Chaban, Peter
Department of Psychiatry
Sunnybrook Hospital, Toronto

Peter Chaban
Department of Psychiatry
Sunnybrook Hospital
2075 Bayview Avenue
Toronto, Ont.

Strand: language disorders and problems

Title: The Relationship between Text Formation and Register Selection in the Writings of Adolescent Patients with Psychotic Symptoms

The term Psychotic in its broadest sense describes a cluster of symptoms that include delusional thinking, hallucinations, disorganized speech and disorganized behavior.(DSM-IV). Psychotic symptoms appear in a variety of psychiatric illnesses, including schizophrenia and bipolar disorder. In both cases, a diagnosis includes identifying aberrant language usage. The use of aberrant language has been seen as either an expression of disordered thought content or disordered thought form. If it is the content of the thought, then the thought disorder is one of ideation or belief and may have similarities with delusional symptoms. If the thought disorder is one of form, then the thought disorder is one of information processing or language function and may have similarities with disorganized speech and behavior. The ability to describe the differences between form and content of thought disorders has implications identifying neruoanatomical locations for behaviors as well as diagnostic validity for illnesses associated with psychotic symptoms.

A simple writing exercise was developed and administered to adolescent patients at the Youth Division, Dept. of Psychiatry at Sunnybrook Health Science Centre. Patients were acutely psychotic, either with schizophrenia or bipolar disorder. A systemic text analysis was done to the samples in order to delineate aberrant form and aberrant content. Analysis included examining lexico-grammar, cohesion and metafunctions. Analysis showed that even in a psychotic state, bipolar patients were able to produce coherent texts, whereas schizophrenic patients produced incoherent texts. But, when schizophrenic patient texts were reexamined as dialogues rather than monologues, then the texts began to take on a coherent shape. Once the reader adjusted their perception of the register, specifically, the mode and tenor of the text, then the field of the text began to make sense and the writer's metafunctional choices and the associated lexico-grammar became coherent.