145. English story reading education and its effects on language and cognitive functions in patients with schizophrenia

Abstract Background Schizophrenia is a severe psychiatric disorder, and most patients show cognitive impairments that affect social functioning and quality of life. About 70%–80% of patients have deficits in working memory, attention, verbal fluency, and thinking. Medication can reduce symptoms but has limited effects on cognition. In recent years, cognitive training and language rehabilitation have gained attention. English story reading blends language learning with cognitive stimulation. Second-language learning activates multiple brain regions, and story content can support logical thinking and social cognition. However, systematic studies on its effects in schizophrenia remain lacking. This study assesses how English story reading influences language and cognitive functions to offer new ideas for rehabilitation. Methods The study includes 120 stable patients who meet DSM-5 criteria for schizophrenia. Patients are 18–55 years old, have a disease duration of 2–10 years, and have a Positive and Negative Syndrome Scale (PANSS) total score ≤ 60. Patients are randomly assigned to an intervention group (n = 60) or a control group (n = 60). The intervention group receives 12 weeks of English story reading education, three sessions per week, each lasting 60 minutes, guided by English teachers and psychiatrists. Reading materials include short English stories about daily life and social interaction. The sessions include vocabulary learning, sentence comprehension, story retelling, and plot discussion. The control group receives routine rehabilitation, including occupational therapy and social skills training. After the intervention, the Verbal Fluency Test (VFT) assesses language function. The Wisconsin Card Sorting Test (WCST) assesses executive function. The Digit Span Test and the Trail Making Test assess working memory and attention. Class participation, interaction frequency, and learning progress are also recorded. Results After 12 weeks, semantic fluency scores in the intervention group increased from 12.3 ± 3.1 to 17.8 ± 3.5, while the control group increased from 12.5 ± 2.9 to 13.9 ± 3.2 (p<.001, d = 1.15). Phonemic fluency scores in the intervention group increased from 9.8 ± 2.6 to 14.2 ± 3.1, while the control group increased from 9.5 ± 2.7 to 10.8 ± 2.9 (p<.001, d = 0.98). WCST results showed that the intervention group had fewer perseverative errors (p=.003, d = 0.67), indicating improved executive function and cognitive flexibility. In the Digit Span Test, forward and backward scores improved significantly in the intervention group (p=.012 and p=.005), while the control group showed no clear changes. Subgroup analysis showed that patients with higher education levels and shorter disease duration had stronger intervention effects. Class participation in the intervention group correlated positively with cognitive improvement (r = 0.58, p<.001). Discussion The study showed that English story reading education improved language and cognitive functions in patients with schizophrenia. The intervention enhanced verbal fluency, executive function, working memory, and attention. These effects may stem from second-language learning activating coordinated activity in prefrontal, temporal, and parietal regions, supporting neuroplasticity. Story comprehension and discussion trained logical reasoning, causal judgment, and social cognition, while group activities improved social motivation and emotional expression. English story reading education could serve as a useful supplement to cognitive rehabilitation, especially for stable patients with higher educational backgrounds. Future studies should examine optimal intervention duration, individualized reading materials, and the long-term stability of cognitive gains, and neuroimaging may help clarify the neural mechanisms. Developing standardized programs could support clinical application.