=Paper= {{Paper |id=Vol-2552/Paper14 |storemode=property |title=Cross-sectional Study of Clinical and Psycholinguistic Characteristics of Mental Disorders in HIV Infection |pdfUrl=https://ceur-ws.org/Vol-2552/Paper14.pdf |volume=Vol-2552 |authors=Nadezhda Khalezova,Xenia Piotrowska,Ekaterina Terbusheva,Ol’ga Koltsova,Veronika Piotrovskaya,Nikolay Neznanov }} ==Cross-sectional Study of Clinical and Psycholinguistic Characteristics of Mental Disorders in HIV Infection== https://ceur-ws.org/Vol-2552/Paper14.pdf

Cross-sectional Study of
Clinical and Psycholinguistic Characteristics of
Mental Disorders in HIV Infection ∗
Nadezhda Khalezova1 Xenia Piotrowska3
khalezo@gmail.com krp62@mail.ru
Ekaterina Terbusheva3 Ol’ga Koltsova2
ekatherina88@mail.ru ovkoltsova@yandex.ru
Veronika Piotrovskaya1,2 Nikolay Neznanov1
vpiotrovskaya@gmail.com neznanov.spbgmu@gmail.com
1
Pavlov First Saint Petersburg State Medical University,
2
Center for Prevention and Control of HIV and Infectious Diseases,
3
Herzen State University of Russia
Saint-Petersburg, Russian Federation

Abstract
The paper considers the use of clinical-linguistic examination method for determining
linguistic markers for mental disorders in HIV patients who did not receive specific an-
tiviral therapy. The study allows to determine linguistic markers of physical and mental
state deterioration, such as increase of verb coefficients and personal pronouns, coefficient
of logical coherence and vocabulary diversity and volume. The identified markers could
be additional signs to be used by any practical doctor and psychiatrist to presume mental
disorders in patients with HIV infection.
Keywords: HIV infection, mental disorders, disorders of adaptation, organic disor-
ders, central nervous system, psycholinguistic method, corpora, psycholinguistic indexes,
linguistic marker

∗
Copyright © 2019 for this paper by its authors. Use permitted under Creative Commons License Attri-
bution 4.0 International (CC BY 4.0).

1
1 Introduction
Current epidemiological data on the pandemic prevalence of HIV in the world expand the
boundaries of the problems associated with the threat of unpredictable spread of infection and
the frequency of mental disorders that accompany HIV infection[Novikov, 2019] 1 2 . The spe-
cific treatment of HIV infection is complicated by psychological, psychotherapeutic, social and
economic problems that need to be resolved [Sherbourne et al., 2000]. HIV-induced mental
disorders have somatogenic and psychogenic etiology. Somatogenic mental disorders are deter-
mined by the fact that the central nervous system (CNS) is one of the reservoirs for HIV. HIV
is indirectly a neurotropic virus and can cause associated neurocognitive impairment (HAND)
[Allory et al., 2000] [Sherbourne et al., 2000][Liu et al., 2000][Nakagawa et al., 2012]. Now it
is known that the main structures damaged by HIV infection are the subcortical parts of the
brain, in particular the area of the limbic system – the hippocampus. When comparing neu-
ropsychological and neuroimaging methods of studying the state of the central nervous system
at the early stages of the HAND formation, it turned out that the following brain regions are
involved in the pathological process: anterior cingulate gyrus, shell, mediobasal parts of the
temporal lobe, premotor sections, corpus callosum, and reticular formation. Involvement of
these structures in the central nervous system is confirmed by symptoms of cognitive impair-
ment and emotional disorders, which are the earliest mental disorders in HIV-infected subjects.
[Ellis et al., 2016].
The most commonly used HAND classification was proposed in 2007 and included 3
categories [Antinori et al., 2007]:
• asymptomatic HAND, which are manifested only when performing complex professional
activities and have little effect on everyday life; neuropsychological testing reveals vio-
lations in at least 2 functional areas, which include speech, attention, working memory,
abstract thinking, executive functions, memory (learning, memorization), information
processing speed, sensory-perceptual and motor skills;
• mild HAND significantly interfere with professional activities and complicate domestic
work and behavior in society;
• severe HAND – HIV-associated dementia that makes a person disabled, requiring care
[Everall et al., 2009][Antinori et al., 2007].
According to Simioni, the overall prevalence of all HAND in patients with undetectable
viral load (VL) of HIV is 69%, the prevalence of asymptomatic disorders - 50%, lungs - 17%
and dementia - 2% [Simoni, 2011]. The psychogenic nature of mental disorders in HIV-infected
patients is provoked by an awareness of the severity of the disease, the need for continuous use
of antiretroviral therapy (ART), the need to change the usual lifestyle and social functioning
[Trofimova et al., 2010][Syropiatov et al., 2013][Koltcova et al., 2011]. A significant cultural
and social problem is stigmatization and discrimination of HIV-infected citizens, which some-
times spreads to their family members [Stigmacija & diskriminacija, 2011][Belyakov et al., 2012].
Psycho-traumatic experiences and initial manifestations of HAND are mutually burden-
some and create difficulties for an HIV-infected patient in deep awareness and verbalization
of their experiences. The latter complicates and reduces the quality of psychological and
psychotherapeutic support of the patient.
1
http://www.demoscope.ru/weekly/2002/069/analit02.php
2
https://www.who.int/ru/news-room/fact-sheets/detail/hiv-aids

