A produção da linguagem na esquizofrenia e sua associação com os sintomas negativos e cognitivos da doença

Abstract

Introduction: Schizophrenia is a disorder whose manifestations include anomalies in spoken language production. To investigate these alterations, the C-ORAL-ESQ corpus was created, comprising recordings of psychiatric consultations with patients diagnosed with schizophrenia, thus allowing the analysis of linguistic variables and their correlations with clinical parameters. Objectives: This study aims to analyze the informational structure of the discourse of patients with schizophrenia through linguistic parameters, which were correlated with positive, negative, and cognitive symptoms. We hypothesize that more severe negative and cognitive symptoms are associated with reduced linguistic productivity and complexity. Methods: This is an observational, cross-sectional, and descriptive study involving clinically stable patients. After providing informed consent, participants underwent sociodemographic and clinical questionnaires and had their consultations recorded. The recorded sessions were later annotated and analyzed for the extraction of linguistic parameters. Results: Of the 43 patients in the C-ORAL-ESQ, 35 met the inclusion criteria. A total of 82,898 words were recorded (46% by patients), with a mean of 1,056 words per recording. The PANSS indicated mild positive symptoms (mean = 10) and moderate negative symptoms (mean = 19). Analyses revealed no correlations between linguistic variables and sociodemographic data. Performance on the working memory task (BACS-SD) correlated with tonal units, and processing speed (BACS-CS) correlated with completed sequences, tonal units, and turns. The severity of negative symptoms was negatively associated with almost all linguistic variables. Additionally, several subitems of the PANSS negative scale showed significant negative correlations with linguistic measures. No correlations were found with N5, chlorpromazine equivalents, extrapyramidal symptoms (EPS), or positive symptoms. Conclusion: The study identified that negative symptoms and cognitive deficits in schizophrenia are associated with changes in the fluency and structure of spontaneous speech.