Verbal Fluency Could Identify Individuals at Risk for Schizophrenia

Cognitive and communication impairments are just some of the symptoms of schizophrenia. People usually begin showing signs of psychosis and schizophrenia in adolescence and young adulthood. Other symptoms include visual, verbal, and auditory hallucinations, lack of affect, social withdrawal, attention problems, executive function deficits and memory impairment. Neurological tests, including event-related potentials (ERPs), are widely used to assess individuals with early symptoms of psychosis for risk of schizophrenia. In fact, the earlier schizophrenia can be diagnosed in those at risk, the better the outcome. Research has shown that the longer the duration of untreated psychosis (DUP), the worse the outcome for the individual.

Some of the barriers to testing include length of test time. Many neurophysiological tests can take upward of 30 minutes to administer. The nature of symptoms associated with psychosis often prevents these tests from being administered. But ERPs and other methods are often conducted in briefer time periods.

Therefore, Yuko Higuchi of the Department of Neuropsychiatry at the University of Toyama Graduate School of Medicine and Pharmaceutical Science in Japan wanted to see if short duration ERPs focused on verbal fluency could predict which individuals at risk for psychosis would later develop schizophrenia. Higuchi used duration mismatch negativity tests (dMMN) on auditory cues in a sample of 17 individuals with early signs of psychosis, 31 with schizophrenia and 20 with neither psychosis nor schizophrenia. The levels of verbal fluency and cognitive performance were measured during dMMN tests.

Higuchi discovered that the at-risk participants who later developed schizophrenia had reduced dMMN measurements, as well as impairments in working memory, information processing, attention, and verbal skills when compared to those who did not. The participants with schizophrenia had the highest level of dMMN impairments. These findings suggest that people with symptoms of psychosis who are at risk for schizophrenia may have poorer verbal skills than those who are not at risk.

Although the verbal fluency test was short in duration and may be easier to use on some clients, it should not take the place of other measures that provide additional cognitive and neurological insight. Higuchi added, “Therefore, combined administration of neurophysiological and neuropsychological assessments would facilitate screening procedures, depending on the condition of patients.” In all, Higuchi hopes that these results aid in the efforts to provide early identification of those most at risk for schizophrenia.

Reference:
Higuchi Y, Sumiyoshi T, Seo T, Miyanishi T, Kawasaki Y, et al. (2013) “Mismatch Negativity and Cognitive Performance for the Prediction of Psychosis in Subjects with At-Risk Mental State.” PLoS ONE 8(1): e54080. doi:10.1371/journal.pone.0054080

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  • EH

    EH

    May 12th, 2013 at 11:09 PM

    this could be a complementary test and a quick one.but it does not seem like it will help in a detailed diagnosis.and it should be treated as such.

  • Connor

    Connor

    May 13th, 2013 at 1:54 AM

    If verbal fluency is how good someone talks y’all better watch out for my nephew he talks about 100 mph.

    I love him to death but goodness he sure can talk my ear off i just don’t know how to handle it.

    Maybe I need to help him not to talk so much i just read something that said if kids ask a bunch of questions they are too dependent so you shouldn’t let them do it.

    I wonder if that’s the same for just talking i mean like talking without coming up for air for two hours.

    I thought maybe he just wasn’t getting enough attention at home i don’t know i ain’t no doctor.

    Of course now I’m just gonna sit here and worry about it guess i should go call my sister and tell her to read this.

  • Harrison

    Harrison

    May 13th, 2013 at 1:57 AM

    That’s right about it starting when you are a late teenager.Or a young adult. Becuase that’s exactly what happened to my niece. She was nice adn sweet adn smart as anybody. Til she turned 24. That was so bad adn so sad to see. She started seeing things that wasn’t there. And hearing things. Said people were out to get her and someobody had planted a listening device in her house. Were always listening to her. And watching her. She finally ended up haivng to live in a group home. Which of course broker her parents hearts.

  • Smith

    Smith

    May 13th, 2013 at 1:59 AM

    So, here’s my question:

    how are you supposed to get someone early treatment when they don’t want it?

    That’s exactly the way it was with my uncle. We tried for years and years and still he wouldn’t go for help. Then we all feel guilty he got so bad off but what could we really do?

  • John

    John

    May 13th, 2013 at 2:00 AM

    Why is a 30 minute test such a challenge to give? Is it because someone with this problem doesn’t have the attention span to sit that long and take a test? I am a bit confused by that statement.

  • Paulson

    Paulson

    May 13th, 2013 at 2:03 AM

    Schizophrenia is such a heart breaking disease. It can take a person who functions very well and turn them into someone who can’t even manage to live on their own. People with schizophrenia seem to be locked in their own minds and cannot find a way out. They go from having jobs and families to sitting in institutions rocking themselves and showing little to no emotion. I certainly do hope we can find a cure in my lifetime.

  • I Bellows

    I Bellows

    May 13th, 2013 at 2:06 AM

    that is interesting as I would have thought it would have been just the opposite, that people with strong verbal skills that talked your ear off would have been more at risk for schizophrenia so thank you for setting the record straight for me on that one.

  • jan A

    jan A

    May 13th, 2013 at 2:10 AM

    Sure does sound like early detection is the key as it is with so many other diseases.

    I just wish I could know what goes on inside the brain of someone with schizophrenia.

    It’s justlike someone locked up their brain adn then threw away the key.

    Who knows maybe someday I’ll find a big pile of keys and then I can help everybody.

    LOL.

  • Trace

    Trace

    May 13th, 2013 at 2:11 AM

    Definitely an incomplete test they used here. Glad to see the suggestion that the more complete ones need to be used.

  • B Garrett

    B Garrett

    May 13th, 2013 at 2:13 AM

    I am just so sorry that giving this population a test to determine what is wrong with them is just so inconvenient for all you medical people. I guess that wagon load of money we pay you isn’t enough to get you to help our relatives sit through a thirty minute test. Maybe we just need some new doctors who will actually be interested in helping our relatives rather than just putting in their time and then going home.

  • jason

    jason

    May 13th, 2013 at 2:17 AM

    i found this to be real helpful. my uncle just got diagnosed. he only five years older than me. i been looking on the internet trying to find out all i can. everything is just depressing the crap out a me so far. i am guessing there ain’t no cure for this thing yet. i sure wish there was so my uncle could get better. sure don’t seem fair.

  • megan

    megan

    May 13th, 2013 at 3:52 AM

    Again, it is another one of those studies that shows who is at risk, but does nothing to address how this would actually equate with helping someone. An earlier diagnosis in this case doesn’t necessarily mean that they won’t develop the symptoms- it just means that they will get a label sooner.

  • Stephen

    Stephen

    May 13th, 2013 at 11:54 PM

    This is interesting.Not only is this sort of a test briefer and helps save time, but it also removes the prejudice and resistance that a person may have towards going in for diagnosis.Neurological test and it may send the alarm bells ringing but a verbal fluency tests does not sound that threatening.

  • Judith W

    Judith W

    January 20th, 2015 at 11:18 AM

    One of the most overlooked cause of poor verbal fluency is childhood deafness or prelingual deafness.

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