2
It is known that the dynamics of linguistic characteristics patient’s speech is to some
extent related to clinical and psychological phenomena. This is manifested in the words and
expressions used, in the literacy, accuracy, richness and imagery of speech utterances, in the
paralinguistic components of speech, in the features of nonverbal speech and many other
signs [Nemov, 2019]. However, even in a few studies on linguistic phenomena in a clinic for
patients with mental disorders, speech structures are considered as leading subjective factors
in the pathogenesis of mental disorders [Piotrowski, Spivak, 2007]; [Pashkovsky et al., 2015];
[Mikirtumov, 2004]; [Smirnova, 2010]; [Spivak, 2004]. The linguistic aspects of the infectious
processes influence on the central nervous system remain currently poorly understood. Several
articles report age-specific keywords in HIV patients [Chena et al., 2017]. Confirmed data on
neuroimaging changes in the speech areas of the temporal lobes of the cerebral cortex in
HIV-infected patients determines the relevance of further additional psycholinguistic studies
[Trofimova et al., 2010].

2 Study Objectives
The main objective of the study in question is to substantiate the use of linguistic examination
method for determining linguistic markers of mental disorders in HIV patients who did not
receive specific antiviral therapy. Such investigation makes it possible:

• to assess the state of mental health in patients with HIV infection from the perspective
of the concept of a biopsychosocial model of diseases.

• to study the structural organization and features of the linguistic characteristics of the
speech of patients with HIV infection.

• to identify linguistic markers of central nervous system damage in HIV infection.

3 Material and Methods
The study group consisted of patients with HIV infection, who are being monitored at the
St. Petersburg State Center for the Prevention and Control of AIDS and Infectious Diseases
(AIDS Center) and are not receiving ART. Criteria for inclusion in the study group were as
follows:

• - written consent of the patient to participate in the study;

• - confirmed diagnosis of HIV infection;

• - lack of antiviral therapy at the time of examination.

The basis for exclusion from the study were:

• confirmed history of abuse or dependence on psychoactive substances (surfactants)
(rubric F1x.x according to the classification of ICD-10);

• post-traumatic changes in the central nervous system (more than 3 craniocerebral trauma
(head injury), concussions in the anamnesis);

3
• concomitant infections of the central nervous system in history;

• confirmed atherosclerotic lesions of the brain;

• concomitant mental disorders of a psychotic level (rubrics F1x.x., F06.5x, F2, F30.x,
F31.x, F39.x, F32.3x, F33.2x, F33.3x according to the ICD-10 classification);

• dementia (F02.x according to the ICD-10 classification);

• mental retardation (F7x.x according to the classification of ICD-10).

The methods of the study were:

1. Primary medical records review

2. Clinical interview using psychometric scales:

• Depression rating scale - MADRS Montgomery;
• Anxiety rating scale - HAMA Hamilton

3. Experimental-psychological methods:

• Impact of Event Scale (IES-R) for assessing the impact of the HIV infection trau-
matic factor on the mental state [Horowitz et al, 1979];
• Munsterberg test to assess impaired attention and verbal fluency;
• CRIq [Nucci et al., 2012] cognitive reserve questionnaire for assessing cognitive re-
sources.

4. Psycholinguistic method: content analysis of oral statements of patients.

5. Biochemical method: comparing the data obtained with indicators of the patients’ im-
mune status and viral load with measurement performed in the laboratory of the AIDS
Center.

