Characterising receptive language processing in schizophrenia using word and sentence tasks

Language dysfunction is proposed to relate to the speech disturbances in schizophrenia, which are more commonly referred to as formal thought disorder (FTD). Presently, language production deficits in schizophrenia are better characterised than language comprehension difficulties. This study thus aimed to examine three aspects of language comprehension in schizophrenia: (1) the role of lexical processing, (2) meaning attribution for words and sentences, and (3) the relationship between comprehension and production.

Fifty-seven schizophrenia/schizoaffective disorder patients and 48 healthy controls completed a clinical assessment and three language tasks assessing word recognition, synonym identification, and sentence comprehension. Poorer patient performance was expected on the latter two tasks.

Recognition of word form was not impaired in schizophrenia, indicating intact lexical processing. Whereas single-word synonym identification was not significantly impaired, there was a tendency to attribute word meanings based on phonological similarity with increasing FTD severity. Importantly, there was a significant sentence comprehension deficit for processing deep structure, which correlated with FTD severity.

These findings established a receptive language deficit in schizophrenia at the syntactic level. There was also evidence for a relationship between some aspects of language comprehension and speech production/FTD. Apart from indicating language as another mechanism in FTD aetiology, the data also suggest that remediating language comprehension problems may be an avenue to pursue in alleviating FTD symptomatology.