Berna Yalınçetin

Formal thought disorder in schizophrenia and bipolar disorder: A systematic review and meta-analysis

Historically, formal thought disorder has been considered as one of the distinctive symptoms of schizophrenia. However, research in last few decades suggested that there is a considerable clinical and neurobiological overlap between schizophrenia and bipolar disorder (BP). We conducted a meta-analysis of studies comparing positive (PTD) and negative formal thought disorder (NTD) in schizophrenia and BP. We included 19 studies comparing 715 schizophrenia and 474 BP patients. In the acute inpatient samples, there was no significant difference in the severity of PTD (d=-0.07, CI=-0.22-0.09) between schizophrenia and BP. In stable patients, schizophrenia was associated with increased PTD compared to BP (d=1.02, CI=0.35-1.70). NTD was significantly more severe (d=0.80, CI=0.52-0.1.08) in schizophrenia compared to BP. Our findings suggest that PTD is a shared feature of both schizophrenia and BP but persistent PTD or NTD can distinguish subgroups of schizophrenia from BP and schizophrenia patients with better clinical outcomes.

Formal thought disorder in first-episode psychosis.

Formal thought disorder (FTD) is one of the fundamental symptom clusters of schizophrenia and it was found to be the strongest predictor determining conversion from first-episode acute transient psychotic disorder to schizophrenia. Our goal in the present study was to compare a first-episode psychosis (FEP) sample to a healthy control group in relation to subtypes of FTD. Fifty six patients aged between 15 and 45years with FEP and forty five control subjects were included in the study. All the patients were under medication for less than six weeks or drug-naive. FTD was assessed using the Thought and Language Index (TLI), which is composed of impoverishment of thought and disorganization of thought subscales. FEP patients showed significantly higher scores on the items of poverty of speech, weakening of goal, perseveration, looseness, peculiar word use, peculiar sentence construction and peculiar logic compared to controls. Poverty of speech, perseveration and peculiar word use were the significant factors differentiating FEP patients from controls when controlling for years of education, family history of psychosis and drug abuse.

Duration of untreated psychosis and neurocognition in first-episode psychosis: A meta-analysis

Neurocognitive impairment is a well-established feature of first-episode psychosis (FEP). Neurotoxicity hypothesis of psychosis suggests that untreated psychosis before the initiation of first effective treatment is associated with loss of acquired cognitive abilities. However, the outcome of the studies investigating the relationship between duration of untreated psychosis (DUP) and cognitive impairment in FEP remains inconclusive. No previous meta-analysis investigating the relationship between DUP and cognitive impairment in FEP has been published. Following the systematic review of FEP studies, a random-effects meta-analysis of the relationship between DUP and neurocognition in schizophrenia was conducted. Current meta-analysis included 27 studies including 3127 patients with first-episode psychosis. Overall, DUP and cognitive abilities were not significantly related, with the exception of evidence for a weak relationship with a single cognitive domain. There was a very small but significant association between longer DUP and reduced performance in planning/problem-solving ability (r=-0.09, CI=-0.14 to -0.03). Current findings do not provide support for the neurotoxicity hypothesis of psychosis.

Relation of formal thought disorder to symptomatic remission and social functioning in schizophrenia

OBJECTIVE The aim of this cross-sectional study is to examine the relation of formal thought disorder (FTD) with symptomatic remission (SR) and social functioning in patients with schizophrenia. METHOD The study was carried out with a sample consisting of 117 patients diagnosed with schizophrenia according to DSM-IV. The patients were assessed with the Positive and Negative Syndrome Scale (PANSS), the Thought and Language Index (TLI), and the Personal and Social Performance Scale (PSP). We used logistic regression in order to determine the relation between FTD and SR and linear regression to identify the strength of association between FTD and social functioning. RESULTS Logistic regression analysis revealed that poverty of speech (odds ratio: 1.47, p<0.01) and peculiar logic (odds ratio: 1.66, p=0.01) differentiated the remitted patients from the non-remitted ones. Linear regression analysis showed that the PSP total score was associated with poverty of speech and peculiar logic items of the TLI (B=-0.23, p<0.01, B=-0.24, p=0.01, respectively). CONCLUSION Our findings suggest that poverty of speech and peculiar logic are the specific domains of FTD which are related to both SR status and social functioning in patients with schizophrenia.

