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Language impairment in premorbid cases of schizophrenia: a path to early detection of the disease
- Eleni Katsouni1
© The Author(s) 2006
Published: 28 February 2006
Prodromal or psychotic-like symptoms can be conceptualised as being a sign of vulnerability to psychosis. Recent findings indicate that certain impairments in language precede the first episode of schizophrenia and and are already evident in persons who are considered to be at risk, or seem to run the prodrom phase of the disease. According to the neurodevelopmental hypothesis, these impairments are mostly observed in childhood and adolescence of of individuals, who later manifest the disease, something which supports the notion that delay in the processes underlying the development of language may prexist. There is also evidence that in a crucial developmental stage of schizophrenia, there is a failure of lateralization of the components of language. Also, in some cases, language impairments appear to have a heritable base.
Material and method
In this paper, I review the knowledge with regard to the way that premorbid cases of schizophrenia can be ditectable by language impairment.
Premorbid language impairment may exist for months or years before the manifestation of the disease. Some of the most common premorbid impairments are the disorganised and incoherent speech, the disturbances in the expressive and receptive speech and the poor verbal productionspecific impairments of language production and comprehension as well as low IQ and poor academic performance in the areas of speech and reading have been associated with juvenile and childhood-onset schizophrenia. Also, some cases of early childhood, such as elective mutism may also be precursors of a later divelopment of thge disease. It has been observed by most researches that such impairments are not related to the gender. The developmental abnormalities in premorbid language functions precipitata an earlier age of onset in schizophrenia. However, recent findings  suggest that this may be more relevant to those with an adolescent onset. There is evidence also, supporting that several premorbid intetional perturbances in speech could predict the particularity of the clinical course and that the premorbid language production is relevant to the type of the thought disorder that the individual will develop.
Neuropsychological tasks can shed light to language impairments before the onset of the disease. The linguistic analysis of permorbid speech can also be a useful tool for a differential diagnosis. However, the prediction of the disease based only on language impairments appers to be difficult, since most of these diorders disturbances are not pathognomical. Especially after the age of 20 this is more difficult, since the premorbid speech symptoms are much less evident.
This is a public health issue, because drug tretmnt is much more effective in case it is started early and early ditection of the disease can preserv the patient from a variety of misfortunes.