Skip to main content Accessibility help
×
Home

Altered syntactic abilities in first episode patients: An inner phenomenon characterizing psychosis

  • Giuseppe Delvecchio (a1), Elisabetta Caletti (a2), Cinzia Perlini (a3), Francesca Marzia Siri (a2), Angela Andreella (a4), Livio Finos (a5), Marcella Bellani (a6), Franco Fabbro (a7), Antonio Lasalvia (a3) (a6), Chiara Bonetto (a3), Doriana Cristofalo (a3), Paolo Scocco (a8), Armando D’Agostino (a9), Stefano Torresani (a10), Massimiliano Imbesi (a11), Francesca Bellini (a12), Angela Veronese (a8), Cinzia Bressi (a1) (a2), Mirella Ruggeri (a3) (a6), Paolo Brambilla (a1) (a2) and the GET UP Group...

Abstract

Background.

Research has consistently shown that language abilities represent a core dimension of psychosis; however, to date, very little is known about syntactic comprehension performance in the early stages of psychosis. This study aims to compare the linguistic abilities involved in syntactic comprehension in a large group of First Episode Psychosis (FEP) patients and healthy controls (HCs).

Methods.

A multiple choice test of comprehension of syntax was administered to 218 FEP patients (166 non-affective FEP patients [FEP-NA] and 52 affective FEP patients [FEP-A]) and 106 HCs. All participants were asked to match a sentence they listen with one out of four vignettes on a pc screen. Only one vignette represents the stimulus target, while the others are grammatical or non-grammatical (visual) distractors. Both grammatical and non-grammatical errors and performance in different syntactic constructions were considered.

Results.

FEP committed greater number of errors in the majority of TCGB language domains compared to HCs. Moreover, FEP-NA patients committed significantly more non-grammatical (z = −3.2, p = 0.007), locative (z = −4.7, p < 0.001), passive-negative (z = −3.2, p = 0.02), and relative (z = −4.6, p < 0.001) errors compared to HCs as well as more passive-affirmative errors compared to both HCs (z = −4.3, p < 0.001) and FEP-A (z = 3.1, p = 0.04). Finally, we also found that both FEP-NA and FEP-A committed more grammatical (FEP-NA: z = −9.2, p < 0.001 and FEP-A: z = −4.4, p < 0.001), total (FEP-NA: z = −8.2, p < 0.001 and FEP-A: z = 3.9, p = 0.002), and active-negative (FEP-NA: z = −5.8, p < 0.001 and FEP-A: z = −3.5, p = 0.01) errors compared to HCs.

Conclusions.

This study shows that the access to syntactic structures is already impaired in FEP patients, especially in those with FEP-NA, ultimately suggesting that language impairments represent a core and inner feature of psychosis even at early stages.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Altered syntactic abilities in first episode patients: An inner phenomenon characterizing psychosis
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Altered syntactic abilities in first episode patients: An inner phenomenon characterizing psychosis
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Altered syntactic abilities in first episode patients: An inner phenomenon characterizing psychosis
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author at: Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, via F. Sforza 35, 20122 Milan, Italy. E-mail address: paolo.brambilla1@unimi.it (P. Brambilla).

Footnotes

Hide All
1.

The two authors contributed equally to this work.

