Seidman Larry J, Lanca Margaret, Kremen William S, Faraone Stephen V, Tsuang Ming T
Harvard Medical, School Department of Psychiatry at Massachusetts Mental Health Center, Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, MA 02115, USA.
J Clin Exp Neuropsychol. 2003 Oct;25(7):949-64. doi: 10.1076/jcen.25.7.949.16482.
Verbal declarative memory deficits in schizophrenia are well documented whereas visual declarative memory is less studied. Moreover, there are limited data on whether organizational and visual memory deficits are specific to schizophrenic psychoses. We compared visual memory and organizational function in patients with chronic schizophrenia (n=79) and chronic bipolar psychotic disorder (n=14), and in healthy controls (n=84) using the Rey-Osterrieth Complex Figure (ROCF), testing whether organizational impairments (i.e., executive dysfunctions) account for the visual memory deficit. Groups were comparable on age, handedness and expected intellectual ability (based on single word reading). Using analyses of covariance with sex, parental SES and ethnicity as co-variates, patients with schizophrenia were significantly more impaired than controls on copy accuracy, on recall accuracy, and on percent accuracy of recall. Patients with schizophrenia used a more detail-oriented style on copy and recall and had significantly worse recognition memory. After co-varying IQ, copy organization was also significantly different between the groups. Results for accuracy of copy and recall were not significantly attenuated when controlling for copy organization. Duration of illness was associated with visual memory. Bipolar patients performed at an intermediate level between controls and patients with schizophrenia. The data suggest that in schizophrenia, patients have a visual memory disorder characterized by both organizational processing impairments and retention difficulties, and that there is a decline in visual memory functions with duration of illness. Further research is required to determine whether similar mechanisms underlie the neurocognitive deficits in these psychotic disorders.
精神分裂症患者的言语陈述性记忆缺陷已有充分文献记载,而视觉陈述性记忆的研究较少。此外,关于组织记忆和视觉记忆缺陷是否为精神分裂症所特有,相关数据有限。我们使用雷-奥斯特里茨复杂图形(ROCF)对79例慢性精神分裂症患者、14例慢性双相情感障碍精神病患者和84名健康对照者的视觉记忆和组织功能进行了比较,以检验组织损伤(即执行功能障碍)是否导致了视觉记忆缺陷。三组在年龄、利手和预期智力能力(基于单字阅读)方面具有可比性。以性别、父母社会经济地位和种族作为协变量进行协方差分析,结果显示,精神分裂症患者在复制准确性、回忆准确性和回忆准确率方面显著低于对照组。精神分裂症患者在复制和回忆时采用更注重细节的方式,其识别记忆明显更差。在对智商进行协变量调整后,三组在复制组织方面也存在显著差异。在控制复制组织后,复制和回忆准确性的结果并未显著减弱。病程与视觉记忆相关。双相情感障碍患者的表现介于对照组和精神分裂症患者之间。数据表明,在精神分裂症中,患者存在一种视觉记忆障碍,其特征为组织加工损伤和记忆保持困难,且视觉记忆功能随病程延长而下降。需要进一步研究以确定这些精神障碍的神经认知缺陷是否存在相似的机制。