BACKGROUND: The 20th century ended without a resolution of the debate about the supremacy of Schneider's psychopathological conceptualisation of schizophrenia (the first-rank symptoms) over Bleuler's 'four As' (disorders of association and affect, ambivalence and autism). AIMS: To examine the relationships between linguistic deviations and symptoms in patients with acute psychosis. METHOD: We assessed language disturbances and first-rank symptoms with the Clinical Language Disorder Rating Scale (CLANG) in 30 consecutive patients with acute psychosis, selected for the presence of at least one active first-rank symptom, and 15 control participants with depression but no psychotic symptoms. RESULTS: Strong positive correlations were found between the CLANG factor 'poverty' and first-rank delusions of control and between semantic/phonemic paraphasias and verbal auditory hallucinations [corrected]. Language disturbances were superior to nuclear symptoms in discriminating ICD-10 schizophrenia from other psychoses. CONCLUSIONS: Evaluating the features of psychosis as deviations in the cerebral organisation of language paves the way to a concept of psychosis that supersedes these traditional but competing categorical concepts.
BACKGROUND: The 20th century ended without a resolution of the debate about the supremacy of Schneider's psychopathological conceptualisation of schizophrenia (the first-rank symptoms) over Bleuler's 'four As' (disorders of association and affect, ambivalence and autism). AIMS: To examine the relationships between linguistic deviations and symptoms in patients with acute psychosis. METHOD: We assessed language disturbances and first-rank symptoms with the Clinical Language Disorder Rating Scale (CLANG) in 30 consecutive patients with acute psychosis, selected for the presence of at least one active first-rank symptom, and 15 control participants with depression but no psychotic symptoms. RESULTS: Strong positive correlations were found between the CLANG factor 'poverty' and first-rank delusions of control and between semantic/phonemic paraphasias and verbal auditory hallucinations [corrected]. Language disturbances were superior to nuclear symptoms in discriminating ICD-10 schizophrenia from other psychoses. CONCLUSIONS: Evaluating the features of psychosis as deviations in the cerebral organisation of language paves the way to a concept of psychosis that supersedes these traditional but competing categorical concepts.
Authors: Wi Hoon Jung; Joon Hwan Jang; Na Young Shin; Sung Nyun Kim; Chi-Hoon Choi; Suk Kyoon An; Jun Soo Kwon Journal: PLoS One Date: 2012-12-14 Impact factor: 3.240