Abstract

Language impairments often appear in patients with schizophrenia and are potential targets for rehabilitation. Clinical practice and research should be intimately connected. The aim was to perform a narrative review of the assessment and intervention tools that have been used for the rehabilitation of schizophrenia patients with language and communication impairments. Two types of tools, general and specific, were developed for both purposes. General tools include the Positive and Negative Syndrome Scale for assessment, and the Integrated Psychological Therapy for intervention. The specific tools used to evaluate language and communication impairments include the Scale for the Assessment of Thought, Language and Communication, the Formal Thought Disorder scales (for caregivers and patients), and the Thought and Language Disorder scale. The most recent language-specific intervention tools include the Cognitive Pragmatic Treatment, Conecta-2, Let’s talk! Multimodal Speech-Gesture training, Speech Therapy Intervention Group, and PragmaCom. These tools primarily involve psychopathology/psychiatry, psychology, linguistics, speech and language therapy, and nursing. In conclusion, a wide range of assessment and intervention tools are available for the rehabilitation of language and communication impairments associated with schizophrenia. An integrative and interdisciplinary approach should always be considered for rehabilitation of language and communication in patients with schizophrenia throughout their lifetime.

Introduction

Language is a basic skill in humans that facilitates communication with their environment, mainly with other humans. Communication has also been recognized by the International Communication Project as a human right which is embedded within Article 19 of the Universal Declaration of Human Rights [1]. This project highlights the importance of human communication and the significant impact of communication disabilities on every aspect of life, including positive social relationships, literacy, and employment, and the need to enable those with communication disability to fully access and participate in society [2].

۱٫۱٫ Heterogeneity of language and communication impairments in schizophreniaAccording to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders [3], a key feature of the schizophrenia spectrum as well as of other psychotic disorders is disorganized speech. However, the term ‘disorganized speech’ remains ambiguous and is often used as a replacement of the formerly used term ‘formal thought disorder’ (FTD), clinically considered as ‘impairments in the production of language and subjective alterations in the thought process’ [۴]. In fact, the term FTD was replaced by ‘disorganized speech’ as the latter can be object to direct observation and assessment, whereas the former can only be deduced from other deviations in overt behaviour.

Conclusions

We conclude that: i) there is currently a wide range of assessment and intervention tools that cover various language and communication impairments in schizophrenia; ii) the rehabilitation of language and communication requires an integrative and interdisciplinary approach, and should always be considered in patients with schizophrenia throughout their lifetime; and iii) further research on the assessment and intervention tools for the rehabilitation of language and communication in patients with schizophrenia is needed.