Errorless learning as a treatment for memory impaired schizophrenic patients

47

VERBAL AND VISUAL MEMORY

DEFICITS

IN SCHIZOPHRENIA R. Hijman, H.E. H u l s h o f f P o l , C.C. Gispen-de Wied, C. van Oel, W. Cahn, J. van der Linden, R.S. K a h n

Depts. ql" Psychiato,, UniversiO, Hospital, and Rudoll" Magnus Institute./or Neurosciences, UniversiO' Utrecht. PO 85500, 3508 GA. The Netherlands' Background: The present study investigates verbal and visual memory processes in schizophrenic patients (n = 50) compared to healthy controls (n = 51 ) using several neuropsychological tests, including a Dutch validated version of the California Verbal Learning Test (CVLT). Methodsv The verbal memory tests that have been used are a Dutch version of the CVLT and the Wechsler-Memory Scale (WMS; Logical Memory). Visuo-spatial memory tests are the Rey-Osterrieth Complex Figure (REYO) and the WMS (Visual Reproduction). The groups did not differ in age and diagnosis was made using the CASH interview according to DSM-1V criteria. Results. The schizophrenic patients were significantly impaired on all tasks. The total score on the CVLT (t=6.98, d1-99, p <0.0001 ) and a measure of retrieval (delayed short-term free recall t=6.58, 41=99, p<0.0001) showed differences between both groups. This was in accordance with deficits on the other verbal memory task (Logical Memory, delayed recall t=7.12, df= 99, p < 0.0001 ). The patient group was impaired on recognition of the target-items on the CVLT. The visuo-spatial tests showed marked significant differences in performance (e.g. REYO, delayed recall 1=6.37, 41=99, p<0.0001). A delayed recognition version of the REYO also showed impairment. Conclusion." The findings imply that retrieval and recognition of verbal and visual information is impaired in schizophrenia. The data of our Dutch group of schizophrenic are in line with results of numerous other studies that demonstrated learning and memory impairments in schizophrenic patients.

INCENTIVE

IMPROVES

RECOGNITION

RECALL

MEMORY

BUT NOT

PERFORMANCE

IN S C H I Z O P H R E N I A T.K. Kondel*, K.R. Laws, P.J. M c K e n n a

*('/taring Cross and Westminster Medical School ( UniversiO' q[' London). Academic Department q['P.~vchiatry, St. Dunstan's Road, London W6 8RP, UK Poor neuropsychotogical test performance, particularly on executive and memory tasks, is well documented in schizophrenia. While it has been claimed that the executive impairment can be ameliorated by incentives (i.e., offering money), whether this can improve memory performance has not yet been examined. 15 patients meeting RDC criteria for chronic schizophrenia were tested on a prospective memory task (learning a sequence of steps for a particular daily living skills "script') on two

occasions a week apart. A counterbalanced design was employed so that subjects learnt different scripts in each session: incentive 1£5) was provided in the second testing session. Measures of recall (number of target items remembered) and recognition (selecting target items from distractors) were obtained. The patients showed significantly improved performance in recall, but not recognition performance on the second testing session. Improvement was related to the level of impairment of memory performance and also was greater in patients with executive deficits.

ERRORLESS LEARNING AS A TREATMENT FOR MEMORY IMPAIRED SCHIZOPHRENIC PATIENTS

S.M. Lawrie, H. Russell, E.C. Johnstone, R.E. O'Carroll

Department o[' Psychiatry, Royal Edinburgh HosT)ital, Edinburgh EHIO 5HF, UK Background" A substantial proportion of patients with schizophrenia demonstrate marked memory impairment. In several studies the neuropsychological profile has been found to closely resemble that of the classical amnesic syndrome, with disproportionate impairment of long-term explicit memory fnnctioning relative to intelligence, short-term and implicit memory. Baddely & Wilson (Neuropsychologia 32: 53) have shown that patients with amnesic syndrome benefit from an 'errorless learning' approach. We have tested whether this is also true for memory impaired patients with schizophrenia. Metltods: 20 memory impaired DSM-IV schizophrenic patients (MIS) were compared with 21 memory unimpaired schizophrenic (MUS) and 20 healthy control subjects (CON). The three groups were matched for age, sex, years in full-time education and current intellectual level. A between group comparison of errorful versus errorless learning was made using the methods of Baddely & Wilson. Results. In the traditional 'trial and error' errorful learning condition, MIS performed significantly more poorly than the other two subject groups (group x trial interaction F = 1.7, p = 0.04). However, in the errorless learning condition, MIS performed just as well as the MUS and CON groups (p=0.6). Conches'ion." Errorless learning principles have potential for cognitive rehabilitation in memory impaired schizophrenic patients.

ACCESS AND STORE MEMORY DISORDERS IN SCHIZOPHRENIA REFLECT DEFICIT SEVERITY K.R. Laws*, P.J. M c K e n n a , T.K. Kondel

*Department qf PsTchology, UniversiO, q/ Hert/brdshire, (~dlege Lane, Hat~qeld, Her([brdshire A L IO 9A B, UK Criteria have been proposed lbr distinguishing between memory disorders that reflect a loss/degradation of underlying