Chair of Psychiatry, Department of Affective and Psychotic Disorders, Medical University of Lodz, Lodz, Poland.
Chair of Neuropsychology, Department of Cognitive Neuropsychology, University of Warsaw, Warsaw, Poland.
Early Interv Psychiatry. 2019 Jun;13(3):369-378. doi: 10.1111/eip.12482. Epub 2017 Aug 31.
Higher-order language functions are associated with understanding indirect speech acts, lexical-semantic processes, the understanding and production of prosody, discourse production and comprehension. Only a few studies imply that language abnormalities may be present in individuals at ultra-high risk for psychosis (UHR) and first-episode of schizophrenia (FE). The purpose of this study was to test the presence of higher-order language dysfunctions in UHR and FE subjects using a standardized comprehensive test battery.
Twenty patients experiencing FE schizophrenia, 33 UHR individuals and 20 healthy controls (HC) took part in the study. Higher-order language and extralinguistic abilities were evaluated using the Right Hemisphere Language Battery (RHLB-PL). The battery consisted of tests covering the comprehension of implicit information, lexico-semantic processing, understanding humour, making inappropriate remarks and comments, understanding and explaining metaphors, understanding prosody and appropriateness of behaviour in communication settings.
The UHR patients scored lower than HC when comprehending implicit information, discourse and in areas associated with the effectiveness of interpersonal communication; however, they scored higher than the FE participants in explanation of metaphors and processing language information in the context of general knowledge. The FE participants scored lower than healthy controls in comprehension of implicit information, explanation of metaphors, discourse understanding, processing language information in the context of general knowledge and effectiveness of interpersonal communication.
The higher-order language dysfunctions mediated by the right hemisphere appear to be present in subjects at UHR of schizophrenia and those experiencing their FE. The results may play a crucial role in diagnostic processes.
高级语言功能与理解间接言语行为、词汇语义过程、韵律的理解和产生、话语生成和理解有关。只有少数研究表明，语言异常可能存在于精神病超高风险（UHR）和首发精神分裂症（FE）个体中。本研究旨在使用标准化综合测试组评估 UHR 和 FE 受试者中是否存在高级语言功能障碍。
20 名首发精神分裂症患者、33 名 UHR 个体和 20 名健康对照者（HC）参加了研究。使用右半球语言测试组（RHLB-PL）评估高级语言和语言外能力。该测试组包括测试理解隐式信息、词汇语义处理、理解幽默、发表不恰当言论和评论、理解隐喻、理解韵律和在交流环境中行为的适当性。
UHR 患者在理解隐式信息、话语和与人际沟通效果相关的领域的得分低于 HC，但在隐喻解释和在一般知识背景下处理语言信息方面的得分高于 FE 参与者。FE 参与者在理解隐式信息、解释隐喻、理解话语、在一般知识背景下处理语言信息和人际沟通效果方面的得分低于健康对照组。
由右脑介导的高级语言功能障碍似乎存在于精神分裂症的 UHR 受试者和首发患者中。这些结果可能在诊断过程中发挥关键作用。
