AUTHOR=Mackinley Michael , Limongi Roberto , Silva Angélica María , Richard Julie , Subramanian Priya , Ganjavi Hooman , Palaniyappan Lena 

TITLE=More than words: Speech production in first-episode psychosis predicts later social and vocational functioning

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1144281

DOI=10.3389/fpsyt.2023.1144281

ISSN=1664-0640

ABSTRACT=Background: Several disturbances in speech are present in psychosis; however, the relationship between these disturbances during the first episode of psychosis (FEP) and later vocational functioning is unclear. Demonstrating this relationship is critical if we expect speech and communication deficits to emerge as targets for early intervention.  
Method: we analyzed three one-minute speech samples using automated speech analysis and Bayes networks in an antipsychotic-naive sample of 39 FEP patients and followed them longitudinally to determine their vocational status (engaged or not engaged in employment education or training - EET vs. NEET) after 6-12 months of treatment. Five linguistic variables with prior evidence of clinical relevance (total and acausal connectives use, pronoun use, analytic thinking, and total words uttered in a limited period) were included in a Bayes network along with longitudinal NEET status and Social and Occupational Functioning Assessment Scale (SOFAS) scores to determine dependencies among our variables. We also included clinical (Positive and Negative Syndrome Scale 8-item version (PANSS-8)), social (parental socioeconomic status,) and cognitive features (processing speed) at the time of presentation as covariates. 
Results: The Bayes network revealed that only total words spoken were directly associated with NEET and had an indirect association with SOFAS, with a second set of dependencies emerging among the remaining linguistic variables. The primary (speech-only) model outperformed models including parental socioeconomic status, processing speed or both as latent variables. 
Conclusion: impoverished speech, even at subclinical levels, may hold prognostic value and warrant clinical consideration when treating first-episode psychosis.