Footnotes

References

Hide All
[1]Stain, H.J., Hodne, S., Joa, I., ten Velden Hegelstad, W., Douglas, K.M., Langveld, J., et al. The relationship of verbal learning and verbal fluency with written story production: implications for social functioning in first episode psychosis. Schizophr Res, 2012; 138(2–3): 212217.
[2]Reser, M.P., Allott, K.A., Killackey, E., Farhall, J., Cotton, S.M., Exploring cognitive heterogeneity in first-episode psychosis: what cluster analysis can reveal. Psychiatry Res. 2015; 229(3): 819827
[3]Underwood, R., Kumari, V., Peters, E., Cognitive and neural models of threat appraisal in psychosis: a theoretical integration. Psychiatry Res, 2016; 239: 131138.
[4]Wilcox, J., Winokur, G., Tsuang, M., Predictive value of thought disorder in new-onset psychosis. Compr Psychiatry. 2012; 53(6): 674678
[5]Roche, E., Segurado, R., Renwick, L., McClenaghan, A., Sexton, S., Frawley, T., et al. Language disturbance and functioning in first episode psychosis. Psychiatry Res, 2016; 235: 2937.
[6]Crow, T.J., Is schizophrenia the price that Homo sapiens pays for language?. Schizophr Res, 1997; 28(2–3): 127141.
[7]Crow, T.J., Schizophrenia as the price that Homo sapiens pays for language: a resolution of the central paradox in the origin of the species. Brain Res Rev, 2000; 31(2–3): 118129.
[8]Condray, R., Steinhauer, S.R., Goldstein, G., Language comprehension in schizophrenics and their brothers. Biol Psychiatry. 1992; 32(9): 790802
[9]Klosterkötter, J., Hellmich, M., Steinmeyer, E.M., Schultze-Lutter, F., Diagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiatry. 2001; 58(2): 158164
[10]Cannon, M., Caspi, A., Moffitt, T.E., Harrington, H., Taylor, A., Murray, R.M., et al. Evidence for early-childhood, pan-developmental impairment specific to schizophreniform disorder: results from a longitudinal birth cohort. Arch Gen Psychiatry. 2002; 59(5): 449456
[11]Fuller, R., Nopoulos, P., Arndt, S., O’Leary, D., Ho, B.C., Andreasen, N.C., Longitudinal assessment of premorbid cognitive functioning in patients with schizophrenia through examination of standardized scholastic test performance. Am J Psychiatry. 2002; 159(7): 11831189
[12]Thomas, P., Leudar, I., Newby, D., Johnston, M., Syntactic processing and written language output in first onset psychosis. J Commun Disord. 1993; 26(4): 209230
[13]Solomon, M., Olsen, E., Niendam, T., Ragland, J.D., Yoon, J., Minzenberg, M., et al. From lumping to splitting and back again: atypical social and language development in individuals with clinical-high-risk for psychosis, first episode schizophrenia, and autism spectrum disorders. Schizophr Res, 2011; 131(1–3): 146151.
[14]Lott, P.R., Guggenbühl, S., Schneeberger, A., Pulver, A.E., Stassen, H.H., Linguistic analysis of the speech output of schizophrenic, bipolar, and depressive patients. Psychopathology. 2002; 35(4): 220227
[15]Kravariti, E., Reichenberg, A., Morgan, K., Dazzan, P., Morgan, C., Zanelli, J.W., et al. Selective deficits in semantic verbal fluency in patients with a first affective episode with psychotic symptoms and a positive history of mania. Bipolar Disord. 2009; 11(3): 323329
[16]Xu, J.Q., Hui, C.L.M., Longenecker, J., Lee, E.H.M., Chang, W.C., Chan, S.K.W., et al. Executive function as predictors of persistent thought disorder in first-episode schizophrenia: a one-year follow-up study. Schizophr Res. 2014; 159(2): 465470
[17]Bellani, M., Brambilla, P., Social cognition, schizophrenia and brain imaging. Epidemiol Psychiatry Soc. 2008; 17(2): 117119
[18]Tavano, A., Sponda, S., Fabbro, F., Perlini, C., Rambaldelli, G., Ferro, A., et al. Specific linguistic and pragmatic deficits in Italian patients with schizophrenia. Schizophr Res, 2008; 102(1–3): 5362.
[19]Perlini, C., Marini, A., Garzitto, M., Isola, M., Cerruti, S., Marinelli, V., et al. Linguistic production and syntactic comprehension in schizophrenia and bipolar disorder. Acta Psychiatr Scand. 2012; 126(5): 363376
[20]Bambini, V., Arcara, G., Bechi, M., Buonocorec, M., Cavallaro, R., Bosia, M., The communicative impairment as a core feature of schizophrenia: frequency of pragmatic deficit, cognitive substrates, and relation with quality of life. Compr Psychiatry, 2016; 71: 106120.
[21]Moro, A., Bambini, V., Bosia, M., Anselmetti, S., Riccaboni, R., Cappa, S.F., et al. Detecting syntactic and semantic anomalies in schizophrenia. Neuropsychologia, 2015; 79: 147157.
