{"paper_id":"fe29f5d5-4be2-4a00-95dc-8bbf2c2826ed","body_text":"Pragmatic language production in mood and psychotic disorders a systematic review and meta-analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Pragmatic language production in mood and psychotic disorders a systematic review and meta-analysis Fiona Meister, Martin Sellier-Silva, Gleb Melshin, El Chaimaa Mouslih, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6839307/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Pragmatic language impairments—difficulties using language effectively in social contexts—are common in adults suffering from severe mental illnesses (SMIs) such as schizophrenia spectrum disorders (SSD), major depressive disorder (MDD), and bipolar disorder (BD). These impairments hinder social functioning and recovery but have been explored most widely using comprehension tasks, with pragmatic production being poorly described. We undertook a systematic review and meta-analysis of studies assessing expressive pragmatic language in adults with SMIs versus healthy controls. 18 items were tested, including coherence, cohesion, Gricean maxims, figurative language, prosody, and turn-taking. The searches were PRISMA-compliant and were conducted in PubMed and Scopus. 47 studies were included; 28 were meta-analyzed. Results showed significant impairments in cooperativity and coherence, moderate in anaphoras, and low in metaphors. Male gender negatively mediated effect sizes. Our results emphasize the need for standardized pragmatic testing and intervention for language production in clinical settings. Health sciences/Medical research/Biomarkers Health sciences/Diseases/Psychiatric disorders Health sciences/Diseases/Psychiatric disorders/Bipolar disorder Health sciences/Diseases/Psychiatric disorders/Depression Health sciences/Diseases/Psychiatric disorders/Psychosis Health sciences/Diseases/Psychiatric disorders/Schizophrenia Pragmatics Schizophrenia Spectrum Disorders Major Depressive Disorder Bipolar Disorder Meta-analysis Social Communication Language Production Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryMaterialFM.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-6839307\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Article\",\"associatedPublications\":[],\"authors\":[{\"id\":468591305,\"identity\":\"b426c6f9-479f-4c3e-b327-a2646bd814aa\",\"order_by\":0,\"name\":\"Fiona Meister\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"McGill University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Fiona\",\"middleName\":\"\",\"lastName\":\"Meister\",\"suffix\":\"\"},{\"id\":468591306,\"identity\":\"008c7831-e8cb-481b-bf3d-8c11b4062b18\",\"order_by\":1,\"name\":\"Martin 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