Nonverbal communication remains untouched: No beneficial effect of symptomatic improvement on poor gesture performance in schizophrenia

Florian Wüthrich,Anastasia Pavlidou,Katharina Stegmayer,Sarah Eisenhardt,Jeanne Moor,Lea Schäppi,Tim Vanbellingen,Stephan Bohlhalter,Sebastian Walther

doi:10.1016/j.schres.2020.08.013

Florian Wüthrich, Anastasia Pavlidou + Show 7 more

Open Access

https://doi.org/10.1016/j.schres.2020.08.013

Copy DOI

Abstract

BackgroundGestures are an important part of communication. Patients with schizophrenia present gesture deficits that tend to deteriorate in the course of the disease and hamper functional outcome. This gesture deficit has been associated with motor abnormalities, cognitive impairment, and psychotic symptoms. Unaffected, first-degree relatives of schizophrenia patients share some subclinical motor and cognitive abnormalities. We aimed to investigate, whether gesture performance changes with symptomatic improvement in patients, and to test the longitudinal performance in unaffected, first-degree relatives. MethodsIn this study, we measured gesture performance using a validated test in 33 patients, 29 first-degree relatives and 38 healthy controls. Measurements were completed shortly after admission and before discharge in patients. Performance was rated blindly by experts using video recordings of the gesture task. Additionally, we evaluated cognitive function and psychotic symptoms at both visits. ResultsGesture performance was poorer in relatives compared to controls and poorer in patients compared to both relatives and controls. Patients showed an improvement in psychopathology but a significant decrease in gesture performance at follow-up, while performance in the other groups remained stable. Proportional change of gesture performance correlated with change of cognitive function in patients, whereas there were no correlations with change of cognitive function in the other groups. ConclusionWhile symptom severity was reduced, the gesture deficit further deteriorated in schizophrenia. The finding argues for distinct processes contributing to poor nonverbal communication skills in patients, requiring novel alternative treatment efforts.

Highlights

Gestures are important for communication as they carry meaningful information (Cartmill et al, 2012; Goldin-Meadow, 1999)
Post-hoc analysis revealed a significant difference in age only between patients and first-degree relatives, while first-degree relatives had significantly higher number of female participants compared to patients and controls
Both differences are due to including mothers as first-degree relatives (Table 1)

Summary

Introduction

Gestures are important for communication as they carry meaningful information (Cartmill et al, 2012; Goldin-Meadow, 1999). Patients with schizophrenia exhibit deficits in gesture performance, recognition and interpretation when compared to healthy controls, affecting overall communication (Grusser et al, 1990; Troisi et al, 1998; Walther et al, 2015). Patients with schizophrenia present gesture deficits that tend to deteriorate in the course of the disease and hamper functional outcome. This gesture deficit has been associated with motor abnormalities, cognitive impairment, and psychotic symptoms. Whether gesture performance changes with symptomatic improvement in patients, and to test the longitudinal performance in unaffected, first-degree relatives. Methods: In this study, we measured gesture performance using a validated test in 33 patients, 29 first-degree relatives and 38 healthy controls. The finding argues for distinct processes contributing to poor nonverbal communication skills in patients, requiring novel alternative treatment efforts

Objectives

Methods

Results

Discussion

Conclusion