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. 2011 Jul;50(7):669-80.
doi: 10.1016/j.jaac.2011.03.021. Epub 2011 Jun 2.

Thought disorder and communication deviance as predictors of outcome in youth at clinical high risk for psychosis

Carrie E Bearden  1 , Keng Nei Wu, Rochelle Caplan, Tyrone D Cannon
Affiliations

Thought disorder and communication deviance as predictors of outcome in youth at clinical high risk for psychosis

Carrie E Bearden et al. J Am Acad Child Adolesc Psychiatry. 2011 Jul.

Abstract

Objective: Given the fundamental role of thought disorder in schizophrenia, subtle communication disturbance may be a valuable predictor of subsequent development of psychosis. Here we examined the contribution of thought and communication disturbance to the prediction of outcome in adolescents identified as putatively prodromal for psychosis.

Method: Transcribed speech samples were elicited from 105 adolescents (54 identified as being at clinical high risk for a first episode of psychosis [CHR], and 51 demographically comparable comparison subjects) and coded for formal thought disorder (FTD) and linguistic cohesion. We then examined the association of baseline FTD/cohesion with conversion to psychosis and social and role outcome at follow-up, approximately 1 year later.

Results: At baseline, CHR patients who subsequently converted to psychosis (CHR+) showed an elevated rate of illogical thinking and poverty of content (POC) in their speech, relative to both typically developing controls and CHR patients who did not convert to psychosis (CHR-). CHR+ youth also used significantly less referential cohesion at baseline, indicating that they provide fewer references to persons, objects, or events mentioned in preceding utterances. Multiple regression models indicated that, among measures of FTD/cohesion, illogical thinking was uniquely predictive of subsequent conversion to psychosis, whereas POC and referential cohesion were significant predictors of social and role functioning, respectively.

Conclusions: Despite the absence of fully psychotic symptoms, putatively prodromal individuals evidence signs of communication disturbance that are qualitatively similar to those seen in schizophrenia and are predictive of both conversion to psychosis and psychosocial outcome. These findings suggest that FTD measures have prognostic significance for at-risk youth.

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Conflict of interest statement

Disclosures: Dr. Cannon has served as a consultant to Rules-Based Medicine on serum-based assays for psychiatric disorders. Drs. Bearden, and Caplan, and Ms. Wu report no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1
Figure 1
Baseline formal thought disorder (FTD) measures in clinical high risk (CHR) youth who subsequently converted to psychosis (CHR+), CHR youth who did not convert to psychosis (CHR−), and typically developing controls. SE = standard error. *p<.05; **p<.01
Figure 2
Figure 2
Linguistic cohesion measures in clinical high risk youth who subsequently converted to psychosis (CHR+), CHR youth who did not convert to psychosis (CHR−), and typically developing controls. *p<.05. SE = standard error.
See this image and copyright information in PMC

Comment in

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