Abstract

Language abnormalities are a core symptom of schizophrenia-spectrum disorders and could serve as a potential diagnostic marker. Natural language processing enables quantification of language connectedness, which may be lower in schizophrenia-spectrum disorders. Here, we investigated connectedness of spontaneous speech in schizophrenia-spectrum patients and controls and determine its accuracy in classification. Using a semi-structured interview, speech of 50 patients with a schizophrenia-spectrum disorder and 50 controls was recorded. Language connectedness in a semantic word2vec model was calculated using consecutive word similarity in moving windows of increasing sizes (2–20 words). Mean, minimal and variance of similarity were calculated per window size and used in a random forest classifier to distinguish patients and healthy controls. Classification based on connectedness reached 85% cross-validated accuracy, with 84% specificity and 86% sensitivity. Features that best discriminated patients from controls were variance of similarity at window sizes between 5 and 10. We show impaired connectedness in spontaneous speech of patients with schizophrenia-spectrum disorders even in patients with low ratings of positive symptoms. Effects were most prominent at the level of sentence connectedness. The high sensitivity, specificity and tolerability of this method show that language analysis is an accurate and feasible digital assistant in diagnosing schizophrenia-spectrum disorders.

Highlights

  • Schizophrenia-spectrum disorders (: SSD) include a com­ plex variety of psychiatric illnesses that affect approximately 2–3% of the population (Rossler et al, 2005)

  • Using a word2vec model applied to transcriptions of recorded semi-spontaneous speech, we show connectedness in language as a robust feature suitable to classify SSD participants and healthy controls

  • Features of connectedness fit for classification were found over word ranges of varying window sizes in minimum and especially variance of word similarity, with features most informative for classification for variance at window sizes of 5–10 words

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Summary

Introduction

Schizophrenia-spectrum disorders (: SSD) include a com­ plex variety of psychiatric illnesses that affect approximately 2–3% of the population (Rossler et al, 2005). Language and speech disturbances are one of the key diagnostic features of SSD (American Psychiatric Association, 2013). Language abnormalities have been investigated extensively in patients with SSD (Chaika, 1990; Covington et al, 2005; DeLisi, 2001; Kuperberg, 2010). These studies show that greatest difficulties arise at the level of semantics (meaning) and syntax (grammar). Language abnormalities have recently gained traction due to their possible use for classification of diagnosis; for reviews, see Corcoran and Cecchi, 2020; de Boer et al, 2020a. Given the multi-facetedness of language, research on this topic is broad and there is as of yet little overlap between methodologies or approaches

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