Unterschiede im verbalen Lernen und Gedächtnis zwischen (teil–)remittierten Patienten mit depressiver Episode und Schizophrenie
Abstract
Zusammenfassung. Die Studie untersuchte den Unterschied zwischen (teil–)remittierten Patienten mit einer nicht psychotischen depressiven Episode (N = 65) oder Schizophrenie (N = 76) in ihrer Leistung beim Lernen und Gedächtnis von kontextabhängigen (gemessen mittels des Untertests „Logisches Gedächtnis“ aus dem WMS-R) versus kontextunabhängigen (gemessen mittels VLMT) Wortmaterial. Schizophrenie-Patienten zeigten eine signifikant schlechtere Leistung als depressive Patienten im Abruf von kontextabhängigem Wortmaterial sowie beim kontextunabhängigen Wortmaterial in den meisten Gedächtnisparametern, ausgenommen die unmittelbare Merkspanne (Supraspanne). Explorative Analysen der Prozentränge und T-Werte deuteten außerdem darauf hin, dass die Supraspanne auch im Vergleich zur gesunden Bevölkerung in beiden Patientengruppen nicht beeinträchtigt zu sein scheint. Darüber hinaus zeigen Patienten mit einer depressiven Episode beim verzögerten Abruf (VLMT und WMS-R) Defizite. Die praktischen Implikationen werden näher diskutiert.
Abstract. This study investigates context dependent differences in verbal learning and memory between patients in (partial) remission with nonpsychotic major depression (N = 65) or schizophrenia (N = 76). Schizophrenia patients in comparison to depressive patients showed significantly poorer performance in the recall of context dependent (assessed with the subtest “Logical memory” from the WMS-R) as well as the context independent (assessed with the VLMT) verbal tasks in most learning and memory parameters, except for the immediate memory span (supra span). Exploratory analyzes of percentile ranks and T-scores also indicated that supra span seems not to be impaired in comparison to healthy population in both patient groups. Furthermore, patients with Major Depression presented deficits in delayed recall (VLMT and WMS-R). The practical implications are discussed in detail.
Literatur
2006). Multivariate Analysemethoden. Berlin: Springer.
(2010). The role of cognitive impairment in general functioning in major depression. Psychiatry Res, 176, 183 – 189.
(1999). Neuropsychological correlates of major depression: A short-term follow-up. Cognitive Neuropsychiatry, 4, 333 – 341.
(2001). Work rehabilitation in schizophrenia: Does cognitive impairment limit improvement? Schizophrenia Bulletin, 27, 269.
(2000). Neuropsychology of first-episode schizophrenia: Initial characterization and clinical correlates. American Journal of Psychiatry, 157, 549 – 559.
(2007). A longitudinal analysis of neurocognitive function in unipolar depression. Journal of Clinical and Experimental Neuropsychology, 29, 879 – 891.
(1997). Neuropsychological evidence supporting a neurodevelopmental model of schizophrenia: A longitudinal study. Schizophrenia Research, 24, 289 – 298.
(2000). Memory and organizational strategies in chronic and acute schizophrenic patients. Schizophrenia Research, 41, 431 – 445.
(1982). Effort and cognition in depression. Archives of General Psychiatry, 39, 593 – 597.
(1996). Comorbidity of personality disorders and unipolar major depression: A review. Journal of Affective Disorders, 37, 157 – 170.
(1992). Childhood attentional dysfunctions predict social deficits in unaffected adults at risk for schizophrenia. British Journal of Psychiatry, Suppl 18, 59 – 64.
(1987). The California Verbal Learning Test: Research Edition. New York: The Psychological Corporation.
((Hrsg.) (1994). Internationale Klassifikation psychischer Störungen, ICD-10, Forschungskriterien. Bern: Huber.
2009). Longitudinal assessment of neuropsychological function in major depression. Australian and New Zealand Journal of Psychiatry, 43, 1105 – 1117.
(2003). Sensitivity and specificity of memory dysfunction in schizophrenia: A comparison with major depression. Journal of Clinical and Experimental Neuropsychology, 25, 79 – 93.
(1992). Forms of memory failure in schizophrenia. Journal of Abnormal Psychology, 101, 487 – 494.
(1993). Contrasts between patients with affective disorders and patients with schizophrenia on a neuropsychological test battery. American Journal of Psychiatry, 150, 1355 – 1362.
(1996). What are the functional consequences of neurocognitive deficits in schizophrenia? American Journal of Psychiatry, 153, 321 – 330.
(2004). Longitudinal studies of cognition and functional outcome in schizophrenia: Implications for MATRICS. Schizophrenia Research, 72, 41 – 51.
(2011). The role of encoding strategies in the verbal memory performance in patients with schizophrenia. