Descriptive Psychopathology: The Signs and Symptoms of ...

240 Section 3: Examination domainsTable 9.3. 47 Characteristic speech patterns of patients withsubcortical aphasiaInitial mutism and non-fluent speech followed by adequate fluencybut a paucity of speechDiminished spontaneous speechDysarthric speechPreserved repetition and namingPhonemic and semantic paraphasiaPreserved auditory comprehensionWord-finding difficultiesImpaired lexical–semantic processingTable 9.4. Characteristic speech patterns of schizophreniaPreserved speech fluency despite a paucity of speechReduced spontaneous speechAble to repeat simple words and sentences (“No ifs, ands, or buts”)Adequate auditory comprehensionAdequate use of complex (polysyllabic) wordsMild word-finding problemsReduced use of nouns (speech seems empty)Circumloculatory speechElliptical and non-sequitive speechPrivate word usage (out-of-class semantic paraphasia)Intermittent use of neologisms, paraphasias, portmanteau words,strings of jargon speech, derailed speech, perseverationsyndromes also have speech and language problems, but these are phenomenologicallydistinguished from FTD. 48 One factor analytic study of 170 schizophrenicand 62 manic patients found that the degree of verbal output (high inmanics and low in schizophrenics) and the presence or absence of FTD (observedin schizophrenics) captured 44% of variance of the sample, and that using thederived factors in a discriminant function analysis correctly classified 91% of thesample. 49 Manic patients who meet criteria for schizoaffective disorder exhibitsome elements of FTD as well as the classic speech of mania, and the presence ofFTD in a manic patient is associated with poor long-term outcome. 50 Descriptionsfollow of the forms of FTD.Elliptical and non-sequitive speechElliptical speech is speech that is fluent and mostly grammatically and syntacticallynormal, but which skirts the topic rather than getting to the point or straying