[22]DeLisi, L.E., Speech disorder in schizophrenia: review of the literature and exploration of its relation to the uniquely human capacity for language. Schizophr Bull. 2001; 27(3): 481496
[23]David, A.S., The cognitive neuropsychiatry of auditory verbal hallucinations: an overview. Cogn Neuropsychiatry, 2004; 9(1–2): 107123.
[24]McKenna, P.J., Oh, T.M., Schizophrenic speech. Making sense of bathroots and ponds that fall in doorways, Cambridge, New York: Cambridge University Press; 2015.
[25]Strik, W., Dierks, T., Hubl, D., Horn, H., Hallucinations, thought disorders, and the language domain in schizophrenia. Clin EEG Neurosci. 2008; 39(2): 9194
[26]Spalletta, G., Tomaiuolo, F., Marino, V., Bonaviri, G., Trequattrini, A., Caltagirone, C., Chronic schizophrenia as a brain misconnection syndrome: a white matter voxel-based morphometry study. Schizophr Res. 2003; 64(1): 1523
[27]Iwashiro, N., Koike, S., Satomura, Y., Suga, M., Nagai, T., Natsubori, T., et al. Association between impaired brain activity and volume at the sub-region of Broca’s area in ultra-high risk and first-episode schizophrenia: a multi-modal neuroimaging study. Schizophr Res, 2016; 172(1–3): 915.
[28]Marini, A., Spoletini, I., Rubino, I.A., Ciuffa, M., Bria, P., Martinotti, G., et al. The language of schizophrenia: an analysis of micro and macrolinguistic abilities and their neuropsychological correlates. Schizophr Res, 2008; 105(1–3): 144155.
[29]Ruggeri, M., Bonetto, C., Lasalvia, A., De Girolamo, G., Fioritti, A., Rucci, P. et al. A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial. Trials, 2012: 3(1)73
[30]Ruggeri, M., Bonetto, C., Lasalvia, A., Fioritti, A., De Girolamo, G., Santonastaso, P., et al. Feasibility and effectiveness of a multi-element psychosocial intervention for first-episode psychosis: results from the cluster-randomized controlled GET UP PIANO trial in a catchment area of 10 million inhabitants. Schizophr Bull. 2015; 41(5): 11921203
[31]World Health Organization, , Schedules for clinical assessment in neuropsychiatry, Geneva: WHO; 1992.
[32]Kay, S.R., Fiszbein, A., Opler, L.A., The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987; 13(2): 261276
[33]Hamilton, M., A rating scale for depression. J Neurol Neurosurg Psychiatry, 1960; 23: 5662.
[34]Bech, P., Rafaelsen, O.J., Kramp, P., Bolwig, T.G., The mania rating scale: scale construction and inter-observer agreement. Neuropharmacology. 1978; 17(6): 430431
[35]American Psychiatric Association, , Diagnostic and statistical manual of mental disorders 3rd edn, revised, Washington, DC: APA; 1987. (DSM–III–R)
[36]Colombo, L., Sartori, G., Brivio, C., Stima del quoziente intellettivo tramite l’applicazione del TIB (test breve di Intelligenza). Giornale Italiano di Psicologia.. 2002; 29(3): 613638
[37]Chilosi, A.M., Cipriani, P., Test di Comprensione Grammaticale per Bambini, Italy: Del Cerro, Tirrenia; 1995.
[38]Team, R.C., R: a language and environment for statistical computing, Vienna, Austria: R Foundation for Statistical Computing; 2013.
[39]Goeman, J.J., Finos, L., The inheritance procedure: multiple testing of tree structured hypotheses. Stat Appl Genet Mol Biol, 2012; 11(1): 21
[40]Cohen, J., Statistical power analysis for the behavioral sciences 2nd ed., Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers; 1988.
[41]Sullivan, G.M., Feinn, R., Using effect size—or why the P value is not enough. J Grad Med Educ. 2012; 4(3): 279282
[42]Grodzinsky, Y., The neurology of syntax: language use without Broca’s area. Behav Brain Sci. 2000; 23(1): 121
[43]Rodd, J.M., Vitello, S., Woollams, A.M., Adank, P., Localising semantic and syntactic processing in spoken and written language comprehension: an activation likelihood estimation meta-analysis. Brain Lang, 2015; 141: 89102.
[44]Zaccarella, E., Friederici, A.D., Merge in the human brain: a sub-region based functional investigation in the left pars opercularis. Front Psychol, 2015; 6: 1818
[45]Xiao, Y., Friederici, A.D., Margulies, D.S., Brauer, J., Development of a selective left-hemispheric fronto-temporal network for processing syntactic complexity in language comprehension. Neuropsychologia, 2016; 3: 274282.
[46]Blank, I., Balewski, Z., Mahowald, K., Fedorenko, E., Syntactic processing is distributed across the language system. Neuroimage, 2016; 127: 307323.
