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Schizophrenia, culture and neuropsychology: sensory deficits, language impairments and social functioning in Chinese-speaking schizophrenia patients

Published online by Cambridge University Press:  21 November 2011

L. Yang ,
S. Chen ,
C.-M. Chen ,
F. Khan ,
G. Forchelli  and
D. C. Javitt
L. Yang*
Affiliation:
Columbia University Mailman School of Public Health, New York, NY, USA
S. Chen
Affiliation:
Columbia University Mailman School of Public Health, New York, NY, USA
C.-M. Chen
Affiliation:
University of Connecticut, Storrs, CT, USA
F. Khan
Affiliation:
Widener University Institute of Graduate and Clinical Psychology, Chester, PA, USA
G. Forchelli
Affiliation:
Nathan Kline Institute for Psychiatric Research, New York, NY, USA
D. C. Javitt*
Affiliation:
Nathan Kline Institute for Psychiatric Research, New York, NY, USA Columbia University College of Physicians and Surgeons, New York, NY, USA
*
*Address for correspondence: Dr L. Yang, 722 West 168th Street, Room 1610, Columbia University, New York, NY 10032, USA. (Email: lhy2001@columbia.edu) [L. Yang] (Email: javitt@nki.rfmh.org) [D. C. Javitt]
*Address for correspondence: Dr L. Yang, 722 West 168th Street, Room 1610, Columbia University, New York, NY 10032, USA. (Email: lhy2001@columbia.edu) [L. Yang] (Email: javitt@nki.rfmh.org) [D. C. Javitt]
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Abstract

Background

While 20% of schizophrenia patients worldwide speak tonal languages (e.g. Mandarin), studies are limited to Western-language patients. Western-language patients show tonal deficits that are related to impaired emotional processing of speech. However, language processing is minimally affected. In contrast, in Mandarin, syllables are voiced in one of four tones, with word meaning varying accordingly. We hypothesized that Mandarin-speaking schizophrenia patients would show impairments in underlying basic auditory processing that, unlike in Western groups, would relate to deficits in word recognition and social outcomes.

Method

Altogether, 22 Mandarin-speaking schizophrenia patients and 44 matched healthy participants were recruited from New York City. The auditory tasks were: (1) tone matching; (2) distorted tunes; (3) Chinese word discrimination; (4) Chinese word identification. Social outcomes were measured by marital status, employment and most recent employment status.

Results

Patients showed deficits in tone-matching, distorted tunes, word discrimination and word identification versus controls (all p<0.0001). Impairments in tone-matching across groups correlated with both word identification (p<0.0001) and discrimination (p<0.0001). On social outcomes, tonally impaired patients had ‘lower-status’ jobs overall when compared with tonally intact patients (p<0.005) and controls (p<0.0001).

Conclusions

Our study is the first to investigate an interaction between neuropsychology and language among Mandarin-speaking schizophrenia patients. As predicted, patients were highly impaired in both tone and auditory word processing, with these two measures significantly correlated. Tonally impaired patients showed significantly worse employment-status function than tonally intact patients, suggesting a link between sensory impairment and employment status outcome. While neuropsychological deficits appear similar cross-culturally, their consequences may be language- and culture-dependent.

Keywords

Chinesecognitioncultureemploymentschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 7 , July 2012 , pp. 1485 - 1494
Copyright
Copyright © Cambridge University Press 2011

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