Referential noun phrases distribute differently in Turkish speakers with schizophrenia

In all human languages, noun phrases (NPs) (e.g., 'a field', 'the woman with a book') are used to identify entities in discourse. Previous evidence has shown that the spontaneous speech of patients with schizophrenia (Sz) shows differences in the distribution of grammatically different types of NPs, which are in part specific to patients with formal thought disorder (FTD). Here we sought to provide the first evidence of related grammatical effects in a non-Indo-European language. Results from a picture description task in a sample of 16 Turkish speakers with FTD (+FTD), 15 without FTD (-FTD), and 27 controls revealed that relative to controls, people with Sz over-produced NPs that are 'bare' (in the sense of lacking any grammatical items such as the or a in English). The +FTD group generally showed stronger effects than -FTD, and used more pronouns and less NPs co-referring with previously mentioned NPs. In addition, the dynamic distribution of NP types over narrative time showed an effect of increased mean distance between definite NPs in -FTD relative to controls. In +FTD but no other group there was an unexpected random distribution of indefinite DPs. Incidence rates of referential anomalies increased from controls to the -FTD and +FTD groups. These findings further confirm that Sz is manifest through specific linguistic effects in the referential structure of meaning as mediated by grammar. They provide a linguistic baseline for neurocognitive models of FTD and help to define appropriate targets for the automatic extraction of linguistic features to classify psychotic speech.