Introduction: Dysfunctional social communication is one of the most stable characteristics in patients with schizophrenia that severely affects quality of life. Interpreting abstract speech and integrating nonverbal information is particularly affected which has been associated with neural dysfunctions in temporal lobe regions.Objectives: Considering the difficulty to treat communication dysfunctions with usual intervention, we investigated the possibility to improve quality of life and co-verbal gesture processing in patients with schizophrenia by applying a multimodal speech-gesture training (MSG training).Methods: In the MSG training, we offered eight sessions (60 min each) of training including perceptive and expressive tasks as well as meta-learning elements and transfer exercises to 29 patients with schizophrenia spectrum disorder (SSD). Patients were randomized to a waiting-first group (N=20) or a training-first group (N=9), and were compared to healthy controls (N=17). Outcomes were quality of life and related changes in the neural processing of abstract speech-gesture information, which were measured pre-post training through standardized psychological questionnaires and functional Magnetic Resonance Imaging, respectively.Results: Pre-training, patients showed reduced quality of life as compared to controls but improved significantly during the training. Strikingly, this improvement was correlated with neural activation changes in the middle temporal gyrus for the processing of abstract multimodal content. Conclusion: With this study, we provide first promising results of a novel multimodal speech-gesture training for patients with schizophrenia. We could link training induced changes in speech-gesture processing to changes in quality of life, demonstrating the relevance of intact communication skills and gesture processing for well-being.
Effects of depression and cognitive impairment on quality of life in older adults with schizophrenia spectrum disorder: Results from a multicenter study