Boucard C, Laffy-Beaufils B
Service de psychiatrie, hôpital Corentin-Celton, 4 parvis Corentin-Celton, 92130 Issy-les-Moulineaux, France.
Encephale. 2008 Jun;34(3):226-32. doi: 10.1016/j.encep.2007.04.005. Epub 2007 Nov 5.
This study investigates a comprehensive assessment of language disorders in order to identify impaired and unaffected language abilities of individuals with schizophrenia. Furthermore, the purpose of this study was to demonstrate the importance of the role of speech therapists in the treatment of schizophrenia. Speech therapy is especially thought to treat language disorders. However, to date, speech therapists have not been solicited in the treatment of schizophrenia, despite growing evidence supporting that schizophrenia is characterized by cognitive disorders such as impairments in memory, attention, executive functioning and language. In this article, we discuss the fact that elements of language and cognition are interactively affected and that cognition influences language. We then demonstrate that language impairments can be treated in the same way as neurological language impairments (cerebrovascular disease, brain injury), in order to reduce their functional outcome. Schizophrenia affects the pragmatic component of language with a major negative outcome in daily living skills [Champagne M, Stip E, Joanette Y. Social cognition deficit in schizophrenia: accounting for pragmatic deficits in communication abilities? Curr Psychiatry Rev:2006;(2):309-315]. The results of our comprehensive assessment also provide a basis for the design of a care plan. For this, subjects with schizophrenia were examined for language comprehension and language production with a focus on pragmatic abilities. In neurology, standardized tests are available that have been designed specifically to assess language functions. However, no such tests are available in psychiatry, so we gathered assessments widely used in neurology and examined the more relevant skills. In this article, each test we chose is described and particular attention is paid to the information they provided on impaired language abilities in schizophrenia. In this manner, we provide an accurate characterization of schizophrenia-associated language impairments and offer a solid foundation for rehabilitation. Current research makes connections between schizophrenia and other neurological disorders concerning language. Nevertheless, further studies are needed to explore these connections to complete our investigations. The strategies we designed are aimed at enabling a subject with schizophrenia to improve his/her language skills. We support the idea that such improvement could be reached by speech therapy. We conclude that speech therapists can play an important role in the non pharmacological treatment of schizophrenia, by selecting appropriate interventions that capitalize on spared abilities to compensate for impaired abilities.
本研究对语言障碍进行了全面评估，以确定精神分裂症患者受损和未受影响的语言能力。此外，本研究的目的是证明言语治疗师在精神分裂症治疗中的重要作用。人们特别认为言语治疗可治疗语言障碍。然而，迄今为止，尽管越来越多的证据支持精神分裂症具有认知障碍，如记忆、注意力、执行功能和语言受损，但言语治疗师尚未被纳入精神分裂症的治疗中。在本文中，我们讨论了语言和认知要素相互影响且认知影响语言这一事实。然后我们证明，语言障碍可以像治疗神经源性语言障碍（脑血管疾病、脑损伤）一样进行治疗，以降低其功能后果。精神分裂症会影响语言的语用成分，对日常生活技能产生重大负面影响[香槟M，斯蒂普E，乔阿内特Y。精神分裂症中的社会认知缺陷：能否解释沟通能力中的语用缺陷？《当代精神病学评论》：2006年；（2）：309 - 315]。我们全面评估的结果也为护理计划的设计提供了依据。为此，对精神分裂症患者进行了语言理解和语言表达检查，重点关注语用能力。在神经病学领域，有专门设计用于评估语言功能的标准化测试。然而，在精神病学领域却没有这样的测试，所以我们收集了神经病学中广泛使用的评估方法，并检查了更相关的技能。在本文中，我们描述了所选择的每项测试，并特别关注它们所提供的关于精神分裂症患者语言能力受损的信息。通过这种方式，我们对与精神分裂症相关的语言障碍进行了准确描述，并为康复提供了坚实基础。当前的研究建立了精神分裂症与其他与语言相关的神经疾病之间的联系。然而，还需要进一步的研究来探索这些联系，以完善我们的调查。我们设计的策略旨在使精神分裂症患者能够提高其语言技能。我们支持这样的观点，即通过言语治疗可以实现这种改善。我们得出结论，言语治疗师可以在精神分裂症的非药物治疗中发挥重要作用，通过选择适当的干预措施，利用未受损的能力来补偿受损的能力。
