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Rethinking language, cognition and assessment in psychosis: How bilingualism challenges psychiatry and how natural
Sandra Anna Just1,2, Vincent DeLuca3, Jason Rothman3,4,5
1Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway. sandra.a.just@uit.no.
Schizophrenia (Heidelberg, Germany)
|March 15, 2026
Summary
Bilingualism significantly impacts psychosis assessments. Ignoring its effects risks confounding clinical research and practices, necessitating a focus on bilingual individuals in psychiatric care.
Area of Science:
- Psychiatry
- Neuroscience
- Linguistics
Background:
- Language is crucial for assessing psychosis patients.
- Bilingualism (speaking multiple languages) influences cognitive and neural functions.
- Current psychiatric practices often overlook bilingualism's impact, risking diagnostic and research confounds.
Purpose of the Study:
- To highlight the unaddressed impact of bilingualism on psychosis assessment and research.
- To propose a framework for systematically studying bilingualism in psychosis.
- To advocate for inclusive psychiatric practices and treatments for bilingual individuals with psychosis.
Main Methods:
- Critical review drawing on neuropsychology, psycholinguistics, and cognitive neuroscience.
- Identification of potential interactions between bilingualism and psychosis.
- Development of a decision tree framework for clinical and research settings.
Main Results:
- Bilingualism's effects on psychosis are often unconsidered, leading to potential confounds.
- A systematic framework is proposed to address these interactions.
- The review lays groundwork for technology-assisted treatments tailored to bilingual individuals.
Conclusions:
- Psychiatric diagnostic practices must differentiate language from other cognitive domains.
- Acknowledging bilingualism promotes equity for individuals with psychosis.
- Integrating bilingualism considerations enhances research validity and clinical practice.
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