Memory impairment in schizophrenia: its extent, affiliations and neuropsychological character

SYNOPSISIn a sample of 60 schizophrenic patients encompassing all grades of severity and chronicity memory impairment was found to be prevalent, often substantial, and disproportionate to the overall level of intellectual impairment. The deficits were not easily attributable to poor cooperation, attention or motivation; nor were they related to neuroleptic or anticholinergic medication. Memory impairment was significantly associated with severity and chronicity of illness and also with negative symptoms and formal thought disorder. There was evidence from the sample as a whole, and from a more detailed examination of five patients with relatively isolated deficits, that schizophrenic memory impairment conformed to the pattern seen in the classical amnesic syndrome. Additionally, there was preliminary evidence for a marked deficit in semantic memory.

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Amnesic syndrome in schizophrenia

Psychological Medicine ◽

10.1017/s0033291700036667 ◽

1990 ◽

Vol 20 (4) ◽

pp. 967-972 ◽

Cited By ~ 181

Author(s):

P. J. McKenna ◽

D. Tamlyn ◽

C. E. Lund ◽

A. M. Mortimer ◽

S. Hammond ◽

...

Keyword(s):

Clinical Picture ◽

Memory Impairment ◽

Memory Performance ◽

Alzheimer Type ◽

Intellectual Impairment ◽

Impaired Memory ◽

Alzheimer Type Dementia ◽

Amnesic Syndrome ◽

Form Part ◽

Poor Memory

SynopsisMemory impairment is not usually considered to form part of the clinical picture of schizophrenia, except perhaps in severely deteriorated patients. In a survey of 60 patients encompassing all grades of severity and chronicity poor memory performance was found to be common, sometimes substantial, and disproportionately pronounced compared to the degree of general intellectual impairment. Although associated with severity and chronicity of illness, impaired memory was by no means confined to old, institutionalized, or markedly deteriorated patients. The pattern of deficit appeared to resemble that of the classic amnesic syndrome rather than that seen in Alzheimer-type dementia.

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Medications and verbal memory impairment in schizophrenia: the role of anticholinergic drugs

Psychological Medicine ◽

10.1017/s0033291703008900 ◽

2004 ◽

Vol 34 (2) ◽

pp. 369-374 ◽

Cited By ~ 32

Author(s):

G. BRÉBION ◽

R. A. BRESSAN ◽

X. AMADOR ◽

D. MALASPINA ◽

J. M. GORMAN

Keyword(s):

Free Recall ◽

Antipsychotic Medication ◽

Verbal Memory ◽

Memory Impairment ◽

Negative Symptoms ◽

Memory Span ◽

Anticholinergic Medication ◽

Anticholinergic Drugs ◽

Anticholinergic Activity ◽

Semantic Organization

Background. We wished to assess the effect of three types of medication on verbal memory impairments in schizophrenia.Method. Forty-eight patients with schizophrenia and 40 healthy control subjects underwent a battery of verbal memory tasks, including free recall, recognition and short-term memory span. All the patients were on antipsychotic medication. In addition, 24 were taking anticholinergic drugs (benztropine) and 30 were taking benzodiazepines. A subsample of 39 had clinical ratings for depressive symptoms. Regression analyses were conducted on the memory measures in this subsample, with negative symptoms, depression, type of antipsychotic medication (conventional v. atypical), benzodiazepines and anticholinergic drugs as predictors.Results. Type of antipsychotic medication made no significant contribution to memory deficits and benzodiazepine use made very little contribution. However, anticholinergic medication was a predictor of memory impairment, especially with regard to semantic organization. Complementary analyses revealed that patients taking any type of drug with anticholinergic activity (benztropine and/or antipsychotic agents) were significantly impaired relative to the other patients on measures reflecting free recall efficiency and semantic organization.Conclusions. Drugs with anticholinergic activity are the major pharmacological agents that contribute to the verbal memory deficit observed in patients with schizophrenia. These drugs appear to act by impeding semantic organization at encoding.

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Tardive Dyskinesia and Type II Schizophrenia

The British Journal of Psychiatry ◽

10.1192/bjp.160.2.253 ◽

1992 ◽

Vol 160 (2) ◽

pp. 253-256 ◽

Cited By ~ 18

Author(s):

Elizabeth J. B. Davis ◽

Milind Borde ◽

L. N. Sharma

Keyword(s):

Cognitive Impairment ◽

Negative Symptoms ◽

Chronic Schizophrenia ◽

Thought Disorder ◽

Control Group ◽

Positive Symptoms ◽

Type Ii ◽

Formal Thought Disorder ◽

Schizophrenic Patients ◽

Male Patients

Cognitive impairment, negative and positive symptoms, primitive release reflexes, and age/temporal disorientation were assessed in 20 male patients meeting the DSM–III–R criteria for chronic schizophrenia and Schooler & Kane's criteria for TD. The control group comprised 20 age-matched male chronic schizophrenic patients without TD. Significant associations were found between TD, cognitive impairment, some negative symptoms, and formal thought disorder. These associations were independent of other illness and treatment variables. The severity of TD correlated significantly with that of cognitive impairment.

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Late Onset Involuntary Movements in Chronic Schizophrenia: Relationship of ‘Tardive’ Dyskinesia to Intellectual Impairment and Negative Symptoms

The British Journal of Psychiatry ◽

10.1192/bjp.149.5.616 ◽

1986 ◽

Vol 149 (5) ◽

pp. 616-620 ◽

Cited By ~ 59

Author(s):

J. L. Waddington ◽

H. A. Youssef

Keyword(s):

Tardive Dyskinesia ◽

Negative Symptoms ◽

Late Onset ◽

Chronic Schizophrenia ◽

Intellectual Impairment ◽

Medication History ◽

Involuntary Movements ◽

Schizophrenic Patients ◽

Relationship Of

Intellectual impairment, negative symptoms, and medication history were assessed in chronic schizophrenic patients with and without abnormal involuntary movements (tardive dyskinesia). Patients with involuntary movements had received neither longer nor more intensive treatment with neuroleptics or anticholinergics. However, the presence or absence of involuntary movements was prominently associated with the presence or absence of intellectual impairment/negative symptoms; these features are characteristic of the defect state/type II syndrome of schizophrenia, in which structural abnormalities of the brain may be over-represented. The role of subtle organic changes in conferring vulnerability to the emergence of such involuntary movements should be re-evaluated.

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Cannabis use and abuse correlates in a homogenous South African schizophrenia population

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v15i1.99 ◽

2009 ◽

Vol 15 (1) ◽

pp. 5 ◽

Cited By ~ 3

Author(s):

Liezl Koen ◽

Regan Jonathan ◽

Dana JH Niehaus

Keyword(s):

South African ◽

Functional Outcomes ◽

Negative Symptoms ◽

Age Of Onset ◽

Cannabis Use ◽

Positive Symptoms ◽

International Studies ◽

Formal Thought Disorder ◽

Schizophrenic Patients

Objective. Worldwide, cannabis is the most widely used illicit substance, and it has been identified as a correlate in schizophrenia samples for poorer symptomatic and functional outcomes in many international studies. The object of this retrospective study was to identify the prevalence of cannabis use/abuse and the demographic and clinical correlates therefor in a large homogeneous South African schizophrenia population.Methods. As part of a large genetic study, 547 subjects with a diagnosis of schizophrenia were recruited. Demographic and clinical data were collected and each participant underwent a urinary drug screen. Use/abuse of cannabis was defined as using cannabis more than 21 times in a single year. Subjects with and without cannabis use/abuse were statistically compared. Results. Significant differences between the two groups were found in terms of gender, marital status, age of onset of schizophrenia, number of hospitalisations and relapses, alcohol abuse, smoking, the Scale for the Assessment of Positive Symptoms (SAPS) scores for hallucinations, delusions, bizarre behaviour and formal thought disorder, and the Scale for the Assessment of Negative Symptoms (SANS) score for avolition/apathy. Conclusion. The prevalence of cannabis use/abuse in this study was high, and our findings were comparable with those of previous international studies. Abuse/use started mainly in the teenage years, was more prevalent among males than females, and was associated with negative overall outcomes. There was also a positive correlation between cannabis and nicotine and alcohol use/abuse. Determination of cannabis abuse based solely on history was found to be reliable, and urine cannabis testing appeared to be of limited value in routine management of this group of schizophrenic patients.

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Memory impairment in schizophrenia – a comparison with that observed in the Alcoholic Korsakoff Syndrome

Psychological Medicine ◽

10.1017/s0033291700026921 ◽

1994 ◽

Vol 24 (1) ◽

pp. 155-165 ◽

Cited By ~ 72

Author(s):

Louise Duffy ◽

Ronan O'Carroll

Keyword(s):

Episodic Memory ◽

Memory Impairment ◽

Anticholinergic Medication ◽

Central Feature ◽

Double Dissociation ◽

Memory Functioning ◽

Korsakoff Syndrome ◽

Amnesic Syndrome ◽

Schizophrenic Group

SynopsisUntil very recently, memory impairment was not considered to be a central feature of schizophrenia, except in chronic, deteriorated patients. In this study of a heterogeneous sample of 40 patients with DSM-III-R schizophrenia, episodic memory impairment was found to be prevalent, and in some cases, severe. The degree of memory impairment was not attributable to neuroleptic or anticholinergic medication, or to poor motivation or cooperation. These results, therefore, replicate those reported by McKenna et al. (1990) and Tamlyn et al. (1992), who suggested that the pattern of memory impairment in schizophrenia may conform in important respects to that of the classic amnesic syndrome. However, in a direct comparison of the schizophrenic sample with 18 patients suffering from the Alcoholic Korsakoff Syndrome (AKS), both quantitative and qualitative differences were found to exist between the two groups of patients. In particular, the level of long-term episodic memory impairment was found in the AKS sample to be far greater than that in the schizophrenic group. An interesting possible double-dissociation emerged between the two groups; although demonstrating superior episodic memory functioning, the schizophrenic sample were found to perform significantly more poorly than the AKS sample on a test of semantic memory.

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The Assessment of Negative and Positive Features in Schizophrenia

The British Journal of Psychiatry ◽

10.1192/s0007125000291460 ◽

1989 ◽

Vol 155 (S7) ◽

pp. 41-44 ◽

Cited By ~ 14

Author(s):

Eve C. Johnstone

Keyword(s):

Negative Symptoms ◽

Normal Function ◽

Thought Disorder ◽

List Type ◽

Type Number ◽

Formal Thought Disorder ◽

Clinical Correlates ◽

Schizophrenic Patients ◽

The Relationship ◽

Positive And Negative Symptoms

It has become customary to classify the typical abnormalities of the mental state of schizophrenic patients into positive and negative features, with reference to behavioural excesses and deficits. Positive features are pathological by their presence and negative features represent the loss of some normal function. Positive features are generally considered to include delusions, hallucinations and positive formal thought disorder (Fish, 1962). Some studies (e.g. Johnstone et al, 1978) have also included incongruity of affect under this heading. Negative features include affective flattening, poverty of speech, retardation, apathy, lack of sociability. There is some evidence that the clinical correlates of positive and negative features may not be the same (Owens & Johnstone, 1980). Some workers (Andreasen & Olsen, 1982) but not others (Pogue-Geile & Harrow, 1984) have found that among schizophrenic patients positive and negative symptoms were negatively correlated. Although the nature of the relationship between positive and negative features is not entirely established and may not be simple (Wing, 1978) certain generalisations may be applied: (a)Positive features are characteristic of earlier and negative of later phases of the illness (Pfohl & Winokur, 1982).(b)The effects of drugs upon positive features are greater than those upon negative features. Thus neuroleptics produce more marked improvement (Johnstone et al, 1978; Angrist et al, 1980) and amphetamine more marked exacerbation (Angrist et al, 1980) of positive than of negative features.(c)Positive features have been said to be relatively variable and negative features relatively stable (Ovchinnikov, 1968; Snezhnevsky, 1968).

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Confabulation in schizophrenia and its relationship to clinical and neuropsychological features of the disorder

Psychological Medicine ◽

10.1017/s0033291707000566 ◽

2007 ◽

Vol 37 (10) ◽

pp. 1403-1412 ◽

Cited By ~ 8

Author(s):

E. LORENTE-ROVIRA ◽

E. POMAROL-CLOTET ◽

R. A. McCARTHY ◽

G. E. BERRIOS ◽

P. J. McKENNA

Keyword(s):

Semantic Memory ◽

Memory Impairment ◽

Chronic Schizophrenia ◽

Recall Task ◽

Thought Disorder ◽

Healthy Controls ◽

Intellectual Impairment ◽

Neurological Patients ◽

Schizophrenic Patients ◽

Executive Impairment

ABSTRACTBackgroundA form of confabulation has been documented in schizophrenia and appears to be related to the symptom of thought disorder. It is unclear whether it is associated with the same pattern of neuropsychological deficits as confabulation in neurological patients.MethodThirty-four patients with chronic schizophrenia, including those with and without thought disorder, and 17 healthy controls were given a fable recall task to elicit confabulation. They were also examined on a range of executive, episodic and semantic memory tests.ResultsConfabulation was seen at a significantly higher rate in the schizophrenic patients than the controls, and predominated in those with thought disorder. Neuropsychologically, it was not a function of general intellectual impairment, and was not clearly related to episodic memory or executive impairment. However, there were indications of an association with semantic memory impairment.ConclusionsThe findings support the existence of a form of confabulation in schizophrenia that is related to thought disorder and has a different neuropsychological signature to the neurological form of the symptom.

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The Positive: Negative Dichotomy in Schizophrenia

The British Journal of Psychiatry ◽

10.1192/bjp.157.1.41 ◽

1990 ◽

Vol 157 (1) ◽

pp. 41-49 ◽

Cited By ~ 65

Author(s):

A. M. Mortimer ◽

C. E. Lund ◽

P. J. McKenna

Keyword(s):

Cognitive Impairment ◽

Negative Symptom ◽

Negative Symptoms ◽

Thought Disorder ◽

Motor Disorder ◽

Positive Symptoms ◽

Formal Thought Disorder ◽

Symptom Scores ◽

Schizophrenic Patients ◽

Positive And Negative Symptoms

Two studies are reported. In the first, of 62 schizophrenic patients, no correlation between negative symptom scores (rated blindly) and any measure of positive symptoms was found. This independence was confirmed by factor and cluster analyses, which left the question of a third ‘disorganisation’ class of schizophrenic symptoms open. In the second study, of 80 patients, formal thought disorder separated unequivocally into ‘positive formal thought disorder’ and ‘alogia’ syndromes on the basis of correlations with positive and negative symptoms. Catatonic motor disorder also showed evidence of a corresponding positive: negative division, although this only emerged when severity or chronicity of illness was controlled for. Cognitive impairment showed a broad range of affiliations and its particular correlation with negative symptoms was perhaps artefactual.

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