Assessing Pragmatic Language Skills in Adults with Major Depressive Disorder: An Exploratory Study

Abstract

Introduction: There is increasing evidence that major depressive disorder (MDD) is associated with significant pragmatic language impairments. However, there is a lack of studies that use standardized tools and simultaneously investigate all pragmatic language skills among MDD patients. The aim of this study was to propose a more thorough investigation of all pragmatic language skills in patients with MDD. Methods: Twenty adults (aged 22–65) with a DSM-5 diagnosis of MDD were assessed using BLED Santa Lucia (Batteria sul Linguaggio dell’Emisfero Destro Santa Lucia), a battery designed to evaluate pragmatic language skills (comprehension of inferences, of picture and written metaphors, of indirect requests, of humoristic expressions, and of prosody). The performance of the MDD participants on all BLED Santa Lucia subscales was compared to 20 healthy control subjects (aged 20–60) matched for gender, age, years of education, and employment status. Results: MDD patients performed poorer than controls in comprehension of inferences (p < 0.01), picture metaphors (p < 0.001), written metaphors (p < 0.001), indirect requests (p < 0.01), humoristic expression (p < 0.05), and prosody (p < 0.05). Conclusions: All pragmatic language skills can be significantly impaired in MDD patients. A valid assessment of all pragmatic language skills can allow, for each patient, the definition of a specific profile of risk and protective factors before and during psychotherapy.

Case report: Pragmatic impairment in multiple sclerosis after worsening of clinical symptoms

“…This worsening in mood was also qualitatively noted by the clinician in PM’s behavior in the days before the second assessment (lying in bed for prolonged periods of time), strongly suggesting a depressive/apathic symptomatology. Although depression may have a role in PM’s worsening in attention and pragmatic abilities ( Zurlo and Ruggiero, 2021 ), it is hardly to be the sole reason of the observed pattern of deficits. If depression had a major role, we would expect an effect extending not only to pragmatics but also to other aspects of cognitive functions that have been reported to be sensitive to mood in MS (as executive functions and verbal memory; Chiaravalloti and DeLuca, 2008 ; Mattioli et al, 2011 ), which were nevertheless spared in PM’s performance.…”