Verbal and visual–spatial memory impairment in youth at familial risk for schizophrenia or affective psychosis: A pilot study

Abstract

Background Schizophrenia and affective psychoses share several common biological origins, particularly genetic susceptibility. Kraepelin posited that differing clinical expressions in these disorders reflect different etiopathologies. We tested a neuropsychological component of this hypothesis by evaluating verbal and visual memory performance in nonpsychotic youth at familial risk for psychosis, taking into account contributions to memory dysfunction including executive processing and psychopathology. Methods Teenage and young adults (ages 13-25) at familial high-risk (FHR) for schizophrenia (HR-SCZ, n=41) or affective psychosis (HR-AFF, n=24) were compared to community controls (CC, n=54) on verbal (Miller-Selfridge Context Memory) and visual (Rey-Osterreith Complex Figure) memory tests in which the roles of strategy and contextual processing on distinct recall domains could be assessed. Effects of psychopathology, vigilance and working memory were investigated to determine their influence on memory performance. Results HR-AFF and HR-SCZ exhibited similarly impaired memory profiles and elevated levels of psychopathology compared to CC. HR-SCZ were significantly impaired on both verbal and visual-spatial memory, while HR-AFF in verbal memory only. However, effect sizes, in the medium range, were largely comparable between the two HR groups. Deficits in verbal recall and in visual memory organization remained significant after adjustment for confounders. Conclusions Youth at FHR for psychosis present relatively common memory deficits across both visual-spatial and verbal modalities that are not explained by current psychopathology, vigilance or working memory deficits. Deficits in organizing information to be recalled represent a promising trait of psychosis vulnerability.

Auditory Vigilance and Working Memory in Youth at Familial Risk for Schizophrenia or Affective Psychosis in the Harvard Adolescent Family High Risk Study

“…Similar results were found on measurements of verbal and linguistic abilities, specifically on the Word-Pair Test, where the FHR-SCZ group performed worse than the FHR-AFF group in immediate recall and 1-hr delayed recall Schubert & McNeil, 2005. However, in a study of verbal and visual memory using the identical sample as reported here, Scala et al (2013) reported no significant differences in verbal or spatial memory performance between the two groups of relatives. In Eastern Quebec Multigenerational Families, Maziade et al (2009) found that both relatives of schizophrenia and bipolar probands shared cognitive impairments in memory and executive functions.…”

“…Participants are asked, "how much that problem has bothered you during the past 7 days including today"; thus, it is a measure of current symptomatology. In a previous report on this sample (Scala et al, 2013; Table 3), we reported that three SCL-90-R dimensions were significantly worse in the high-risk groups than in controls, Obsessive-Compulsive (FHR-AFF > controls), Phobic Anxiety (FHR-AFF > controls), and Psychoticism (FHR-SZ > controls), while none of the clinical scales significantly distinguished the two high-risk groups from each other. In this study, we tested the effects of these three variables as well as Depression on cognition, as depression is often associated with cognitive impairment.…”

“…As noted in Scala et al (2013), three SCL-90-R dimensions were significantly worse in the high-risk groups than in controls, Obsessive-Compulsive (FHR-AFF > controls), Phobic Anxiety (FHR-AFF > controls), and Psychoticism (FHR-SZ > controls), and none of the clinical scales distinguished the two high-risk groups from each other. There were no significant differences between high-risk groups and controls or between high-risk groups on the Depression scale.…”

Childhood abuse and neglect may induce deficits in cognitive precursors of psychosis in high-risk children

“…Abuse and neglect are known to have a negative influence on cognitive functioning in community samples of healthy adults 20,21 and children/adolescents 22,23 as well as in patients with psychosis. 8,24,25 Congruent with other studies, [26][27][28] we have reported that children from densely affected multigenerational families who had a parent affected by schizophrenia or BD had fullscale IQ impairments as well as deficits in specific cognitive domains, such as visual and verbal episodic memory, working memory and executive functions of initiation. 12,16 These domains are among the most impaired in adult patients and are consistently found to be associated with schizophrenia and BD.…”

Impaired motor performance in adolescents at familial high-risk for schizophrenia

“…While a variety of neuropsychological measures have been previously reported from the Harvard Adolescent FHR study (Seidman et al, 2006a,b;Scala et al, 2013), the line-drawing task data has not been previously reported. The FHR group consisted of the children (n = 14) and siblings (n = 19) of 25 adult probands who met DSM-IV criteria for SZ.…”