntactic comprehension in a large group of First Episode Psychosis (FEP) patients and healthy controls (HCs). Methods: A multiple choice test of comprehension of syntax was administered to 218 FEP patients (166 non-affective FEP patients [FEP-NA] and 52 affective FEP patients [FEP-A]) and 106 HCs. All participants were asked to match a sentence they listen with one out of four vignettes on a pc screen. Only one vignette represents the stimulus target, while the others are grammatical or non-grammatical (visual) distractors. Both grammatical and non-grammatical errors and performance in different syntactic constructions were considered. Results: FEP committed greater number of errors in the majority of TCGB language domains compared to HCs. Moreover, FEP-NA patients committed significantly more non-grammatical (z = À3.2, p = 0.007), locative (z = À4.7, p < 0.001), passive-negative (z = À3.2, p = 0.02), and relative (z = À4.6, p < 0.001) errors compared to HCs as well as more passive-affirmative errors compared to both HCs (z = À4.3, p < 0.001) and FEP-A (z = 3.1, p = 0.04). Finally, we also found that both FEP-NA and FEP-A committed more grammatical (FEP-NA: z = À9.2, p < 0.001 and FEP-A: z = À4.4, p < 0.001), total (FEP-NA: z = À8.2, p < 0.001 and FEP-A: z = 3.9, p = 0.002), and active-negative (FEP-NA: z = À5.8, p < 0.001 and FEP-A: z = À3.5, p = 0.01) errors compared to HCs. Conclusions: This study shows that the access to syntactic structures is already impaired in FEP patients, especially in those with FEP-NA, ultimately suggesting that language impairments represent a core and inner feature of psychosis even at early stages.

Language production impairments in patients with a first episode of psychosis

“…Another interesting issue in clinical research is represented by the investigation of similarities and differences in patients with affective and non-affective psychosis. In previous studies by our group, we detected linguistic deficits in both affective and non-affective chronic patients at both receptive [ 13 , 15 – 17 ] and productive levels [ 14 ], with more severe and generalized impairment in patients with schizophrenia than in those with bipolar disorder. In particular, in narrative production, participants with schizophrenia had slight problems in speech rate (that is number of word/unit time) and deficits at both local and global discourse coherence, whereas patients with bipolar disorder showed reduced mean length of utterance, compared with healthy participants [ 14 ].…”

“…Based on such premises, we think that the use of language in the assessment of FEP and in classifying groups represents an extremely useful tool. Specifically, we think that linguistic deficits represent a core dimension of psychosis, being present both at the first stages and in the chronic phase of the illness and covering a large range of linguistic dimensions (both receptive and productive), as showed by a series of publications by our group [13][14][15][16][17] and elsewhere [i.e. 27].…”

“…Language processing rests on the integration between different systems (e.g., those processing phonological, morphological, syntactic, semantic or pragmatic information, see [ 11 , 12 ], for reviews), so their systematic investigation can represent a useful tool to clarify the nature of the linguistic deficits observed in psychosis and to guide the understanding of the pathogenic trajectories of the disease from first episodes to the chronic condition. While the current literature on language impairments is quite large for psychotic patients, also including several papers by our group [ 1 , 12 – 17 ], with chronic patients showing alterations in both language comprehension and production [ 18 ], much less emphasis has been given to the first episode so far. In previous studies, linguistic impairments have been observed in patients with a first episode of psychosis (FEP) at the receptive level [ 15 – 17 , 19 , 20 ].…”

“…While the current literature on language impairments is quite large for psychotic patients, also including several papers by our group [ 1 , 12 – 17 ], with chronic patients showing alterations in both language comprehension and production [ 18 ], much less emphasis has been given to the first episode so far. In previous studies, linguistic impairments have been observed in patients with a first episode of psychosis (FEP) at the receptive level [ 15 – 17 , 19 , 20 ]. By contrast, the investigation of the linguistic productive level has been less investigated in the first phases of the illness.…”

Case Report: The Association Between Chromosomal Anomalies and Cluster A Personality Disorders: The Case of Two Siblings With 16p11.2 Deletion and a Review of the Literature

“…Following the biopsychosocial pathogenetic paradigm, the evolution of personality disorders generally starts from a genetic pre-disposition, on which environmental triggers and traumatic life events are grafted ( 16 , 17 ). Thus, the identification of a connection between chromosomal abnormalities and personality disorders may lead to a better understanding of biological mechanisms underlying these psychiatric conditions and the pre-disposing factors to them ( 18 , 19 ). Moreover, focusing on finding sub-threshold psychotic symptoms often associated with CAPD in patients with a CNV may allow early identification of subjects at risk of developing psychotic disorders in their future ( 20 , 21 ).…”