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Disintegration of the components of language as the path to a revision of Bleuler's and Schneider's concepts of schizophrenia: Linguistic disturbances compared with first-rank symptoms in acute psychosis

  • Alfonso Ceccherini-Nelli (a1) and Timothy J. Crow (a2)
Abstract
Background

The 20th century ended without a resolution of the debate about the supremacy of Schneider's psychopathological conceptualisation of schizophrenia (the first-rank symptoms) over Bleuler's ‘four As' (disorders of association and affect, ambivalence and autism).

Aims

To examine the relationships between linguistic deviations and symptoms in patients with acute psychosis.

Method

We assessed language disturbances and first-rank symptoms with the Clinical Language Disorder Rating Scale (CLANG) in 30 consecutive patients with acute psychosis, selected for the presence of at least one active first-rank symptom, and 15 control participants with depression but no psychotic symptoms.

Results

Strong positive correlations were found between the CLANG factor ‘poverty’ (of speech) and first-rank delusions of control and (‘delusional perceptions’) between semantic/phonemic paraphasias and verbal auditory hallucinations. Language disturbances were superior to nuclear symptoms in discriminating ICD–10 schizophrenia from other psychoses.

Conclusions

Evaluating the features of psychosis as deviations in the cerebral organisation of language paves the way to a concept of psychosis that supersedes these traditional but competing categorical concepts.

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Copyright
Corresponding author
Professor T. J. Crow, POWIC, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK. Tel: 01865 226474; fax: 01865 244990; e-mail: tim.crow@psychiatry.oxford.ac.uk
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Declaration of interest

None.

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References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Disintegration of the components of language as the path to a revision of Bleuler's and Schneider's concepts of schizophrenia: Linguistic disturbances compared with first-rank symptoms in acute psychosis

  • Alfonso Ceccherini-Nelli (a1) and Timothy J. Crow (a2)
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