Rating verbal communication impairment in schizophrenia and affective disorders

Audio recordings of interviews with 42 psychiatric patients (10 schizophrenic, 11 manic, 11 schizoaffective, and 10 depressive patients) and 10 hospitalized orthopedic patients were rated for the presence of verbal communication impairment using the system developed by Andreasen. The definitions of some categories required additional qualifying statements before agreement could be reached on their meaning and applicability in specific circumstances. Nevertheless, the results indicate that the scales can be used reliably by carefully trained, nonprofessional raters. Significant differences were found between diagnostic groups with regard to the frequency and severity of some categories of communication impairment, but the general pattern of results supports previous suggestions that these problems are not pathognomonic of schizophrenia. Based on our experience, we suggest a few changes that might be helpful to other investigators, both in the procedures used for obtaining samples of speech and the definitions of subcategories of verbal communication impairment.