Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK.
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK.
Schizophr Res. 2021 Feb;228:493-501. doi: 10.1016/j.schres.2020.09.002. Epub 2020 Sep 18.
Formal thought disorder is a cardinal feature of psychotic disorders, and is also evident in subtle forms before psychosis onset in individuals at clinical high-risk for psychosis (CHR-P). Assessing speech output or assessing expressive language with speech as the medium at this stage may be particularly useful in predicting later transition to psychosis.
Speech samples were acquired through administration of the Thought and Language Index (TLI) in 24 CHR-P participants, 16 people with first-episode psychosis (FEP) and 13 healthy controls. The CHR-P individuals were then followed clinically for a mean of 7 years (s.d. = 1.5) to determine if they transitioned to psychosis. Non-semantic speech graph analysis was used to assess the connectedness of transcribed speech in all groups.
Speech was significantly more disconnected in the FEP group than in both healthy controls (p < .01) and the CHR-P group (p < .05). Results remained significant when IQ was included as a covariate. Significant correlations were found between speech connectedness measures and scores on the TLI, a manual assessment of formal thought disorder. In the CHR-P group, lower scores on two measures of speech connectedness were associated with subsequent transition to psychosis (8 transitions, 16 non-transitions; p < .05).
These findings support the utility and validity of speech graph analysis methods in characterizing speech connectedness in the early phases of psychosis. This approach has the potential to be developed into an automated, objective and time-efficient way of stratifying individuals at CHR-P according to level of psychosis risk.
思维形式障碍是精神障碍的一个主要特征，在精神病高危个体（CHR-P）出现精神病前，也存在细微形式。在该阶段评估言语输出或评估以言语为媒介的表达性语言，可能对预测以后向精神病的转变特别有用。
通过对 24 名 CHR-P 参与者、16 名首发精神病（FEP）患者和 13 名健康对照者进行思维与语言索引（TLI）测试，获取了言语样本。然后，对 CHR-P 个体进行了平均 7 年（标准差=1.5）的临床随访，以确定他们是否向精神病转变。在所有组中，使用非语义言语图分析来评估转录言语的连贯性。
与健康对照组（p<.01）和 CHR-P 组（p<.05）相比，FEP 组的言语明显更不连贯。当将智商作为协变量纳入时，结果仍然显著。言语连贯性测量值与 TLI 之间存在显著相关性，TLI 是对形式思维障碍的手动评估。在 CHR-P 组中，言语连贯性两个测量值的得分较低与随后向精神病的转变相关（8 次转变，16 次未转变；p<.05）。
这些发现支持言语图分析方法在精神病早期阶段描述言语连贯性的有效性和有效性。这种方法有可能发展成为一种自动化、客观和高效的方法，根据精神病风险水平对 CHR-P 个体进行分层。