6. Lingua-statistical methods: building frequency vocabulary, concordances and colloca-
tions with AntConc program (Waseda University, Japan) [Anthony, 2004]. Previously,
the texts were lemmatized using the LemmaGen program[JURŠIČ et al.].

7. Statistical processing methods: calculating all quantitative indicators with Statistica
10.0 software (Statsoft Inc., USA) (mean and standard deviations (SD)). For qualitative
indicators frequencies and percentages were received. To assess the normality of the dis-
tribution the Shapiro–Wilks test was performed. Student’s test was used for independent
samples to assess the differences in quantitative characteristics between groups (distribu-
tion close to normal). Data symmetrization was carried out using logarithm. To compare
the mean values, the non-parametric Mann–Whitney test was used for two independent
samples. A correlation analysis was also performed using Pearson/Spearman correlation
coefficients. Differences were considered statistically significant at a significance level
of less than p < 0.05. Also, in order to clarify and identify correlation relationships
between parameters, we used data mining system Weka [Witten et al., 2007].

4
4 General Characteristics and Analysis of the Study
Group
The cohort of 52 subjects was examined (24 (46.2%) male, 28 (53.8%) female). The average
age of the patients was 35.9 ±9.0 (22 to 56) years. The distribution of the sample of patients
by stages of HIV infection is presented in Table 1. Most patients were at stages 3 and 4A of
HIV infection.

Table 1: HIV stages in the examined patients

HIV stages Number of patients %
2Б 3 5,9
3 27 51
4А 19 37,3
4Б 3 5,9

The average length of time for registration with the AIDS Center was 1.3 ±3.5 years
(from 1 week to 18 years). The age of diagnosis of HIV infection was 1.7 ±3.7 years (from
1 week to 18 years), and in most cases it coincided with the age of registration at the AIDS
Center. Most of the examined patients recently learned about the diagnosis of HIV infection,
recently registered with the AIDS Center, and underwent a commission examination before
starting ART.
Viral load in patients was 198562.1 ±822679.9 (506-5887422) copies / ml. Average CD4
abs. T –lymphocytes were 522.5 ±289.1 (18 to 1283) cells / l. The large dispersion of viral load
and CD4 abs. T–lymphocytes is explained by different duration and stages of HIV infection
and the lack of correction of ART. Two (3.8%) patients suffered from concomitant chronic viral
hepatitis C. Concomitant diseases were observed in 21 patients (40.4%) and were represented
by mild and moderate pathology of many organs and systems of the body. Acute and severe
concomitant conditions were not observed. Nine (17.3%) patients took medications, most
often for the prevention of tuberculosis (isoniazid, vitamin B6).
Thus, the sample included somatically healthy people suffering from HIV infection and
not taking medications with neurotoxic effects.

4.1 Patients’ social characteristics.
Most of the patients (42.3%) were higher educated. On average, patients had been educated
(including school and post-secondary education) for 13.5 ±2.8 (10 to 19) years. Their distri-
bution according to the education level is presented in Table 2.
Patients were divided according to their job rankling level ( see Table 3) . The quality
of work in 21 patients (40.4%) did not correspond to their education. They were engaged
in low-skilled manual labor such as manicurist, gas station operator, housekeeper, assistant
educator, cleaner. Professional experience in working patients was 10.3±3.6 (from 5 to 16
years)
Most patients were single 16 (30.8%) and 12 (23.1%) divorced. Living conditions for
almost all patients (47 (90.4%) were satisfactory. Only 5 of them (9.6%) lived in separate
rooms in social apartments.

5
Table 2: Educational level of patients

Educational level Number of patients (n) To the whole sample(%)
Lower secondary 2 3,8
Specialized secondary 7 13,5
Secondary 12 23,1
Secondary technical 3 5,8
Incomplete higher 6 11,5
Higher 22 42,3

Table 3: Distribution of patients according to their level of skills

Job rankling Number of patients (n) (%)
Low skilled manual 21 40,4
Qualified manual 11 21,2
Skilled non-manual 13 25
Professional 6 11,5
Highly responsible intelligent 1 1,9

Table 4: Psychopathological syndromes in the examined patients

Syndrome Number of patients (n) Number of patients (%)
anxious 11 21,2
anxious hypochondria 6 11,5
psychoorganic 5 9,6
anxious depressive 3 5,8
depressive 2 3,8
parasomnic 1 1,9
psychopathic 1 1,9
without pathology 23 44,2

In general, the level of social adaptation in more than half of the patients (30 (57.7%))
was high.
All patients actively used the Internet, a mobile phone, took an active part in household
chores (cleaning, cooking, etc.).

