Language

How is language ability measured?

Language may be altered in people with bipolar disorder and may present in the form of disorganised speech. Tasks designed to assess language ability include; letter fluency tasks that assess the ability to generate words starting with a particular letter; and category fluency tasks that assess the ability to name words within a specified category. Working memory is needed for both letter and category fluency as participants must organise and retrieve relevant information.

Other tests designed to assess language include: Boston Naming task; Wechsler Adult Intelligence Scale (WAIS) comprehension (including the subtest information, similarities and vocabulary), WAIS verbal memory, verbal fluency, National Adult Reading Test (NART)/ Wide Range Achievement Test (WRAT), Controlled Oral Word Association Test (COWA), Category Instance Generation Test (CIGT), Multiple Choice Vocabulary Test (MWT-B), Hopkins Verbal Learning test (HVLT), California Verbal Learning Test (CVLT), Rey Auditory Verbal Learning Test (AVLT), semantic priming tasks and Lexical Decision Task and the Peabody Individual Achievement reading comprehension (PIAT).

What is the evidence on language fluency in people with bipolar disorder?

Moderate quality evidence suggests a medium-sized effect of poorer language fluency in people with bipolar I or II disorder compared to controls. The effect is smaller in people with first-episode bipolar disorder compared to controls, and larger in elderly people with bipolar disorder compared to controls who were matched for age and education. There were no changes in language fluency over time (3-4 years).

High quality evidence shows a small to medium-sized effect of poorer fluency in first-degree relatives of people with bipolar disorder compared to controls. However, there was better fluency in first-degree relatives of people with bipolar disorder than in first-degree relatives of people with schizophrenia, and better fluency in people with first-episode bipolar disorder than first-episode schizophrenia.

High quality evidence suggests a small association between poor fluency and poor general functioning.

March 2019

Last updated at: 4:56 am, 31st March 2019
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