조현병 환자에서 와해된 언어의 증상학적 개념화

Abstract

Objectives : Our study aimed to present the distinctive correlates of disorganized speech in patients with schizophrenia, using theScale for the Assessment of Thought, Language and Communication (TLC scale). Methods : We compared the formal thought and other clinical characteristics between schizophrenia inpatients with (n=82) andwithout (n=80) disorganized speech. Psychometric scales including the TLC scale, Brief Psychiatric Rating Scale (BPRS), YoungMania Rating Scale (YMRS), Calgery Depression Scale for Schizophrenia (CDSS) and Word Fluency Test (WFT) were used. Thepresence or absence of disorganized speech was established using transformed dummy variable of score on the Clinician-RatedDimension of Psychosis Symptom Severity (CRDPSS). Results : After adjusting the effects of age, sex and total scores on the BPRS, YMRS and WFT, the subjects with disorganizedspeech presented significantly higher score on the poverty of contents of speech (p=0.001), distractible speech (p＜0.0001), tangentiality(p＜0.0001), derailment (p＜0.0001), incoherence (p＜0.0001), ilogicality (p＜0.0001), word approximations(p=0.003), loss of goal (p＜0.0001), blocking (p=0.006) and self-reference (p=0.002) items than those without disorganizedspeech. With defining the mentioned item scores as covariates, binary logistic regression model predicted that derailment (p=0.0001)and poverty of contents of speech (p＜0.0001) were significant independent-correlates of disorganized speech in patients withschizophrenia. Conclusion : Our findings suggest that derailment and poverty of contents of speech are significant correlates of disorganizedspeech in patients with schizophrenia. Our findings might be used to evaluate disorganized speech in patients with schizophreniaefficiently.