The prognostic value of formal thought disorder following first episode psychosis

Roche, Eric; Lyne, John; O’Donoghue, Brian; Segurado, Ricardo; Behan, Caragh; Renwick, Laoise; Fanning, Felicity; Madigan, Kevin; Clarke, Mary

doi:10.1016/j.schres.2016.09.017

Cited by 38 publications

(30 citation statements)

References 54 publications

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“…Formal thought disorder (FTD) is defined by substantial disturbances in a patient's ability to express cogent, complex thoughts (Bleuler, 1950). Although not necessary for a diagnosis of schizophrenia, the presence of FTD predicts onset of psychosis in clinical high risk patients (Dominguez et al, 2010; Ziermans et al, 2014), is present in over 55% of patients in their first episode of psychosis (Roche, Lyne, et al, 2015), and its persistence is linked to worsened social/community functioning (Bowie, Gupta, & Holshausen, 2011; Bowie & Harvey, 2008; Roche et al, 2016), cognitive deficits and poorer clinical outcomes (Cuesta, Peralta, & De Leon, 1994; Roche, Creed, MacMahon, Brennan, & Clarke, 2015). Despite the recognized importance of this syndrome, no effective interventions are available to reduce the burden of FTD in schizophrenia when antipsychotics are ineffective.…”

Section: Introductionmentioning

confidence: 99%

Linguistic determinants of formal thought disorder in first episode psychosis

Mackinley

Chan

et al. 2020

Early Intervention Psych

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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‐naïve, 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.

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Section: Introductionmentioning

confidence: 99%

Linguistic determinants of formal thought disorder in first episode psychosis

Mackinley

Chan

et al. 2020

Early Intervention Psych

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“…Research on the prognostic value of FTD dimensions on functional outcome is limited and inconclusive . However, negative FTD has been reported as predictive for occupation and rehospitalization rates in first episode schizophrenia .…”

Section: Discussionmentioning

confidence: 99%

“…On a behavioral level, negative FTD was linked to global functioning (GAF) . In contrast, Roche and colleges detected positive FTD (disorganized FTD) as the only FTD dimension associated with functional outcome after one year in first episode psychosis . Thus, there is growing evidence that dimensions of FTD have a selective impact on functional outcome .…”

Section: Discussionmentioning

confidence: 99%

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Resting state perfusion in the language network is linked to formal thought disorder and poor functional outcome in schizophrenia

Stegmayer

Stettler

Strik

et al. 2017

Acta Psychiatr Scand

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ObjectiveFormal thought disorder (FTD) is a core symptom in schizophrenia. Here, we focus on resting state cerebral blood flow (rCBF) linked to dimensions of FTD.MethodsWe included 47 schizophrenia spectrum patients and 30 age‐ and gender‐matched healthy controls. We assessed FTD with the assessment of thought, language, and communication (TLC) and imaging on a 3T MRI scanner. Within patients, we tested the association of FTD dimensions and in a subgroup (n = 27) the association of functional outcome after 6 months with whole brain rCBF.ResultsNegative FTD was most prominently associated with perfusion within the superior temporal gyrus, while positive FTD was associated with perfusion within the supplementary motor area, and inferior frontal gyrus. Perfusion within the left supramarginal gyrus was associated with social functioning after 6 months.ConclusionsDistinguishable associations of rCBF with FTD dimensions point to distinct underlying pathophysiology. The location of aberrant perfusion patterns suggests that negative FTD might reflect defective access to semantic memory while positive FTD likely reflects defective suppression of irrelevant information during increased speech production. Finally, the neural correlates of thought block were also predictive of poor functional outcome. Thus, functional outcome and distinct FTD dimensions may share some pathophysiology.

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“…Formal thought disorder (FTD) is defined by substantial disturbances in a patient's ability to express cogent, complex thoughts (Bleuler, 1950). While not necessary for a diagnosis of schizophrenia, the presence of FTD predicts onset of psychosis in individuals who are at clinical high risk of developing psychosis (Dominguez et al, 2010;Ziermans et al, 2014), is present in over 55% of patients in their first episode of psychosis (Roche, Lyne, et al, 2015), and its persistence is linked to worsened social/community functioning (Bowie, Gupta, & Holshausen, 2011;Bowie & Harvey, 2008;Roche et al, 2016), cognitive deficits and poorer clinical outcomes (Cuesta, Peralta, & De Leon, 1994;Roche, Creed, MacMahon, Brennan, & Clarke, 2015). Despite the recognized importance of this syndrome, no effective interventions are available to reduce the burden of FTD in schizophrenia when antipsychotics are ineffective.…”

mentioning

confidence: 99%

Linguistic Determinants of Formal Thought Disorder in First Episode Psychosis

Mackinley¹,

Chan²,

Dempster³

et al. 2019

Preprint

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Background: Disturbances in the expression of thought is a core feature of schizophrenia but assessment of disordered thinking is challenging, relying on clinical intuition which may contribute to the paucity of mechanistic understanding of disorganization seen in early stages of 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: Data were collected from 39 treatment-naïve, actively psychotic first episode patients (FEPs) recruited on first contact and 23 group matched healthy controls. Three one-minute speech samples were induced in response to photographs from the Thematic Apperception Test and speech was analyzed 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: linguistic connective factors predicted disorganized thought, but not impoverishment suggesting aberrant use of connectives is specific to positive thought disorder. Factor 2 (increased temporal, reduced logical connectives), showed statistically significant main effects (F[2,56]=5.58, p=0.006) on ANOVA among HCs, low- and high-disorganization FEPs. Post-hoc differences were noted between High- and Low- disorganization FEPs (p=0.004). Factor 2 was not correlated with measures of disease severity or cognition suggesting connective use is a specific index of disorganized thinking rather than overall illness status.Conclusions: Disorganization in psychosis, assessed on the basis of clinical judgement, is likely linked to the excessive or inappropriate use of linguistic connectives leading to an intuitive sense of incoherence to the observer. In the early stages of untreated psychosis, thought disorder may be quantifiable more reliably using automated syntax analysis.

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The prognostic value of formal thought disorder following first episode psychosis

Cited by 38 publications

References 54 publications

Linguistic determinants of formal thought disorder in first episode psychosis

Linguistic determinants of formal thought disorder in first episode psychosis

Resting state perfusion in the language network is linked to formal thought disorder and poor functional outcome in schizophrenia

Linguistic Determinants of Formal Thought Disorder in First Episode Psychosis

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