Assessing Pragmatic Language Skills and SWAP-200 Personality Factors in Adults with Major Depressive Disorder: an Exploratory Study

Introduction There is increasing evidence that Major Depressive Disorder (MDD) is associated with significant impairments in pragmatic language, yet this issue is still underresearched and - mainly - there is a lack of studies using standardized tools. The present study aims at investigating pragmatic language skills in association with SWAP-200 Personality Q Factors among patients with MDD, also comparing findings by using a control group of patients who did not receive an MDD diagnosis (non-MDD patients). A single case was also deepened to explore potential changes in personality factors and in pragmatic language skills after two years of psychotherapy. Methods Twenty adults (aged 22-65) with a DSM-5 diagnosis of MDD were evaluated by using the SWAP-200, to assess Personality Q Factors, and the BLED Santa Lucia (Batteria sul Linguaggio dell’Emisfero Destro Santa Lucia), which is a battery designed to investigate pragmatic language skills (comprehension of inferences, picture and written metaphors, indirect requests, humoristic expressions, and prosody). The performance of the MDD participants on all BLED subscales was compared to those reported by twenty subjects (control group of non-MDD patients) matched for gender, age, years of education, and employment status. Associations between pragmatic language skills and Personality Q factors were evaluated. The single case was then analysed by assessing any pre-post changes in study variables after two years of psychotherapy. Results MDD patients performed poorer than controls in Comprehension of Inferences (p < 0.01), Picture Metaphors (p < 0.001), Written Metaphors (p < 0.001), Indirect Requests (p < 0.01), Humoristic expression (p < 0.05), and Prosody (p < 0.05). Moreover, BLED subscales were significantly positively related to SWAP-200 Depressive-High Functioning Q Factor, while significantly negatively related to Dysphoric-Dysregulated Q Factor. Data from the single case revealed significant therapeutic changes towards a more functioning profile. Conclusions Pragmatic language skills can be significantly impaired in MDD patients, yet data supported the possibility to use valid tools in clinical settings for the assessment and monitoring, and to inform psychotherapeutic interventions fostering positive changes in MDD patients.