4.2 Clinical and psychopathological analysis of the data
Patients complained of anxiety, asthenic hypochondria, and obsessive-phobic feelings. The
psychopathological syndromes leading in the clinical picture are indicated in Table 4. Only
two (3.2%) patients were previously consulted by psychiatrist. The average duration of mental
illness in patients in the sample was 48.2 ±89.6 months (from 1 day to 30 years). Fig. 1 shows
the levels of depression according low (0–6 points), moderate (7–19 points) and high (20–34

6
Table 5: Patients distribution into diagnosis

Diagnostic column (ICD-10) Number of patients (%)
Neurotic and stress related disorders, F4 19 (36,5%)
Organic, including symptomatic, mental disorders, F0 6 (11,2%)
Affective disorders (dysthymia and recurrent affective disorder, remission), F3 2 (3,8%)
Without diagnosis 25(48,1%)

points) distribution. (MADRS) is shown in Fig.1. The average score on the HAMA rating
scale of anxiety in the sample was 10.6 ±9.0 (from 0 to 30), which corresponds to a low level
of anxiety experiences. The distribution of patients by anxiety levels is shown in Fig. 1.
According to the MADRS scale in women, the level of depression was higher than in
men (14.2 ±9.9 points in women vs 5.7 ±5.5 points in men, p < 0.05). Also, the level of
depression increased with age (r = 0.3, p <0.05), especially in people over 35 years old. Often,
depressive experiences were accompanied by sleep disorders, anxiety, obsessive–phobic and
hypochondriacal symptoms. The frequency of personal pronouns in patients correlated with
the magnitude score on the MADRS scale (r = 0.4, p < 0.05). The average score on the scale
of attention and verbal fluency (Munsterberg test) was significantly lower than normal (>=
18 points - 23.1%, < 19 points - 76.9%) and amounted to 14.8 ±4.2 (from 3 to 22 points). The
distribution of patients depending on normal indicators or a decrease in the attention scale is
shown in Fig. 2.
The attention scale indicators decreased with a decrease in the number of CD4 lympho-
cytes (CD4%: r = 0.3, p < 0.05; CD4 abs.: r = 0.3, p < 0.05). The severity of experiences
due to the traumatic factor of HIV infection was evaluated on the IES-R scale. As a result,
it is possible to assess the level and characterize the clinical picture of emotional experiences.
According to the IES-R scale, the “Invasion” subscale allows to identify nightmares, obsessive
feelings, images, or thoughts associated with the possible effects of HIV infection. The sub-
scale “Avoidance” allows to identify avoidance symptoms, including attempts to mitigate or
avoid experiences associated with the possible effects of experiences associated with HIV infec-

Figure 1: Distribution of patients by depression levels according to the MADRS and HAMA
scales

7
tion, decreased reactivity. Subscale “Physiological excitability” allows to identify the subject’s
anger and irritability; hypertrophied fright reaction of the possible impact of thoughts about
HIV; difficulty concentrating psychophysiological agitation due to memories of the presence
of HIV, insomnia. “Integral indicator” is a general scale for assessing the impact of thoughts
about HIV as a traumatic effect. It allows to reveal the presence of adverse emotional and
personal characteristics among the examined, which have arisen as a result of the subjective
perception of the threat from HIV infection. The results of the IES-R scale are shown in Ta-
ble 7. The highest scores are presented on the “Avoidance” subscale, which characterizes the
desire to distance oneself from thoughts about HIV infection, not to remember the diagnosis,
unwillingness to visit the AIDS Center, and a likely passive attitude towards the disease.
A third of patients expressed asthenic complaints (18 (34.6%)). Anxious experiences
were determined in half of the patients (29 (55.8%)). Moreover, in 7 (13.5%) cases experiences
were represented by obsessions, in 7 (13.5%) by phobias of mainly AIDS-phobic content.
Hypochondria of an obsessive level was detected in 10 (19.2%) patients, overvalued - in 5
(3.8%).
Eight (15.4%) patients complained of bad mood, which clinically confirmed the presence
of depression. 1 (1.9%) patient had suicidal impulse. No one had a suicide attempt in history.
Sleep disorders were found with 15 patients and were distributed as follows: early insomnia
in 9 (17.3%) patients, average insomnia in 5 (9.6%), mixed insomnia in 1 (1.9%).
In 11 (21.2%) patients, signs of an asthenic variant of the psycho-organic syndrome were
noted. 13 people (24.9%) had a history of up to 2 TBIs of mild severity.

