Chakrabarty Madhushree, Bhattacharya Kaberi, Chatterjee Garga, Biswas Atanu, Ghosal Malay
Bangur Institute of Neuroscience, IPGME&R Kolkata, West Bengal, India.
Midnapore Medical College, Midnapore, West Bengal, India.
Int J Lang Commun Disord. 2023 Jan;58(1):169-188. doi: 10.1111/1460-6984.12778. Epub 2022 Sep 8.
While pragmatic deficits are well documented in patients with schizophrenia (SCZ) and right hemisphere damage (RHD), there is a paucity of research comparing the pragmatic deficits of these two groups. Do they experience similar cognitive dysfunction or is there a dissociation between the two patient groups?
To investigate the nature of pragmatic deficits in these two groups and to gain an understanding of the underlying cognitive mechanisms that might be associated with these deficits to further future investigations.
METHODS & PROCEDURES: A total of 60 participants (15 patients with SCZ; 15 with RHD; 30 (15 + 15) healthy controls (HC) were administered the Bengali Audio-Visual Test-Battery for Assessment of Pragmatic Skills.
OUTCOMES & RESULTS: Both SCZ and RHD patients were found to have significant pragmatic deficits compared with their matched controls. SCZ patients were found to score significantly better than the RHD group in six out of the 10 pragmatic skills when controlled for age and education. Discriminant function analysis was performed and 86.7% of the cases (HC = 100%, SCZ = 73.3% and RHD = 86.7%) were correctly reclassified into their original categories using the test scores.
CONCLUSIONS & IMPLICATIONS: The study suggests that there is heterogeneity in the nature of the pragmatic breakdown within and across patient groups. Therefore, individualized restorative measures targeting the disrupted cognitive mechanism(s) might help elevate pragmatic competence and enhance the social functioning of patients with pragmatic deficits.
What is already known on the subject Pragmatic deficits are common in adults with cognitive impairments of different etiologies. However, few studies have explored pragmatic deficits across clinical populations. Consequently, very little is known about the nature of pragmatic deficits in patients with schizophrenia and right hemisphere damage. What this paper adds to existing knowledge This work offers preliminary data on pragmatic difficulties in patients with schizophrenia and right hemisphere damage. This study overrides the boundaries of traditional classifications and evaluates pragmatic difficulties in these two clinical populations with reference to the underlying cognitive mechanisms, which might be disrupted. What are the potential or actual clinical implications of this work? The study adds a transdiagnostic perspective suggesting that there might be heterogeneity in pragmatic deficits, both within and across patient groups, and stresses the need for individualized therapy.
虽然精神分裂症（SCZ）患者和右半球损伤（RHD）患者的语用缺陷已有充分记录，但比较这两组患者语用缺陷的研究却很少。他们是否经历相似的认知功能障碍，或者这两组患者之间是否存在分离？
研究这两组患者语用缺陷的本质，并了解可能与这些缺陷相关的潜在认知机制，以促进未来的研究。
共有60名参与者（15名SCZ患者；15名RHD患者；30名（15 + 15）健康对照者（HC））接受了孟加拉语视听语用技能评估测试电池。
与匹配的对照组相比，SCZ患者和RHD患者均存在明显的语用缺陷。在控制年龄和教育程度后，发现SCZ患者在10种语用技能中的6种上的得分显著高于RHD组。进行了判别函数分析，使用测试分数将86.7%的病例（HC = 100%，SCZ = 73.3%，RHD = 86.7%）正确重新分类到其原始类别中。
该研究表明，患者组内和组间语用障碍的本质存在异质性。因此，针对受损认知机制的个体化恢复措施可能有助于提高语用能力，增强语用缺陷患者的社会功能。
关于该主题已知的信息 语用缺陷在不同病因的认知障碍成年人中很常见。然而，很少有研究探讨不同临床人群中的语用缺陷。因此，对于精神分裂症患者和右半球损伤患者语用缺陷的本质知之甚少。本文对现有知识的补充 这项工作提供了关于精神分裂症患者和右半球损伤患者语用困难的初步数据。本研究超越了传统分类的界限，并参照可能受损的潜在认知机制评估了这两个临床人群中的语用困难。这项工作的潜在或实际临床意义是什么？该研究增加了一个跨诊断的视角，表明患者组内和组间的语用缺陷可能存在异质性，并强调了个体化治疗的必要性。
