Comorbidity of schizophrenia and prelingual deafness: its impact on social network structures.

Abstract

Prelingually deaf persons usually gain only a rudimentary command of speech and prefer sign language to communicate within the deaf community without the handicap they experience in the hearing world. Maintaining social contact within this rather scattered community, however, requires higher degrees of social initiative and mobility. The aim of the present paper was to study the quantity and quality of social integration among a group of prelingually deaf schizophrenic patients (n = 49) and two control groups comprising prelingually deaf psychiatric but non-psychotic patients (n = 38) and hearing schizophrenic patients (n = 30), with account being taken of the special socialisation conditions of deaf persons and of their cultural standards and values. Data were collected with the help of semi-structured interviews; with the deaf patients these were conducted in German sign language. Using rating procedures we assessed seven social support components, selected items from a history schedule for schizophrenia, and the probands' visual and verbal language skills. The social networks of the two deaf groups were found to have larger gaps than those of the hearing schizophrenic patients, with significant differences being registered most clearly in the comparison between deaf schizophrenic and hearing schizophrenic patients. Comparison of the verbal and visual language skills of the two deaf groups revealed a substantial deficit among the deaf schizophrenics. Visual language skills were found to correlate more strongly than verbal language skills with the social support components. Prelingual deafness has a strong impact on the course of schizophrenia. In the long run, many of these patients belong to a "minority within a minority".