Table 6: IES-R scale results for the examined patients

Subscale Average±SD Min-max Socio-psychological tension
level
Invasion 7,4±6,3 0–26 between average and low
Avoidance 13,1 ±8,9 0–32 average
Physiological excitability 5,7±6,3 0–23 low
Integral indicator 26,2±18,3 0–67 between low and average

4.3 Psycholinguistic and lingua-statistical analysis of patient inter-
view
To conduct psycholinguistic measurements, according to the hierarchical levels of language
organization, various levels of text analysis were determined:

• lexical—grammatical level percentage ratio of different parts of speech reflected general
mental functioning, development of intelligence,
• lexical—stylistic level (Aggressiveness Index, Coherence Index, CTTR) reflected personal
characteristics,
• syntactic level (volume of speech production, number of sentences, average size of sen-
tences, percentage of simple and complex sentences) reflected current emotional state,

8
• pragmatic level (highlighting keywords and semantic categories that reflect a person’s
unique experience and his subjective world).
During the interview, patients were asked to speak on their health and attitude to the
disease in monologue form. It was proposed to describe the impact of HIV infection on
their relationships with other people, including the professional environment and family. The
patients talked about their diagnosis and how it affects their household activities, family and
professional duties. The time of the monologue was not limited. All interviews were conducted
in Russian, audio-recorded and then transformed into text form. The total volume of word
types was 1995 the total volume of word tokens was 8766.
Main psychometrics indexes, ratios and metrics [Balin et al, 2000] are shown in Table 7.

Table 7: The results of psycholinguistic indexes, rates and metrics in the text corpus of
examined patients
Indexes / Rates / Metrics Average±SD Min-max Regulatory data Differences
between
sample
data and
regu-
latory
data
N( Volume of patients’ speech pro- 172,4 ±119,4 56 - 745 – –
duction)
L(Number of sentences in pa- 18,0 ± 9,4 5 - 47 – –
tients’ speech production)
Average size of sentences 9,8±3,5 4,6–20,8 6–8 p > 0,05
A-Index(Aggressiveness Index) 17,3 ±3,3 10,5 – 26,8 < 60 p > 0,05
N
= verbs/verb
N
f orms
· 100%
PWR(Participle per 0,6 ±1,0 0 – 4,4 – –
Words/Passive Voice Ratio )
N
= participle
N
· 100%
PPWR(Personal Pronouns per Words) 9,0 ±3,3 1,7 - 16,5 – –
N
= personalN pronouns · 100%
CW(Clq per Words) 7,4 ±4,6 0 – 18,1 <1 p < 0,05
N
= colloquial wordsN and vulgarisms · 100%
CTTR(Corrected Type Token Ratio) 24,2 ±6,9 15,5 – 52,7 5 – 15 p < 0,05
= N√lemmas
2·N
· 100%
Coh-Index(Coherence Index) 0,99 ±0,47 0,0096 – 2,1 <1 p < 0,05
N +N +Nprepositions
= participle conjunctions
3·L
·100%
SCS-Index(Simple to Complex Sen- 151,9 ±124,7 16,7 – 650,0 – –
tences Ratio)
Nsimple sentences
= Ncomplex sentences
· 100%

Aggressiveness Indexes were very low for all patients (< 60%), this situation character-
izes passive, weak-willed participation in one’s own destiny, decrease in their aggressiveness
level and low readiness for vigorous activity. Indicators increase was observed in patients
with anxious, hypochondriacal symptoms, sleep disturbances, presence of a psycho-organic
syndrome, compared with patients without these psychopathological phenomena (p < 0.05).
The A-Indexes decreased depending on the severity of the somatic state (r = – 0.4, p < 0.05)
(Fig.2).
Participle per Words/Passive Voice Ratio stands for number of passive voice in the text
shows the level of verbal intelligence. It was lower in anxious patients than in patients with-

