Depression, Avolition, and Attention Disorders in Patients with Schizophrenia: Associations with Verbal Memory Efficiency

Abstract

The authors undertook a study of the clinical correlates of verbal memory deficits in schizophrenia. The first purpose was to replicate the finding of a significant association between depression and impairment in the deep encoding memory processes. The second purpose was to test the hypothesis that certain clinical symptoms--avolition, disorders of attention--also play a role in verbal memory impairment, distinct from a global negative symptomatology score. Forty-one patients with schizophrenia underwent a memory task including forward digit span and learning lists of words with different levels of semantic organization. Regression analyses revealed that the depression score was associated with the total number of recalled words, whereas the global negative symptom score was not. Depression score was not associated with the forward digit span, a measure of superficial serial encoding processes. An analysis of individual symptoms from the Scale for the Assessment of Negative Symptoms (SANS) indicated that avolition was associated with several memory scores, suggesting a pervasive effect of this symptom. Attention disorders were associated with impaired efficiency in serial learning, but not with word recall efficiency. It is suggested that more consideration should be given to depression and motivation in the investigation of cognitive impairment in schizophrenia, as well as in cognitive remediation strategies.

Neural activity during object perception in schizophrenia patients is associated with illness duration and affective symptoms

“…Thus, depression appears to be the genuine predictor of increased brain activation in this area, while the trend association with negative symptoms seems to be a mere artifact of the overlap between negative and depressive symptomatology. This pattern of associations corroborates and extends our previous finding of a role of affective, rather than negative, symptoms in memory performance, observed in several schizophrenia samples (Brébion et al, 2015(Brébion et al, , 2013(Brébion et al, , 2009(Brébion et al, , 2001. Previously reported associations between impaired visual abilities and negative symptoms might similarly have been influenced by depressive symptoms.…”

“…Our previous work suggested that depression and/or anxiety affected verbal (Brébion et al, 2013(Brébion et al, , 2009(Brébion et al, , 2001) as well as visual (Brébion et al, 2015) memory, while potential associations between memory and negative symptoms were mostly an artifact of the overlap between affective and negative symptoms. Depression and anxiety, rather than negative symptoms, might similarly have some effect on visual perception.…”

Visual encoding impairment in patients with schizophrenia: Contribution of reduced working memory span, decreased processing speed, and affective symptoms.

“…Given that this dissociation was unanticipated and that it might be a chance finding, we conducted a retrospective analysis of three databases to investigate whether this gender effect could be replicated. We had reported associations between verbal memory performance and depressive symptoms in a schizophrenia sample from North America (Brébion et al, 2001) and another from England (Brébion, Bressan, Pilowsky, et al, 2009; Brébion et al, 2007). Separate analyses of each sex group confirmed the differential role of anxiety in men and depressed mood in women 3 .…”

“…Our previous research on verbal memory suggested that affective symptoms might be a more crucial factor in memory impairment than negative symptoms. We observed in two independent schizophrenia samples that depression was associated with various verbal memory measures, whereas a negative symptom score was not (Brébion, Bressan, Pilowsky, & David, 2009; Brébion, David, Bressan, & Pilowsky, 2007; Brébion, Gorman, Malaspina, Sharif, & Amador, 2001). Our pattern of data further suggested that this association with depression was mostly accounted for by the anxiety component of depressive symptomatology.…”

What accounts for poor functioning in people with schizophrenia: a re-evaluation of the contributions of neurocognitive v. attitudinal and motivational factors

“…Decreased motivation has been found to correlate with neurocognitive performance (Brebion et al 2000 a ; Nakagami et al 2008; Brebion et al 2009; Barch et al 2013), associations that remain significant when controlling for antipsychotic treatment, medical comorbidity, and the severity of positive, depressive, and the other negative symptoms (Fervaha et al 2014). Greater motivation has been shown to longitudinally predict better test scores and improvement in performance over time; however, the reverse was not true, test scores did not predict improvement in motivation (Nakagami et al 2010).…”