Cammisuli Davide Maria, Sportiello Marco Timpano
Department of Surgical, Medical, Molecular and Critical Area Pathology, Pisa University School of Medicine, 2 Via Paradisa, 56124 Pisa, Italy,
Psychiatr Danub. 2016 Jun;28(2):118-26.
Memory system turns out to be one of the cognitive domains most severely impaired in schizophrenia. Within the theoretical framework of cognitive psychopathology, we compared the performance of schizophrenia patients on the Wechsler Memory Scale-IV with that in matched patients with Obsessive-compulsive disorder and that in healthy control subjects to establish the specific nature of memory deficits in schizophrenia.
30 schizophrenia patients, 30 obsessive-compulsive disorder patients and 40 healthy controls completed the Wechsler Memory Scale-IV. Schizophrenia symptom severity was assessed by the Positive and Negative Syndrome Scale (PANSS). Performances on memory battery including Indexes and subtests scores were compared by a One-Way ANOVA (Scheffé post-hoc test). Spearman Rank correlations were performed between scores on PANSS subscales and symptoms and WMS-IV Indexes and subtests, respectively.
Schizophrenia patients showed a memory profile characterized by mild difficulties in auditory memory and visual working memory and poor functioning of visual, immediate and delayed memory. As expected, schizophrenia patients scored lower than healthy controls on all WMS-IV measures. With regard to the WMS-IV Indexes, schizophrenia patients performed worse on Auditory Memory, Visual Memory, Immediate and Delayed Memory than Obsessive-compulsive disorder patients but not on Visual Working Memory. Such a pattern was made even clearer for specific tasks such as immediate and delayed recall and spatial recall and memory for visual details, as revealed by the lowest scores on Logical Memory (immediate and delayed conditions) and Designs (immediate condition) subtests, respectively. Significant negative correlations between Logical Memory I and II were found with PANSS Excitement symptom as well as between DE I and PANSS Tension symptom. Significant positive correlations between LM II and PANSS Blunted affect and Poor rapport symptoms as well as DE I and PANSS Blunted affect and Mannerism and Posturing symptoms, were found too.
Memory damage observed in schizophrenia patients was more severe and wider than that of patients with obsessive-compulsive disorder, except for visual working memory. Memory dysfunction, mainly related to episodic memory damage and reduced efficiency of central executive, is intimately connected to the specific psychopathological processes characterizing schizophrenia. Implications for therapeutics and cognitive remediation techniques are discussed.
记忆系统是精神分裂症中受损最严重的认知领域之一。在认知精神病理学的理论框架内，我们将精神分裂症患者在韦氏记忆量表第四版（WMS-IV）上的表现与相匹配的强迫症患者以及健康对照者进行比较，以确定精神分裂症记忆缺陷的具体性质。
30名精神分裂症患者、30名强迫症患者和40名健康对照者完成了韦氏记忆量表第四版测试。采用阳性和阴性症状量表（PANSS）评估精神分裂症症状的严重程度。通过单因素方差分析（Scheffé事后检验）比较记忆测验电池的表现，包括各指数和分测验得分。分别对PANSS分量表得分与症状以及WMS-IV指数和分测验得分进行斯皮尔曼等级相关分析。
精神分裂症患者表现出的记忆特征为听觉记忆和视觉工作记忆存在轻度困难，视觉、即时和延迟记忆功能较差。不出所料，精神分裂症患者在所有WMS-IV测量指标上的得分均低于健康对照者。就WMS-IV指数而言，精神分裂症患者在听觉记忆、视觉记忆、即时和延迟记忆方面的表现比强迫症患者差，但在视觉工作记忆方面并非如此。对于即时和延迟回忆、空间回忆以及视觉细节记忆等特定任务，这种模式更为明显，分别通过逻辑记忆（即时和延迟条件）和图形设计（即时条件）分测验中的最低得分得以体现。逻辑记忆I和II与PANSS激越症状之间以及图形设计I与PANSS紧张症状之间存在显著负相关。同时还发现逻辑记忆II与PANSS情感迟钝和关系妄想症状以及图形设计I与PANSS情感迟钝和行为障碍及姿态症状之间存在显著正相关。
除视觉工作记忆外，精神分裂症患者中观察到的记忆损害比强迫症患者更严重且范围更广。记忆功能障碍主要与情景记忆损害和中央执行功能效率降低有关，与精神分裂症特有的心理病理过程密切相关。文中还讨论了其对治疗和认知矫正技术的启示。
