Abstract
Early psychiatry investigated dreams to understand psychopathologies. Contemporary psychiatry, which neglects dreams, has been criticized for lack of objectivity. In search of quantitative insight into the structure of psychotic speech, we investigated speech graph attributes (SGA) in patients with schizophrenia, bipolar disorder type I, and non-psychotic controls as they reported waking and dream contents. Schizophrenic subjects spoke with reduced connectivity, in tight correlation with negative and cognitive symptoms measured by standard psychometric scales. Bipolar and control subjects were undistinguishable by waking reports, but in dream reports bipolar subjects showed significantly less connectivity. Dream-related SGA outperformed psychometric scores or waking-related data for group sorting. Altogether, the results indicate that online and offline processing, the two most fundamental modes of brain operation, produce nearly opposite effects on recollections: While dreaming exposes differences in the mnemonic records across individuals, waking dampens distinctions. The results also demonstrate the feasibility of the differential diagnosis of psychosis based on the analysis of dream graphs, pointing to a fast, low-cost and language-invariant tool for psychiatric diagnosis and the objective search for biomarkers. The Freudian notion that “dreams are the royal road to the unconscious” is clinically useful, after all.
Highlights
Schizophrenic subjects spoke with reduced connectivity, in tight correlation with negative and cognitive symptoms measured by standard psychometric scales
We found that most speech graph attributes (SGA) differed between dream and wake reports from bipolar and control subjects (Figure 3a)
The investigation of correlations between dream-related SGA and psychopathological symptoms grasped by Positive and Negative Syndrome Scale’’ (PANSS) and BPRS considering all 60 subjects produced interesting results: Using the attributes that best differentiated schizophrenic subjects from other groups (E, LCC and LSC), we found significant anti-correlations with negative and cognitive symptoms (Figure 6, Supplementary Fig. S2), known to be more frequent among schizophrenic subjects than among individuals with other psychotic syndromes[7]
Summary
Psychiatry investigated dreams to understand psychopathologies. Contemporary psychiatry, which neglects dreams, has been criticized for lack of objectivity. These differences in symptomatology led us to hypothesize that schizophrenic and bipolar subjects would produce less connected word graphs than control subjects, in correlation with negative symptoms It remains unsettled whether dream reports are crucial for the differential diagnosis of psychosis, as early psychiatrists would have sustained[11,12], or whether waking contents are informative. To elucidate these issues, we quantified the speech graph attributes (SGA; Figure 1a, Figure 2) of dream and waking reports obtained from clinical oral interviews of schizophrenic, bipolar type I, and control subjects (Supplementary Table S1). Translation of the reports into five major Western languages was performed to assess language-related variations
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