The Epidemiology and Associated Phenomenology of Formal Thought Disorder: A Systematic Review: Fig. 1.

Roche, Eric; Creed, Lisa; MacMahon, Donagh; Brennan, Daria; Clarke, Mary

doi:10.1093/schbul/sbu129

Cited by 137 publications

(128 citation statements)

References 158 publications

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“…Further, this same classifier discriminated the speech of recentonset psychosis patients from that of healthy individuals with 72% accuracy, suggesting that its discriminatory power was relatively robust across illness stages, as has been found for clinical ratings of thought disorder 1,6 . Finally, the predictive automated and manual linguistic features were highly correlated in the cohort, providing evidence of concurrent validity.…”

Section: Discussionmentioning

confidence: 56%

Prediction of psychosis across protocols and risk cohorts using automated language analysis

et al. 2018

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Language and speech are the primary source of data for psychiatrists to diagnose and treat mental disorders. In psychosis, the very structure of language can be disturbed, including semantic coherence (e.g., derailment and tangentiality) and syntactic complexity (e.g., concreteness). Subtle disturbances in language are evident in schizophrenia even prior to first psychosis onset, during prodromal stages. Using computer-based natural language processing analyses, we previously showed that, among English-speaking clinical (e.g., ultra) high-risk youths, baseline reduction in semantic coherence (the flow of meaning in speech) and in syntactic complexity could predict subsequent psychosis onset with high accuracy. Herein, we aimed to cross-validate these automated linguistic analytic methods in a second larger risk cohort, also English-speaking, and to discriminate speech in psychosis from normal speech. We identified an automated machine-learning speech classifier -comprising decreased semantic coherence, greater variance in that coherence, and reduced usage of possessive pronouns -that had an 83% accuracy in predicting psychosis onset (intra-protocol), a cross-validated accuracy of 79% of psychosis onset prediction in the original risk cohort (cross-protocol), and a 72% accuracy in discriminating the speech of recent-onset psychosis patients from that of healthy individuals. The classifier was highly correlated with previously identified manual linguistic predictors. Our findings support the utility and validity of automated natural language processing methods to characterize disturbances in semantics and syntax across stages of psychotic disorder. The next steps will be to apply these methods in larger risk cohorts to further test reproducibility, also in languages other than English, and identify sources of variability. This technology has the potential to improve prediction of psychosis outcome among at-risk youths and identify linguistic targets for remediation and preventive intervention. More broadly, automated linguistic analysis can be a powerful tool for diagnosis and treatment across neuropsychiatry.Key words: Automated language analysis, prediction of psychosis, semantic coherence, syntactic complexity, high-risk youths, machine learning (World Psychiatry 2018;17:67-75) Language offers a privileged view into the mind: it is the basis by which we infer others' thought processes, such that disorganized language is considered to reflect disorder in thought. Language disturbance is prevalent in schizophrenia and is related to functional disability, given that an individual needs to think and speak clearly in order to maintain friends and a job 1 . In schizophrenia, the speaker "violates the syntactical and semantic conventions which govern language usage", yielding reduction in syntactic complexity (concrete speech, poverty of content) and loss of semantic coherence, e.g. the disruption in flow of meaning in language (derailment, tangentiality) 2. This language disturbance is an early core feature of sch...

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Section: Discussionmentioning

confidence: 56%

Prediction of psychosis across protocols and risk cohorts using automated language analysis

et al. 2018

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“…Other TD dimensions have been described and there are a number of different TD scales. 165,166 It would be potentially informative to compare the same individuals on different TD scales and to examine the longitudinal patterns of TD across scales.…”

Section: Discussionmentioning

confidence: 99%

“…Although severity of TD does fluctuate with clinical state, the risk of TD false negatives is relatively low, especially in relation to SZ. 46,165,167,168 Notably, over 80% of BP patients continued to show detectable TD as outpatients, whether or not they were in full or partial remission or still met criteria for BP. Furthermore, for BP who showed some TD, subtype of most recent episode (manic, depressed, or mixed) was not significantly associated with the severity of the TD.…”