Is There any Relation Between Impaired Emotion Perception and Thought Disorder in Schizophrenia

Introduction Many patients with schizophrenia demonstrate an impaired recognition of emotions as well as thought disorder. However, there may be a correlation between these core impairment domains of schizophrenia. The objective of the present study was to investigate the relationship between the perception of emotion and thought disturbance in schizophrenia. Methods The sample consisted of 53 patients with schizophrenia and 38 healthy controls. The Emotions Battery of the University of Pennsylvania Computerised Neuropsychological Test Battery (PennCNP) and the Thought Language Index (TLI) were used to examine the association of the perception of emotion and thought disorders. Results Statistical analyses revealed that patients with schizophrenia had poor performance on the recognition of happy, sad, fear, anger, and neutral facial emotion expressions compared to controls. Severity of negative and disorganisation symptoms in schizophrenia patients was found to be related to negative emotions (fear, anger, etc.). Moreover, results revealed that disorganised thoughts are related to misidentification of positive emotions (happy). Conclusions Our results suggested that emotion perception disturbances could be associated with disorganised thought in schizophrenia. Impaired recognition and misinterpretation of positive emotions may contribute to the occurrence of disorganised thought.

The Relation of Thought-language Disorders in Schizophrenia with Remission of Symptoms and Psychosocial Improvement

Objective Thought and language disorders are one of the fundamental symptom clusters of schizophrenia. Thought disorders that exacerbate in acute episodes might persist during the illness chronically in a vague form. In severe mental disorders such as schizophrenia, psychosocial functioning is an important dimension as well along with symptoms in phases of diagnosis and assessment. The aim of this study is to investigate the relation of thought and language disorders seen in schizophrenia with the course of symptomatic remission (SR) and psychosocial functioning. Method The study was carried out with the sample consisted of 117 patients diagnosed with schizophrenia according to DSM-IV-TR. The patients were assessed with the Positive and Negative Syndrome Scale (PANSS), the Thought and Language Index (TLI) and the Personal and Social Performance Scale (PSP). Results Statistical significance was found between patients in SR and patients not in SR in terms of poverty of speech, weakening of goal, peculiar logic, impoverishment of thought and disorganization of thought. Peculiar logic, peculiar sentence construction and especially poverty of speech indicating negative formal thought disorder were found to predict the dimensions of psychososcial functioning. Conclusion Patients in SR show less impoverishment of thought/speech and disorganization of thought compared to patients not in SR. Thought and language disorders are significantly correlated with psychosocial dysfunctioning in schizophrenia. Social activities, personal/social relations and aggressive behaviors are associated aspects with impoverishment of thought and disorganization of thought.

Relationship between thought and language disorder with Positive and Negative Syndrome Scale and sociodemographic characteristics in patients with schizophrenia

Objective: Thought disorders are one of the important and less understood characteristics of schizophrenia. Thought disorder is generally considered in two parts as thought content and thought process. However, it has been suggested that thought disorder in schizophrenia is strongly related to impairment in thought process. Thought and language disorder in schizophrenia is known to be associated with particular clinical symptoms. The aim of this study is to investigate relationship between thought and language disorder and subscales and items of PANSS in patients with schizophrenia. Methods: This study was conducted with 176 patients who met DSM-IV criteria for schizophrenia. Sociodemographic data form, Thought and Language Index (TLI) and Positive and Negative Syn-drome Scale (PANSS) were administered to the patients. Results: TLI score was significantly correlated with posi-tive, negative, general psychopathology subscale scores and total score of PANSS. When the relationship between TLI and items of PANSS was evaluated; conceptual disorganization (P2), suspiciousness/persecution (P6), blunted affect (N1), emotional withdrawal (N2), difficulty in abstract thinking (N5), lack of spontaneity and flow of conver-sation (N6), motor retardation (G7) and unusual thought content (G9) items of PANSS were significantly correlated with TLI. Conclusion: Thought and language disorder was found related with positive, negative, general psycho-pathology subscales of PANSS.