Bilingualism and psychosis: a linguistic analysis of a patient with differential symptom severity across languages

Abstract

Several lines of evidence suggest important links between language and schizophrenia. Individuals with schizophrenia show numerous abnormalities related to language function, including disorganised speech and verbal memory impairments. Psychotic patients who communicate in two or more languages provide an opportunity to study the relationships between language and psychosis in more detail. This is a case report of a 27-year-old late bilingual male with a first psychotic episode who switched to his second language (English) during the psychotic episode and displayed more psychotic features, including prominent speech and thought disorder, when assessed in his first  language (Afrikaans) compared to English. A language history was  obtained and a language evaluation conducted, including analysis of a spontaneous language sample for the evaluation of structural and  pragmatic aspects. Unexpectedly, the patient displayed more language abnormalities in English than in Afrikaans, suggesting a complex relationship between language and psychosis. One implication of these  findings is that clinicians should assess bilingual psychotic patients in  both languages in order to elicit the full spectrum of symptoms.

Southern African Linguistics and Applied Language Studies 2009, 27(2): 163–171