Errorless learning and memory performance in schizophrenia
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摘要
Methods: We used May et al. (1988) criteria to identify 20 treatment responsive and 20 treatment resistant patients with DSM-III-R schizophrenia, matched for age, sex and illness duration. Each subject received the following standard tests: NART (premorbid) IQ and QUICK (current) IQ, Mini-Mental State Exam, Digit Span, Digit Symbol Substitution, Verbal Fluency, Stroop, Trails A & B, and a Continuous Performance Test. In addition, we selected sub-tests from the Cambridge Neuropsychological Testing Automated Battery--motor screening, reaction time, spatial/pattern recognition memory, delayed matching to sample, ID/ED shift and the Tower of London--and employed the Rivermead Behavioural Memory Test (RBMT) as an index of everyday episodic memory functioning. Results in the two response groups were compared by analysis of variance and confounders examined with an analysis of co-variance.

Results: Treatment resistant patients showed significantly poorer performance on several measures of global, executive and memory functioning. After controlling for years of education only the RBMT discriminated between them (F1,35=9.7,P =0.004), but this test did so even after controlling for global intellectual performance or medication exposure. The greatest group differences were on verbal memory sub-tests of the RBMT. Episodic memory scores were significantly correlated with total time in hospital (r = −0.5) and employment (r = 0.6), as well as the severity of delusions (r = −0.5) and hallucinations (r = −0.4).

Conclusions: Episodic memory impairment, akin to a dysmnesic syndrome, is associated with treatment resistance and poor outcome in schizophrenia. Memory deficits may be amenable to cognitive interventions (such as ‘errorless learning’) that could improve the outcome for such patients.


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Errorless learning and memory performance in schizophrenia

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