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      Speech Graphs Provide a Quantitative Measure of Thought Disorder in Psychosis

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          Abstract

          Background

          Psychosis has various causes, including mania and schizophrenia. Since the differential diagnosis of psychosis is exclusively based on subjective assessments of oral interviews with patients, an objective quantification of the speech disturbances that characterize mania and schizophrenia is in order. In principle, such quantification could be achieved by the analysis of speech graphs. A graph represents a network with nodes connected by edges; in speech graphs, nodes correspond to words and edges correspond to semantic and grammatical relationships.

          Methodology/Principal Findings

          To quantify speech differences related to psychosis, interviews with schizophrenics, manics and normal subjects were recorded and represented as graphs. Manics scored significantly higher than schizophrenics in ten graph measures. Psychopathological symptoms such as logorrhea, poor speech, and flight of thoughts were grasped by the analysis even when verbosity differences were discounted. Binary classifiers based on speech graph measures sorted schizophrenics from manics with up to 93.8% of sensitivity and 93.7% of specificity. In contrast, sorting based on the scores of two standard psychiatric scales (BPRS and PANSS) reached only 62.5% of sensitivity and specificity.

          Conclusions/Significance

          The results demonstrate that alterations of the thought process manifested in the speech of psychotic patients can be objectively measured using graph-theoretical tools, developed to capture specific features of the normal and dysfunctional flow of thought, such as divergence and recurrence. The quantitative analysis of speech graphs is not redundant with standard psychometric scales but rather complementary, as it yields a very accurate sorting of schizophrenics and manics. Overall, the results point to automated psychiatric diagnosis based not on what is said, but on how it is said.

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          Most cited references25

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          The positive and negative syndrome scale (PANSS) for schizophrenia.

          The variable results of positive-negative research with schizophrenics underscore the importance of well-characterized, standardized measurement techniques. We report on the development and initial standardization of the Positive and Negative Syndrome Scale (PANSS) for typological and dimensional assessment. Based on two established psychiatric rating systems, the 30-item PANSS was conceived as an operationalized, drug-sensitive instrument that provides balanced representation of positive and negative symptoms and gauges their relationship to one another and to global psychopathology. It thus constitutes four scales measuring positive and negative syndromes, their differential, and general severity of illness. Study of 101 schizophrenics found the four scales to be normally distributed and supported their reliability and stability. Positive and negative scores were inversely correlated once their common association with general psychopathology was extracted, suggesting that they represent mutually exclusive constructs. Review of five studies involving the PANSS provided evidence of its criterion-related validity with antecedent, genealogical, and concurrent measures, its predictive validity, its drug sensitivity, and its utility for both typological and dimensional assessment.
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            Rethinking schizophrenia.

            How will we view schizophrenia in 2030? Schizophrenia today is a chronic, frequently disabling mental disorder that affects about one per cent of the world's population. After a century of studying schizophrenia, the cause of the disorder remains unknown. Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia. These current unsatisfactory outcomes may change as we approach schizophrenia as a neurodevelopmental disorder with psychosis as a late, potentially preventable stage of the illness. This 'rethinking' of schizophrenia as a neurodevelopmental disorder, which is profoundly different from the way we have seen this illness for the past century, yields new hope for prevention and cure over the next two decades.
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              Revisiting the foundations of network analysis.

              Network analysis has emerged as a powerful way of studying phenomena as diverse as interpersonal interaction, connections among neurons, and the structure of the Internet. Appropriate use of network analysis depends, however, on choosing the right network representation for the problem at hand.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2012
                9 April 2012
                11 April 2012
                : 7
                : 4
                : e34928
                Affiliations
                [1 ]Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil
                [2 ]Hospital Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Brazil
                [3 ]Edmond and Lily Safra International Institute of Neuroscience of Natal, Natal, Brazil
                [4 ]Faculdade Natalense para o Desenvolvimento do Rio Grande do Norte, Natal, Brazil
                [5 ]Department of Systems and Computation, Federal University of Campina Grande, Campina Grande, Brazil
                [6 ]Department of Physics, Universidade de São Paulo, Ribeirão Preto, Brazil
                [7 ]Biometaphorical Computing, Computational Biology Center, IBM Research Division, IBM T. J. Watson Research Center, Yorktown Heights, New York, United States of America
                [8 ]Department of Physics, Federal University of Pernambuco, Recife, Brazil
                Universitat Pompeu Fabra, Spain
                Author notes

                Conceived and designed the experiments: SR NBM. Performed the experiments: NBM. Analyzed the data: NBM NAPV NL ACP OK GAC MC SR. Contributed reagents/materials/analysis tools: NAPV. Wrote the paper: SR NBM NAPV MC GAC OK.

                Article
                PONE-D-11-23505
                10.1371/journal.pone.0034928
                3322168
                22506057
                19aad511-1ee4-4f46-9e6d-bf1163301063
                Mota et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 17 November 2011
                : 7 March 2012
                Page count
                Pages: 9
                Categories
                Research Article
                Biology
                Neuroscience
                Neuroethology
                Neurolinguistics
                Mathematics
                Discrete Mathematics
                Medicine
                Mental Health
                Psychiatry
                Mood Disorders
                Psychoses
                Schizophrenia
                Social and Behavioral Sciences
                Linguistics
                Neurolinguistics
                Speech

                Uncategorized
                Uncategorized

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