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조현병 환자에서 와해된 언어의 증상학적 개념화

Symptomatic Conceptualization of Disorganized Speech in Patients with Schizophrenia

이경민|장은영|최준호|김보미|이강욱|박선철|유정민
대한조현병학회 (Korean Academy of Schizophrenia)|2015.10|대한조현병학회지 (Korean Journal of Schizophrenia Research)|제18권 제2호|pp. 51-58

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참고문헌

키워드

Schizophrenia.Derailment탈선와해된 언어형식적 사고장애언어 내용의 빈곤조현병. Schizophrenia.Disorganized speechFormal thought disorderPoverty of contents of speech
주제분류정신과학

초록

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.

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.

참고문헌 (35)

  1. American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders", American Psychiatric Association, ~ (2013)
  2. American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders", American Psychiatric Association, ~ (1994)
  3. Bleuler E, "Dementia Praecox or the Group of Schizophrenias" (1958), International Universities Press
  4. Gorham DR, "Use of the proverbs test for differentiating schizophrenics from normals", J Consult Psychol, 20, pp.435~ (1956)
  5. Andreasen NC, "The significance of thought disorder in diagnostic evaluations", Compr Psychiatry, 15, pp.27~34 (1974)
  6. Andreasen NC, "Scale for the assessment of thought, language, and communication", Schizophr Bull, 12, pp.473~482 (1986)
  7. Andreasen NC, "Thought, language, and communication in schizophrenia: Diagnosis and prognosis", Schizophr Bull, 12, pp.348~ (1986)
  8. Andreasen NC, "Thought, language, and communication disorders:II. Diagnostic significance", Arch Gen Psychiatry, 36, pp.1325~1330 (1979)
  9. Park SC, "Reliability and validity of the Korean version of the scale for the assessment of thought, language and communication", Compr Psychiatry, 61, pp.122~130 (2015)
  10. Park SC, "Psychometric properties of Korean version of the clinical language rating scale", Clin Psychopharmacol Neurosci (2015)
  11. Woods SW, "Chlorpromazine equivalent doses for the newer atypical antipsychotics", J Clin Psychiatry, 64, pp.663~667 (2003)
  12. Heckers S, "Structure of the psychotic disorders classification in DSM-5", Schizophr Res, 150, pp.11~14 (2013)
  13. Overall JE, "The brief psychiatric rating scale", Psychol Rep, 10, pp.799~812 (1962)
  14. Kay SR, "The Positive and Negative Syndrome Scale (PANSS): Rationale and standardization", Br J Psychiatry, 155(suppl 7), pp.59~65 (1989)
  15. 이중서, "한국판 양성 및 음성증후군 척도(Positive and Negative Syndrome Scale)의 신뢰도와 타당도", 신경정신의학, 40(6), pp.1090~1105 (2001), 대한신경정신의학회
  16. Young RC, "A rating scale for mania:reliability, validity, and sensitivity", Br J Psychiatry, 133, pp.429~435 (1978)
  17. 정희연, "Young조증 평가 척도의 한국판 표준화 연구", 신경정신의학, 42(2), pp.263~269 (2003), 대한신경정신의학회
  18. Addington D, "A depression rating scale for schizophrenics", Schizophr Res, 3, pp.247~251 (1990)
  19. 김용구, "한국어판 정신분열병의 캘거리 우울증 척도의 신뢰도 및 타당도 연구", 신경정신의학, 44(4), pp.446~455 (2005), 대한신경정신의학회
  20. Montgomery SA, "A new depression scale designed to be sensitive to change", Br J Psychiatry, 134, pp.382~389 (1979)
  21. Hamilton M, "A rating scale for depression", J Neurol Neurosurg Psychiatry, 23, pp.56~62 (1960)
  22. Lee JH, "Development of the Korean version of the consortium to establish a registry for Alzheimer’s disease assessment packet (CERAD-K): clinical and neuropsychological assessment batteries", J Gerontol B Psychol Sci Soc Sci, 57, pp.47~53 (2002)
  23. Ruff RM, "Benton controlled oral word association test: reliability and updated norms", Arch Clin Neuropsychol, 11, pp.329~338 (1996)
  24. Rosen WG, "Verbal fluency in aging and dementia", J Clin Neuropsychol, 2, pp.135~146 (1980)
  25. Kang YW, "A normative study of the Korean version of controlled oral word association test (COWAT)in the elderly", Kor J Clin Psychol, 19, pp.358~392 (2000)
  26. Harvey PD, "Speech performance in mania and schizophrenia:The association of positive and negative thought disorders and reference failures", J Commun Disord, 19, pp.161~173 (1986)
  27. Reilly F, "Looseness of associations in acute schizophrenia", Br J Psychiatry, 127, pp.240~246 (1975)
  28. Goldberg TE, "Cognitive substrates of thought disorder: I. the semantic system", Am J Psychiatry, 155, pp.1671~1676 (1998)
  29. 김재진, "정신분열병에서 어의처리 과제 수행에 따른 뇌활성화 양상의 특성", 신경정신의학, 43(2), pp.159~164 (2004), 대한신경정신의학회
  30. Hoffman RE, "A comparative study of manic vs schizophrenic speech disorganization", Arch Gen Psychiatry, 43, pp.831~838 (1986)
  31. Barch DM, "The effect of language production manipulations on negative thought disorder and discourse coherence disturbances in schizophrenia", Psychiatry Res, 71, pp.115~127 (1997)
  32. Levelt WJM, "Speaking: from intention to articulation" (1993), MIT press
  33. Manxchereck TC, "Object chaining and thought disorder in schizophrenic speech", Psychol Med, 21, pp.443~446 (1991)
  34. McGrath J, "Ordering thoughts on thought disorder", Br J Psychiatry, 158, pp.307~316 (1991)
  35. H2O PET study, "Am J Psychiatry", 2003, 919~923

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