Verbal memory may signal disease course in first-episode psychosis

By Joanna Lyford, Senior medwireNews Reporter

Verbal memory appears to be a predictor of clinical remission in patients with first-episode psychosis, according to Canadian researchers writing in Schizophrenia Research.

Martin Lepage (Douglas Mental Health University Institute, Montréal, Québec, Canada) and team found that nonremitted patients showed persistently poorer verbal memory compared with remitted patients over 12 months of follow-up.

Given that verbal memory is easily evaluated, Lepage and team suggest that this domain may represent an early marker of future disease course.

The team studied 70 consecutive patients aged 14 to 30 years with a first episode of nonaffective psychosis. Using the Remission in Schizophrenia Working Group criteria, 17 patients were classified as being in symptomatic remission and 53 as being nonremitted.

All patients underwent cognitive assessment approximately 3 and 15 months after admission for treatment.

At the first assessment, both verbal and visual memory were significantly worse in nonremitted than in remitted patients, whereas working memory performance was similar in the two groups.

Over the next 12 months, verbal memory performance remained consistently and significantly poorer in nonremitted than remitted patients.

By contrast, visual memory improved significantly in nonremitted patients and by 15 months was not significantly different between the groups. Working memory improved marginally in both groups over the study period.

Commenting on their observations, the researchers say that the difference in verbal memory between the two groups “was discernible even though performance significantly increased for both groups between the two assessment points”.

Noting that much current research is directed towards early identification of patients who do not respond to treatment, the team concludes: “Evaluation of memory in first-episode patients can be done easily enough and if our results survive extensive replication they could be used with ease in clinical settings to help identify those patients which might not respond well to regular treatment.

“Future directions could also include investigations of cognitive remediation specific for verbal memory and whether the patients’ subsequent clinical outcome can be influenced.”

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