[47]Francis, A.N., Seidman, L.J., Jabbar, G.A., Mesholam-Gately, R., Thermenos, H.W., Juelich, R., et al. Alterations in brain structures underlying language function in young adults at high familial risk for schizophrenia. Schizophr Res. 2012; 141(1): 6571
[48]Li, X., Alapati, V., Jackson, C., Xia, S., Bertisch, H.C., Branch, C.A., et al. Structural abnormalities in language circuits in genetic high-risk subjects and schizophrenia patients. Psychiatry Res. 2012; 201(3): 182189
[49]Park, H.Y., Hwang, J.Y., Jung, W.H., Shin, N.Y., Shim, G., Jang, J.H., et al. Altered asymmetry of the anterior cingulate cortex in subjects at genetic high risk for psychosis. Schizophr Res, 2013; 150(2–3): 512518.
[50]Crow, T.J., Chance, S.A., Priddle, T.H., Radua, J., James, A.C., Laterality interacts with sex across the schizophrenia/bipolarity continuum: an interpretation of meta-analyses of structural MRI. Psychiatry Res. 2013; 210(3): 12321244
[51]Craddock, N., O’Donovan, M.C., Owen, M.J., Psychosis genetics: modeling the relationship between schizophrenia, bipolar disorder, and mixed (or “schizoaffective”) psychoses. Schizophr Bull. 2009; 35(3): 482490
[52]Calvo, A., Delvecchio, G., Altamura, A.C., Soares, J.C., Brambilla, P., Gray matter volume differences between affective and non-affective first episode psychosis: a review of magnetic resonance Imaging studies. J Affect Disord, 2018; 243: 564574.
[53]De Peri, L., Crescini, A., Deste, G., Fusar-Poli, P., Sacchetti, E., Vita, A., Brain structural abnormalities at the onset of schizophrenia and bipolar disorder: a meta-analysis of controlled magnetic resonance imaging studies. Curr Pharm Des. 2012; 18(4): 486494
[54]Lewandowski, K.E., Cohen, B.M., Keshavan, M.S., Öngür, D., Relationship of neurocognitive deficits to diagnosis and symptoms across affective and non-affective psychoses. Schizophr Res, 2011; 133(1–3): 212217.
[55]Caletti, E., Delvecchio, G., Andreella, A., Finos, L., Perlini, C., Tavano, A., et al. Prosody abilities in a large sample of affective and non-affective first episode psychosis patients. Compr Psychiatry, 2018; 86: 3138.
[56]Perlini, C., Bellani, M., Finos, L., Lasalvia, A., Bonetto, C., Scocco, P., et al. Non literal language comprehension in a large sample of first episode psychosis patients in adulthood. Psychiatry Res, 2018; 260: 7889.
[57]Krabbendam, L., Arts, B., van Os, J., Aleman, A., Cognitive functioning in patients with schizophrenia and bipolar disorder: a quantitative review. Schizophr Res, 2005; 80(2–3): 137149.
[58]Caletti, E., Paoli, R.A., Fiorentini, A., Cigliobianco, M., Zugno, E., Serati, M. et al. Neuropsychology, social cognition and global functioning among bipolar, schizophrenic patients and healthy controls: preliminary data. Front Hum Neurosci, 2013; 7: 661
[59]Rao, N.P., Arasappa, R., Reddy, N.N., Venkatasubramanian, G., Gangadhar, B.N., Antithetical asymmetry in schizophrenia and bipolar affective disorder: a line bisection study. Bipolar Disord. 2010; 12(3): 221229
[60]Alary, M., Razafimandimby, A., Delcroix, N., Leroux, E., Delamillieure, P., Brazo, P., et al. Reduced functional cerebral lateralization: a biomarker of schizophrenia?. Bipolar Disord. 2013; 15(4): 449451
[61]Royer, C., Delcroix, N., Leroux, E., Alary, M., Razafimandimby, A., Brazo, P., et al. Functional and structural brain asymmetries in patients with schizophrenia and bipolar disorders. Schizophr Res, 2015; 161(2–3): 210214.
[62]Zubieta, J.K., Huguelet, P., Lajiness-O’Neill, R., Giordani, B.J., Cognitive function in euthymic bipolar I disorder. Psychiatry Res. 2001; 102(1): 920
[63]Heydebrand, G., Weiser, M., Rabinowitz, J., Hoff, A.L., DeLisi, L.E., Csernansky, J.G., Correlates of cognitive deficits in first episode schizophrenia. Schizophr Res, 2004; 68: 19.
[64]Bora, E., Yucel, M., Pantelis, C., Cognitive functioning in schizophrenia, schizoaffective disorder and affective psychoses: meta-analytic study. Br J Psychiatry. 2009; 195(6): 475482
[65]Swets, B., Desmet, T., Hambrick, D.Z., Ferreira, F., The role of working memory in syntactic ambiguity resolution: a psychometric approach. J Exp Psychol Gen, 2007; 136(1): 64
[66]Wilson, S.M., Galantucci, S., Tartaglia, M.C., Rising, K., Patterson, D.K., Henry, M.L., et al. Syntactic processing depends on dorsal language tracts. Neuron. 2011; 2(2): 397403