9
out anxiety symptoms (0.9±1.3% in patients without anxiety vs 0.3 ±0.6% in patients with
anxiety, p < 0.05).
In patients with mental disorders, compared with mentally healthy people, the Personal
Pronouns Ratio was higher (10.5 ±3.3% vs 7.6 ±2.8%, p < 0.05). Thus, the PPR was clearly
higher in people with anxious, depressive experiences, sleep disturbances, and presence of
obsessive-phobic symptoms compared with patients without such conditions (p <0.05). Com-
pared to men, women had higher rates (7,9±2,5% for men vs 10,0±3,7 for women), the in-
creasing was observed depending on the presence and duration of leisure activities (sports,
hunting, dancing, chess, coin collecting, etc.) (r=0,6, p< 0,05).
The results of Clg per Words Ratio shows that indicators of HIV infected patients were
higher than normal (p < 0.05). Most often we have observed such as вот и ну. We did not
find other internal connections for this ratio.
One of the strongest indicators in the speech diagnostics is Type Token Ratio (TTR),
which shows the lexical richness. We have chosen the TTR formula with underwent simple
corrections by Carrol, well-known as CTTR[Carroll, 1964] . Usually mezure of CTTR is in the
range of 5 to 15%. However for patients with HIV infection, this one was higher than normal
and directly depended on the level of labor qualification (r = 0.3, p < 0.05). It decreased
depending on the length of professional work absence (r = 0.6, p < 0.05).
Coherence index(Coh-Index) was increasing with growth of the average size of sentences.
The speech of patients with an organic disorder was longer, more detailed, in comparison
with other patients, as well as in the presence of hypochondriacal experiences (p < 0.05).
The volume of speech production decreased significantly depending on the length of service of
patients (r = –0.6, p = 0.05).
The average size of sentences increased depending on the level of patient labor qualifi-
cation (r = 0.3, p <0.05), level of professional work (managing director of a small company,
lawyer, individual entrepreneur, contractor, doctor, teacher, engineer, etc.) (r = 0.5, p <0.05),
decreased depending on the stage of low professional manual labor (farmer, gardener, house-
wife, educator, waiter, driver, mechanic, plumber, call-center operator, nurse, etc.) ) (r = –
0.5, p <0.05).
There were no connections between speech fluency (Munsterberg test) and psycholinguis-

Figure 2: Aggressiveness index dependence on the stage of the disease

10
tic indicators.
The linear relationships between different indexes were detected using the Pearson cor-
relation coefficient, see Fig. 3. Blue lines correspond to positive correlation and red lines
correspond to negative correlation. In addition, solid lines correspond to high correlation co-
efficient value from 0.7 to 1, dotted lines correspond to moderate correlation coefficient value
from 0.5 to 0.7. In the upshot, it can be noted that linguistic indicators, such as ratio of per-
sonal pronouns or aggressiveness increase with deterioration in the mental state of patients,
as well as with such activities as needle working, gardening or other leisure.
Subsequently, a frequency analysis of patient interview texts was carried out. We identi-
fied the most frequent nouns and personal pronouns, such as: я/ I /, человек/ man, работа/
work, жизнь/ life, отношение/ relationship, друг/подруга/ friend, girlfriend, страх/, fear,
семья/family, партнер/ partner, болезнь/ illness, терапия/ therapy; verbs: знать/ know,
мочь/ be able, думать/ think, сказать/say, влиять/ influence; adjectives: нормальный/,
normal, большой/ large, общий/ general, здоровый/ healthy, хороший/good. These tokens
were regarded as keywords.
Due to comparison of keyword collocations with other tokens, found by AntConc program,
we have identified clear differences in the content of the interview texts between patients
without mental disorders / with a diagnosis of organic non-psychotic mental disorders and
patients with adaptation disorders and non-psychotic affective disorders (Table 8).

Table 8: Collocations of the particle не/not with verbs in patients with adaptation and neu-
rotic disorders
Without mental disor- Adaptation disorders Organic non-psychotic
ders and non-psychotic affec- mental disorders
tive disorders
знать/ to known, подхватил(ла)/ to have приходила/ I have came,
давно/ for a long time, picked up, общаюсь/ I communicate,
человек /man, испугалась/ to be fright- живу/ I live,
умирает/ dies, ened, обычная /normal,
общение/ communication, изгой/ outcast, признаюсь/ I confess,
честно/ honestly, сторонюсь/ I’m avoiding, попросила/ I asked,
понимаю/ understand, слабенькая/ weak, переживаю/ I’m experi-
родственники/ relatives, мнительный/ doubtful, encing
хотеть/to want замкнулась/ locked up,
жалею/ I regret,
бросит/ throws,
боюсь/ I’m afraid,
страшно/ scary

