SynopsisThe CANTAB battery of neuropsychological tests was used to compare the performance of 28 patients with unipolar depression with that of 22 age and IQ matched controls. The patients were impaired on almost all tests studied with deficits in pattern and spatial recognition memory, matching to sample, spatial span, spatial working memory and planning. Most of the patients showed at least some impairment and deficits were seen across cognitive domains. An important finding was the detrimental effect of failure on subsequent performance; having solved one problem incorrectly, patients were far more likely than controls to fail the subsequent problem. Superimposed on the general deficits, there were also specific deficits in executive tasks characteristic of frontostriatal dysfunction and deficits in mnemonic tasks characteristic of temporal lobe dysfunction. This combination of a specific form of motivational deficit, resulting in oversensitivity to negative feedback, and superimposed specific neuropsychological deficits were correlated with severity of depression. The most significant correlations were seen between mnemonic deficits and clinical rating scores. Comparisons of the deficits seen in the depressed patients in this study with other patient groups assessed with the CANTAB neuropsychological battery, showed that one of the hypotheses of the neuropsychological deficits in depression, that of ‘frontosubcortical’ or ‘frontostriatal’ dysfunction, was not supported. These findings are discussed in relation to the likely neural substrates of depression.

Enduring neuropsychological deficits may be a feature of chronic, severe manic-depressive illness.

The psychopathological basis of delusions in schizophrenia is poorly understood. The most enduring of several early theories has suggested a causal link with formal thought disorder, whereas recent approaches have proposed relationships with a variety of cognitive abnormalities. The correlations of delusions with other schizophrenic symptoms and with cognitive functions including semantic memory, executive function, and also probabilistic reasoning bias, were examined in a series of (overlapping) groups of 43-79 schizophrenic patients. Delusions were found to be significantly correlated with formal thought disorder, with evidence for a particular link between bizarreness and fragmentariness of delusions and "loosening of association". Delusions were not significantly correlated with overall intellectual function or memory, although there was some suggestion of a complex interaction between delusions, formal thought disorder, and semantic memory impairment. No association between delusions, formal thought disorder, and any measure of executive function was found. Although, as a group, schizophrenic patients showed evidence of probabilistic reasoning bias, this was unrelated to presence and severity of delusions.

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Objectives: To examine a sample of adults with mental health disorders attending at an area psychiatric service, for the presence of impairments in language, communication and swallowing, using a test battery administered by speech and language therapists.Method: The study surveyed a randomly selected sample (n = 60) of patients from an acute psychiatric inpatient unit and associated community services, using several standardised measures of language, communication and swallowing.Results: On this test battery, over 80% (50/60) of subjects studied demonstrated impairment in language; while over 60% (37/60) presented with impairment in communication and discourse. Over 30% (18/58) of subjects assessed showed some impairment in swallowing.Conclusion: Use of this test battery confirmed the presence of language, communication and swallowing impairments in many patients in this sample of attenders at a general psychiatry service. We suggest that this study provides evidence for a (currently unmet) need for specialist speech and language therapy assessment and support among this patient population.