Pelizza Lorenzo, Berti Andrea, Di Lisi Alessandro, Maida Michele La, Leuci Emanuela, Quattrone Emanuela, Palmisano Derna, Pupo Simona, Paulillo Giuseppina, Pellegrini Clara, Pellegrini Pietro, Menchetti Marco
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - Università di Bologna, Bologna (BO), Italy.
Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.
Eur Arch Psychiatry Clin Neurosci. 2025 Aug 28. doi: 10.1007/s00406-025-02094-w.
Language impairment has the potential to predict the onset and progression of psychosis. However, it was mainly examined using automated extraction of quantitative linguistic features and their associations with observable psychopathological aspects of psychosis (e.g., formal thought disorders). Little interest has been paid to subjective language disturbances that should phenomenologically anticipate these more objective clinical features. Therefore, the aim of this examination was to investigate subjective language disorders in a Ultra-High Risk (UHR) sample and their associations with clinical and functional outcomes along 2 years of follow-up.
170 UHR participants (88 [51.8%] females; mean age = 19.52 ± 6.03 years) were assessed for a broad range of clinical outcomes, including psychosis transition, clinical and functional remission measured with the Positive and Negative Syndrome Scale and the Social and Occupational Functioning Assessment Scale. Comparisons between patients with or without baseline subjective language disorders (specifically explored with the Schizophrenia Proneness Instrument) were analyzed using Chi-Square and Mann-Whitney tests, Kaplan-Meier survival analysis, and binary logistic regression analysis.
Across the follow-up, the UHR subgroup with language disorders at entry (n = 80) showed higher and more enduring severity in psychopathology (especially negative and disorganized features), as well as poorer socio-occupational functioning over time.
The presence of subjective language disturbances at baseline identifies a subgroup of UHR youths with poorer psychopathological and functional prognosis. Further studies examining their association with quantitative linguistic biomarkers are needed, especially to better predict the onset and progression of psychosis.
语言障碍有可能预测精神病的发作和进展。然而，以往主要是通过自动提取定量语言特征及其与精神病可观察到的精神病理学方面（如形式思维障碍）的关联来进行研究。对于那些在现象学上应先于这些更客观临床特征出现的主观语言障碍，人们关注较少。因此，本研究的目的是调查超高风险（UHR）样本中的主观语言障碍及其在两年随访期间与临床和功能结局的关联。
对170名UHR参与者（88名[51.8%]女性；平均年龄 = 19.52 ± 6.03岁）进行了广泛的临床结局评估，包括精神病转化、使用阳性和阴性症状量表以及社会和职业功能评估量表测量的临床和功能缓解情况。使用卡方检验、曼-惠特尼检验、卡普兰-迈耶生存分析和二元逻辑回归分析，对有或无基线主观语言障碍（具体通过精神分裂症倾向量表进行探索）的患者进行比较分析。
在整个随访期间，入组时存在语言障碍的UHR亚组（n = 80）在精神病理学方面表现出更高且更持久的严重程度（尤其是阴性和紊乱特征），并且随着时间推移社会职业功能较差。
基线时存在主观语言障碍可识别出一组UHR青年，他们的精神病理学和功能预后较差。需要进一步研究其与定量语言生物标志物的关联，特别是为了更好地预测精神病的发作和进展。
