The use of linguistic context in positively thought-disordered (TD) schizophrenics was investigated through examination of their performance on an on-line word-monitoring task. Controls and non-TD schizophrenics took longer to recognize words preceded by linguistic anomalies compared with words in normal sentences. Compared with both other groups, TD schizophrenics showed significantly smaller differences in reaction time, suggesting that they were relatively insensitive to linguistic violations. TD schizophrenics were also less sensitive to linguistic violations in an off-line version of the task, in which they judged whether the sentences "made sense." Finally, these participants produced more errors on a verbal fluency task than did non-TD schizophrenics or normal controls. These findings are consistent with the theory that schizophrenic thought disorder arises from a deficit in the use of linguistic context to process and produce speech.
We review advances in the treatment of schizophrenia. We begin with an overview of antipsychotic drug development, focusing on the in vitro and in vivo binding profiles of clozapine and a new generation of D2:5HT antagonists. We then consider the main barriers to effective treatment: non-compliance (and side-effects) of medication, recurrent relapse, 'treatment resistance', negative symptoms and neurocognitive deficits. Within this framework, we review the mechanisms of action and clinical uses of the 'atypical' antipsychotic drugs. We also show how a variety of psychosocial interventions, particularly those that incorporate cognitive techniques, can be used in combination with pharmacotherapy to overcome the same clinical hurdles.