Thus, the speech of a group of patients with neurotic and stress-related disorders, in
comparison with other groups, reveals the signs of emotional tension, depression, anxiety,
anxiety about health, about their relations with colleagues. In other two groups, word forms
were more likely to be of everyday, concrete content, emotionally inexpressive. In comparison
with patients with organic CNS disorders, in groups of patients without mental disorders
and in patients with psychogenic psychic non-psychotic disorders, a more frequent use of the

11
Figure 3: Linear relationships between patients’ characteristics

12
не/not/no particle was revealed (p <0.05). Thus, the occurrence of the не/not/no particle
in relation to the entire body of texts in patients without mental disorders was 16.9%, in
patients with emotional disorders 14.0%, and in patients with organic disorders 9.6%. The
most frequent collocations of analyzed particle with verbs in patients with adaptation and
neurotic disorders are shown in Table 9.

Table 9: Collocations of the particle не/not with verbs in patients with adaptation and neurotic
disorders
Rank Freq Freq( L) Freq( R) Statmeasure ( Mi) Collocates
2 30 3 27 4.00880 знать/to know
6 11 0 11 3.43010 мочь/to be able
14 9 3 6 3.75726 говорить/to speak
21 7 0 7 3.60114 хотеть/to want
25 6 1 5 4.49423 понять/to understand
35 5 1 4 4.49423 измениться/to change
29 5 5 0 4.23119 стараться/to try
33 5 1 4 4.00880 повлиять/to influence
31 5 3 2 3.23119 работать/to work

An example of the concordance of a not particle with the verb to know in three groups
of patients, depending on the psychiatric diagnosis, is shown in Table 10.
Numerous negative statements of patients without mental disorders or with nosogenic
reactions may be associated with inadequate perceptions of themselves and surroundings,
disharmonious attitude to the disease. In the group of patients without mental disorders, this
allows us to think about the possible dissimulation of experiences or the presence of experiences

13
of a subclinical level. Numerous negative statements of patients without mental disorders or
with nosogenic reactions may be associated with inadequate perceptions of themselves and
entourage, disharmonious attitude to the disease. Collocations of the particle not and the
verbs to be, be able, want, speak and others imply a passive, indifferent position in relation as
to both illness and health, and to life in general.

5 Conclusions
The clinical and psychopathological method, implemented through speech interaction between
the doctor and the patient, is the main one for mental disorders diagnosis. However, the
patient’s emotional experiences can be masked by functional impairments on the part of the
somatic sphere or by maladaptation in the professional field, and may not be determined during
a doctor’s routine conversation. In addition, some patients tend to dissimulate experiences. As
a result, it was found that 50% of HIV-infected patients not suffering from addiction syndromes
or surfactant abuse have mental disorders, which are characterized mainly by disorders of
adaptive reactions and mild cognitive impairment. 57.7% of HIV-infected people who do
not use surfactants showed a high level of social adaptation. For patients who do not use
surfactants, and who have undergone a commission examination before starting ART, the
leading psychopathological syndromes are anxiety, anxiety-hypochondria. 44.2% of patients
did not have obvious psychopathological symptoms.
In the course of the work, linguistic markers of deterioration of both somatic and mental
state were revealed. These markers include: a) the verb coefficient decreases with increasing
stages of HIV infection and the duration of the disease; b) the coefficients of verbality and per-
sonal pronouns increase as a characteristic of emotional disorders, obsessive states in patients
with HIV infection.
The level of education did not significantly affect the speech of patients. The coefficient
of logical coherence and vocabulary diversity, vocabulary volume directly depend on the level
of qualification of labor, availability of work, work experience. Pathognomonic for neurotic
stress-related disorders was the frequent use of a not particle.
Thus, a significant result of the research is that the structure of emotional experiences was
revealed in patients who recently learned about the burden of a serious chronic disease with
the corresponding fear of death and self-stigmatization. The group of patients with organic
mental processes of HIV genesis was small, therefore it was not possible to determine the
psycholinguistic features in patients with VANR.
Identified psycholinguistic markers are additionally signs that can be used by physicians
and psychiatrists to diagnose both cognitive impairment and emotional impairment in patients
with HIV infection.

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