Section: Discussionmentioning

confidence: 99%

Thought Disorder in Schizophrenia and Bipolar Disorder Probands, Their Relatives, and Nonpsychiatric Controls

Morgan

Coleman

Ülgen

et al. 2017

Schizophrenia Bulletin

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Thought disorder (TD) has long been associated with schizophrenia (SZ) and is now widely recognized as a symptom of mania and other psychotic disorders as well. Previous studies have suggested that the TD found in the clinically unaffected relatives of SZ, schizoaffective and bipolar probands is qualitatively similar to that found in the probands themselves. Here, we examine which quantitative measures of TD optimize the distinction between patients with diagnoses of SZ and bipolar disorder with psychotic features (BP) from nonpsychiatric controls (NC) and from each other. In addition, we investigate whether these same TD measures also distinguish their respective clinically unaffected relatives (RelSZ, RelBP) from controls as well as from each other. We find that deviant verbalizations are significantly associated with SZ and are co-familial in clinically unaffected RelSZ, but are dissociated from, and are not co-familial for, BP disorder. In contrast, combinatory thinking was nonspecifically associated with psychosis, but did not aggregate in either group of relatives. These results provide further support for the usefulness of TD for identifying potential non-penetrant carriers of SZ-risk genes, in turn enhancing the power of genetic analyses. These findings also suggest that further refinement of the TD phenotype may be needed in order to be suitable for use in genetic studies of bipolar disorder.

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“…Another reason is the homogeneity of the patient groups investigated, primarily focusing on patients with schizophrenia. The inclusion of further samples including healthy subjects, however, is crucial for the identification of FTD as an intermediate phenotype [24]. One last point is the lack of statistical power due to small sample sizes and therewith the generalizability of the obtained correlation results.…”

Section: Introductionmentioning

confidence: 99%

Distinct Neuropsychological Correlates in Positive and Negative Formal Thought Disorder Syndromes: The Thought and Language Disorder Scale in Endogenous Psychoses

et al. 2016

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The correlation of formal thought disorder (FTD) symptoms and subsyndromes with neuropsychological dimensions is as yet unclear. Evidence for a dysexecutive syndrome and semantic access impairments has been discussed in positive FTD, albeit focusing mostly on patients with schizophrenia. We investigated the correlation of the full range of positive and negative as well as subjective and objective FTD with neuropsychological domains in different patient groups. Patients with ICD-10 schizophrenia (n = 51), depression (n = 51), and bipolar mania (n = 18), as well as healthy subjects (n = 60), were interviewed with the Rating Scale for the Assessment of Objective and Subjective Formal Thought and Language Disorder (TALD) and assessed using a multidimensional neuropsychological test battery (executive function, semantic and lexical verbal fluency, attention, working memory, and abstract thinking). Partial correlation analysis, controlling for age and word knowledge, revealed significant results for the objective positive FTD dimension and executive dysfunctions. Objective negative FTD was associated with deficits in lexico-semantic retrieval, as well as attention and working memory dysfunctions. The results suggest that different neuropsychological substrates correlate with the multidimensional and phenomenologically different FTD syndromes. FTD is a complex, multidimensional syndrome with a variety of neuropsychological impairments, which should be accounted for in future studies investigating the pathogenesis of FTD.

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The Epidemiology and Associated Phenomenology of Formal Thought Disorder: A Systematic Review: Fig. 1.

Abstract: FTD is a common symptom of psychosis and may be considered a marker of illness severity. Detailed dimensional assessment of FTD can clarify diagnosis and may help predict prognosis.

Cited by 137 publications

References 158 publications

Prediction of psychosis across protocols and risk cohorts using automated language analysis

Prediction of psychosis across protocols and risk cohorts using automated language analysis

Thought Disorder in Schizophrenia and Bipolar Disorder Probands, Their Relatives, and Nonpsychiatric Controls

Distinct Neuropsychological Correlates in Positive and Negative Formal Thought Disorder Syndromes: The Thought and Language Disorder Scale in Endogenous Psychoses

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