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The nature of learning and memory impairments in schizophrenia

Published online by Cambridge University Press:  26 February 2009

Jane S. Paulsen ,
Robert K. Heaton ,
Joseph R. Sadek ,
William Perry ,
Dean C. Delis ,
David Braff ,
Julie Kuck ,
Sidney Zisook  and
Dilip V. Jeste
Jane S. Paulsen
Affiliation:
Psychology Service, Veterans Affairs Medical Center, San Diego, CA 92161 Department of Psychiatry, University of California, San Diego, CA 92093
Robert K. Heaton
Affiliation:
Department of Psychiatry, University of California, San Diego, CA 92093
Joseph R. Sadek
Affiliation:
Department of Psychiatry, University of California, San Diego, CA 92093
William Perry
Affiliation:
Department of Psychiatry, University of California, San Diego, CA 92093
Dean C. Delis
Affiliation:
Psychology Service, Veterans Affairs Medical Center, San Diego, CA 92161 Department of Psychiatry, University of California, San Diego, CA 92093
David Braff
Affiliation:
Department of Psychiatry, University of California, San Diego, CA 92093
Julie Kuck
Affiliation:
Department of Psychiatry, University of California, San Diego, CA 92093
Sidney Zisook
Affiliation:
Department of Psychiatry, University of California, San Diego, CA 92093
Dilip V. Jeste
Affiliation:
Psychology Service, Veterans Affairs Medical Center, San Diego, CA 92161 Department of Psychiatry, University of California, San Diego, CA 92093 Department of Neurosciences, University of California, San Diego, CA 92093
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Abstract

The California Verbal Learning Test was used to characterize the learning and memory impairment in schizophrenia (SC) and to evaluate potential clinical and demographic factors associated with this impairment. SC patients (n = 175) performed worse than normal comparison (NC) subjects (n = 229) on all learning, recall, and recognition memory measures. The most important clinical correlates of these impairments were earlier age of onset, more negative symptoms, and greater anticholinergic medication dosage. SC patients showed a prominent retrieval deficit as indicated by disproportionate improvement when tested in a recognition, rather than a free recall, format. A residual impairment seen with recognition testing suggests a mild encoding deficit as well. In contrast, the relative absence of a storage deficit is suggested by the lack of rapid forgetting. Using a discriminant function analysis that differentiates cortical dementia [i.e., Alzheimer's disease (AD)], subcortical dementia [i.e., Huntington's disease (HD)], and normals, it was found that 5070 of the SC patients were classified as having a subcortical memory profile and 35% were classified as having a normal profile, whereas only 15% were classified as having a cortical memory profile. Although these findings reflect the clinical heterogeneity often found in SC, results suggest that most SC patients demonstrate a pattern of learning and memory impairments that resembles the pattern seen in patients with primary subcortical (specifically striatal) pathology. (JINS, 1995, I, 88–99.)

Keywords

LearningMemorySchizophrenia
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 1 , Issue 1 , January 1995 , pp. 88 - 99
Copyright
Copyright © The International Neuropsychological Society 1995

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