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Neuroleptic effects on vocal and verbal communication in schizophrenia
BIOL PSYCHIATRY 1991;29:43A- 185A
64A
46
Schizoptaenia
NEUROPSYCHOLOGICAL FUNCTIONING OF ELDERLY SCHIZOPHRENICS: EFFECTS OF DEMENTIA AND LEUKOTOMY Cadna Vocisano, Suzanne Mclntyre, Danya Vardi, Michael Davidson, M.D., Peter Powchik, M.D., Miklos Losonczy, M.D., Ph.D., Philip D. Harvey, Ph.D. Department of Psychiatr),, Mount Sinai School of Medicine and Pilgrim Psychiatric Center, West Bren~,ood, NY 11717. Elderly schizophrenic patients (mean age = 80) were examined with a neuropsychologicai l~nery that examined frontal and posterior cortical functions. Samples (n = 15 each) of leukotomized and nonleukotomized patients were matched for age, gender, and severity of dementia as rated by the Clinical Dementia Rating Scale (CDR). Nondemented patients performed in the age-corrected normal range on tests of posterior cortical functions. All subjects manifested substantial impairments on the tests of frontal functions. Leukotomized patients performed significantly (p < 0.05) more poorly than nonleukotomized patients on tests specifically sensitive to lesions of the dorsolateral prefrontal cortex: spatial delayed response, Wisconsin Card Sorting Test Perservative Errors, and the difference of ,-'ecall and recognition on tests matched for difficulty level. In addition, leukotomized patients had been in the hospital for significantly more consecutive years and had significantly fewer lifetime admissions, suggesting a more chronic course of hospitalization. Dementia status was net associated with chronicity of course or frontal neuropsychological functions, but was predicted by age and deficits on tests of posterior cortical functions. These data suggest that dementia in schizoplu'enic patients does not exaggerate frontal neuropsychological deficits. In addition, these data suggest that leukotomy leads to an incremental deficit in frontal brain functions compared to those found in chronic schizophrenic populations.
47
NEUROLEPTIC EFFECTS ON VOCAL AND VERBAL COMMUNICATION IN SCHIZOPHRENIA Aileen Clark, Ph.D., Philip D. Harvey, Ph.D., Jackie Moskowitz, M.A., Oren Kalus, M.D., Murray Alpert, Ph.D. NYU Medical Center, Millhauser Lab, and Mount Sinai School of Medicine, New York, NY 10016. In previous research we have found that prosodic aspects of the speech of schizophrenics change when these patients are treated with drugs, t~nese changes include decreases in productivity and pause duration and increases in expressiveness. Now we describe further research in this model, which examined the effects of medication on linguistic aspect~ of speech production. Male schizophrenic patients were interviewed twice, once while medication free for at least three weeks and again after four weeks" treatm,~nt with a structured dose of haloperidol. A 5 rain portion of a structured interview was examined with Linguistic ratings of reference processes and coherence of speech, as well as the previous prosodic variables. Coherence, as measured by ability to connect speech to topics introduced by the interviewer was improved by medication, despite decreased overall verbal productivity. Extensive discussion of delusional themes, present to a notable degree in unmedicated patients, was significantly inhibited by r.~edication, despite no significant changes in BPRS scores. These results suggest that neuroleptics enhance attention process in linguistic performance, leading to greater coherence, and do not induce deficits in expressiveness.
64A
46
Schizoptaenia
NEUROPSYCHOLOGICAL FUNCTIONING OF ELDERLY SCHIZOPHRENICS: EFFECTS OF DEMENTIA AND LEUKOTOMY Cadna Vocisano, Suzanne Mclntyre, Danya Vardi, Michael Davidson, M.D., Peter Powchik, M.D., Miklos Losonczy, M.D., Ph.D., Philip D. Harvey, Ph.D. Department of Psychiatr),, Mount Sinai School of Medicine and Pilgrim Psychiatric Center, West Bren~,ood, NY 11717. Elderly schizophrenic patients (mean age = 80) were examined with a neuropsychologicai l~nery that examined frontal and posterior cortical functions. Samples (n = 15 each) of leukotomized and nonleukotomized patients were matched for age, gender, and severity of dementia as rated by the Clinical Dementia Rating Scale (CDR). Nondemented patients performed in the age-corrected normal range on tests of posterior cortical functions. All subjects manifested substantial impairments on the tests of frontal functions. Leukotomized patients performed significantly (p < 0.05) more poorly than nonleukotomized patients on tests specifically sensitive to lesions of the dorsolateral prefrontal cortex: spatial delayed response, Wisconsin Card Sorting Test Perservative Errors, and the difference of ,-'ecall and recognition on tests matched for difficulty level. In addition, leukotomized patients had been in the hospital for significantly more consecutive years and had significantly fewer lifetime admissions, suggesting a more chronic course of hospitalization. Dementia status was net associated with chronicity of course or frontal neuropsychological functions, but was predicted by age and deficits on tests of posterior cortical functions. These data suggest that dementia in schizoplu'enic patients does not exaggerate frontal neuropsychological deficits. In addition, these data suggest that leukotomy leads to an incremental deficit in frontal brain functions compared to those found in chronic schizophrenic populations.
47
NEUROLEPTIC EFFECTS ON VOCAL AND VERBAL COMMUNICATION IN SCHIZOPHRENIA Aileen Clark, Ph.D., Philip D. Harvey, Ph.D., Jackie Moskowitz, M.A., Oren Kalus, M.D., Murray Alpert, Ph.D. NYU Medical Center, Millhauser Lab, and Mount Sinai School of Medicine, New York, NY 10016. In previous research we have found that prosodic aspects of the speech of schizophrenics change when these patients are treated with drugs, t~nese changes include decreases in productivity and pause duration and increases in expressiveness. Now we describe further research in this model, which examined the effects of medication on linguistic aspect~ of speech production. Male schizophrenic patients were interviewed twice, once while medication free for at least three weeks and again after four weeks" treatm,~nt with a structured dose of haloperidol. A 5 rain portion of a structured interview was examined with Linguistic ratings of reference processes and coherence of speech, as well as the previous prosodic variables. Coherence, as measured by ability to connect speech to topics introduced by the interviewer was improved by medication, despite decreased overall verbal productivity. Extensive discussion of delusional themes, present to a notable degree in unmedicated patients, was significantly inhibited by r.~edication, despite no significant changes in BPRS scores. These results suggest that neuroleptics enhance attention process in linguistic performance, leading to greater coherence, and do not induce deficits in expressiveness.