A Multivariate Approach to Communication Impoverishment and Cognitive Performance in Treatment-Resistant Schizophrenia: Analyse à plusieurs variables portant sur l’appauvrissement de la communication et la performance cognitive dans les cas de schizophrénie résistante au traitement

Objective Language and communication disturbances are enduring features of schizophrenia, often manifesting as impoverishment of speech. This exploratory study aims to examine how communicative deficits overlap with a cognitive profile of treatment-resistant chronic schizophrenia inpatients. Methods We employed Iterative Constrained Principal Component Analysis in a sample of inpatients ( n = 138) to identify the optimized, multidimensional overlap between 17 neuropsychological measures and 26 symptom items from the Positive and Negative Syndrome Scale. Cognition was assessed via neuropsychological tests of verbal comprehension, semantic memory/verbal fluency, cognitive flexibility, verbal and visuospatial learning, processing speed, and working memory. Results The analysis identified a distinct symptom-cognition cluster. Communication Impoverishment (specifically the Lack of Spontaneity and Flow of Conversation) was the primary predictor of a cognitive component characterized by Verbal Fluency and Executive Functioning. This component was defined by performance on tasks measuring category-based word generation, the ability to switch between semantic rules, and the depth of word knowledge and general factual information. This association was independent of antipsychotic dosage and correlated with real-world social and occupational functioning. Conclusions The results indicate that communication impoverishment in persistent psychosis reflects dysfunction within the verbal-semantic system, likely involving both the fluid executive ability to navigate categories and the integrity of the semantic store itself.