Keywords

Type Description Title
WORD
Supplementary Table S1-S4

Delvecchio et al. Supplementary Material
Delvecchio et al. Supplementary Material

 Word (35 KB)
35 KB

Altered syntactic abilities in first episode patients: An inner phenomenon characterizing psychosis

  • Giuseppe Delvecchio (a1), Elisabetta Caletti (a2), Cinzia Perlini (a3), Francesca Marzia Siri (a2), Angela Andreella (a4), Livio Finos (a5), Marcella Bellani (a6), Franco Fabbro (a7), Antonio Lasalvia (a3) (a6), Chiara Bonetto (a3), Doriana Cristofalo (a3), Paolo Scocco (a8), Armando D’Agostino (a9), Stefano Torresani (a10), Massimiliano Imbesi (a11), Francesca Bellini (a12), Angela Veronese (a8), Cinzia Bressi (a1) (a2), Mirella Ruggeri (a3) (a6), Paolo Brambilla (a1) (a2) and the GET UP Group...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

Altered syntactic abilities in first episode patients: An inner phenomenon characterizing psychosis

  • Giuseppe Delvecchio (a1), Elisabetta Caletti (a2), Cinzia Perlini (a3), Francesca Marzia Siri (a2), Angela Andreella (a4), Livio Finos (a5), Marcella Bellani (a6), Franco Fabbro (a7), Antonio Lasalvia (a3) (a6), Chiara Bonetto (a3), Doriana Cristofalo (a3), Paolo Scocco (a8), Armando D’Agostino (a9), Stefano Torresani (a10), Massimiliano Imbesi (a11), Francesca Bellini (a12), Angela Veronese (a8), Cinzia Bressi (a1) (a2), Mirella Ruggeri (a3) (a6), Paolo Brambilla (a1) (a2) and the GET UP Group...
Submit a response

Comments

No Comments have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *