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Memory and executive impairment in schizophrenia: comparison with frontal and temporal brain damage

Published online by Cambridge University Press:  10 September 2007

T. J. Ornstein
Affiliation:
Department of Psychology, Ryerson University, Toronto, Canada Department of Psychiatry, University of Cambridge School of Medicine, Addenbrooke's Hospital, Cambridge, UK
B. J. Sahakian
Affiliation:
Department of Psychiatry, University of Cambridge School of Medicine, Addenbrooke's Hospital, Cambridge, UK
P. J. McKenna*
Affiliation:
University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
*
*Address for correspondence: Professor P. J. McKenna, Department of Psychological Medicine, University of Glasgow, Trust HQ Bldg, 1055 Gt Western Rd, Glasgow G12 0XH, UK. (Email: peter.mckenna@virgin.net)

Abstract

Background

Although poor neuropsychological test performance is well documented in schizophrenia, how closely it resembles that seen in patients with brain damage in terms of cognitive failures in daily life and stability over time has been little studied.

Method

Thirty patients with chronic schizophrenia, 24 patients with frontal or temporal brain damage and 30 healthy controls were given a battery of memory and executive tests. Carers of the two patient groups also completed questionnaires rating memory and executive failures in daily life. Testing was repeated 6 weeks later.

Results

The schizophrenia and the brain-damaged patients were significantly impaired on most, but not all tests. The degree of carer-rated memory or executive failure was similar in the two groups, but the schizophrenia patients were rated as having significantly more executive failures than memory failures, whereas the brain-damaged patients showed the reverse pattern. Both groups of patients showed similar consistency of performance across sessions.

Conclusions

Neuropsychological impairment in schizophrenia resembles that seen in patients with brain damage, not only in terms of overall severity, but also in terms of stability and the degree to which poor test performance translates into cognitive failures in daily life.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2007

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References

Aleman, A, Hijman, R, de Haan, EHF, Kahn, RS (1999). Memory impairment in schizophrenia: a meta-analysis. American Journal of Psychiatry 156, 13581366.CrossRefGoogle ScholarPubMed
Baddeley, A, Wilson, B (1988). Frontal amnesia and the dysexecutive syndrome. Brain and Cognition 7, 212230.CrossRefGoogle ScholarPubMed
Baddeley, AD (1986). Working Memory. Clarendon Press: Oxford.Google ScholarPubMed
Baddeley, AD, Harris, J, Sunderland, A, Watts, FP, Wilson, BA (1987). Closed head injury and memory. In Neurobehavioral Recovery from Head Injury (ed. Levin, H. S., Grafman, J. and Eisenberg, H. M.), pp. 295297. Oxford University Press: New York.Google Scholar
Baldo, JV, Shimamura, AP (2002). Frontal lobes and memory. In Handbook of Memory Disorders, 2nd edn (ed Baddeley, A. D., Kopelman, M. D. and Wilson, B. A.), pp. 363381. Wiley: Chichester.Google Scholar
Bleuler, E (1911). Dementia Praecox or the Group of Schizophrenias (trans. J. Zinkin). International Universities Press: New York.Google Scholar
Duffy, L, O'Carroll, R (1994). Memory impairment in schizophrenia – a comparison with that observed in the Alcoholic Korsakoff syndrome. Psychological Medicine 24, 155165.CrossRefGoogle ScholarPubMed
Elliott, R, McKenna, PJ, Robbins, TW, Sahakian, BJ (1995). Neuropsychological evidence on frontostriatal dysfunction in schizophrenia. Psychological Medicine 25, 619630.CrossRefGoogle ScholarPubMed
Elliott, R, Sahakian, B (1995). The neuropsychology of schizophrenia: relations with clinical and neurobiological dimensions. Psychological Medicine 25, 581594.CrossRefGoogle ScholarPubMed
Evans, J, Chua, S, McKenna, P, Wilson, B (1997). Assessment of the dysexecutive syndrome in schizophrenia. Psychological Medicine 27, 635646.CrossRefGoogle ScholarPubMed
Fletcher, PC, Henson, RN (2001). Frontal lobes and human memory: insights from functional neuroimaging. Brain 124, 849881.CrossRefGoogle ScholarPubMed
Goldberg, T, Gold, J (1995). Neurocognitive deficits in schizophrenia. In Schizophrenia (ed. Hirsch, S. R., Weinberger, D. R. and Crow, T.). Blackwell: Oxford.Google ScholarPubMed
Goldstein, G (1978). Cognitive and perceptual differences between schizophrenics and organics. Schizophrenia Bulletin 4, 160185.CrossRefGoogle ScholarPubMed
Green, MF (1996). What are the functional consequences of neurocognitive deficits in schizophrenia? American Journal of Psychiatry 153, 321330.Google ScholarPubMed
Green, MF, Kern, RS, Braff, DL, Mintz, J (2000). Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the ‘right stuff’? Schizophrenia Bulletin 26, 119136.CrossRefGoogle ScholarPubMed
Heaton, R, Baade, L, Johnson, K (1978). Neuropsychological test results associated with psychiatric disorders in adults. Psychological Bulletin 85, 141162.CrossRefGoogle ScholarPubMed
Heaton, RK, Gladsjo, JA, Palmer, BW, Kuck, J, Marcotte, TD, Jeste, DV (2001). Stability and course of neuropsychological deficits in schizophrenia. Archives of General Psychiatry 58, 2432.CrossRefGoogle ScholarPubMed
Heinrichs, RW, Zakzanis, KK (1998). Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 12, 426445.CrossRefGoogle ScholarPubMed
Hughes, C, Kumari, V, Soni, W, Das, M, Binneman, B, Drozd, S, O'Neil, S, Mathew, V, Sharma, T (2003). Longitudinal study of symptoms and cognitive function in chronic schizophrenia. Schizophrenia Research 59, 137146.CrossRefGoogle ScholarPubMed
Kemp, R, David, A (1996). Psychological predictors of insight and compliance in psychotic patients. British Journal of Psychiatry 169, 444450.CrossRefGoogle ScholarPubMed
Kraepelin, E (1913). Dementia Praecox and Paraphrenia (trans. R. M Barclay). Livingstone: Edinburgh.Google Scholar
Malec, J (1978). Neuropsychological assessment of schizophrenia versus brain damage: a review. Journal of Nervous and Mental Disease 166, 507516.CrossRefGoogle ScholarPubMed
McKenna, PJ (2007). Schizophrenia and Related Syndromes, 2nd edn. Routledge: Hove.Google Scholar
McKenna, PJ, Ornstein, T, Baddeley, AD (2002). Schizophrenia. In Handbook of Memory Disorders, 2nd edn (ed. Baddeley, A. D., Kopelman, M. D. and Wilson, B. A.), pp.413435. Wiley: Chichester.Google Scholar
McKenna, PJ, Tamlyn, D, Lund, CE, Mortimer, AM, Hammond, S, Baddeley, AD (1990). Amnesic syndrome in schizophrenia. Psychological Medicine 20, 967972.CrossRefGoogle ScholarPubMed
Nelson, NE (1982). National Adult Reading Test (NART). NFER-Nelson: Berks.Google Scholar
Nuechterlein, KH, Buchsbaum, MS, Dawson, ME (1994). Neuropsychological vulnerability to schizophrenia. In The Neuropsychology of Schizophrenia (ed. David, A. S. and Cutting, J. C.), pp. 5378. Erlbaum: Hove.Google Scholar
Pantelis, C, Barnes, T, Nelson, H, Tanner, S, Weatherley, L, Owen, AM, Robbins, TW (1997). Frontal-striatal cognitive deficits in patients with chronic schizophrenia. Brain 120, 18231843.CrossRefGoogle ScholarPubMed
Park, S, Puschel, J, Sauter, B, Rentsch, M, Hell, D (1999). Spatial working memory deficits and clinical symptoms in schizophrenia: a 4-month follow-up study. Biological Psychiatry 46, 392400.CrossRefGoogle ScholarPubMed
Rosmark, B, Osby, U, Engelbrektson, K, Nyman, H (1999). Stability of performance on neuropsychological tests in patients with schizophrenia. European Archives of Psychiatry and Clinical Neuroscience 249, 299304.CrossRefGoogle ScholarPubMed
Rund, RB, Landro, NI, Orbeck, AL (1997). Stability in cognitive dysfunctions in schizophrenic patients. Psychiatry Research 69, 131141.CrossRefGoogle ScholarPubMed
Rund, BR (1998). A review of longitudinal studies of cognitive functions in schizophrenia patients. Schizophrenia Bulletin 24, 425435.CrossRefGoogle ScholarPubMed
Rushe, T, Morris, R, Miotto, E, Feigenbaum, J, Woodruff, P, Murray, R (1999). Problem-solving and spatial working memory in patients with schizophrenia and with focal frontal and temporal lobe lesions. Schizophrenia Research 37, 2133.CrossRefGoogle ScholarPubMed
Russell, AJ, Munro, JC, Jones, PB, Hemsley, DH, Murray, RM (1997). Schizophrenia and the myth of intellectual decline. American Journal of Psychiatry 154, 635639.Google ScholarPubMed
Smith, EE, Jonides, J (1999). Storage and executive processes in the frontal lobes. Science 283, 16571661.CrossRefGoogle ScholarPubMed
Spitzer, RL, Endicott, J, Robins, E (1978). Research diagnostic criteria. Archives of General Psychiatry 35, 773782.CrossRefGoogle ScholarPubMed
Sunderland, A, Harris, JE, Baddeley, AD (1983). Do laboratory tests predict everyday memory? A neuropsychological study. Journal of Verbal Learning and Verbal Behavior 22, 341357.CrossRefGoogle Scholar
Tracy, J, Oesterling, R, Josiassen, R (1995). Transient fluctuations in cognitive functioning in schizophrenia based on single-case study methods. Schizophrenia Research 17, 201209.CrossRefGoogle ScholarPubMed
Weinberg, S, Goldberg, K (1990). Statistics for the Behavioral Sciences. Cambridge University Press: Cambridge.Google Scholar
Wilson, B, Cockburn, J, Baddeley, A, Hiorns, R (1985). The Rivermead Behavioural Memory Test. Thames Valley Test Company: Bury St Edmunds.Google Scholar
Wilson, B, Cockburn, J, Baddeley, A, Hiorns, R (1989). The development and validation of a test battery for detecting and monitoring everyday memory problems. Journal of Clinical and Experimental Neuropsychology 11, 855870.CrossRefGoogle ScholarPubMed
Wilson, BA, Alderman, N, Burgess, PW, Emslie, HC, Evans, JJ (1996). Behavioural Assessment of the Dysexecutive Syndrome. Thames Valley Test Company: Bury St Edmunds.Google Scholar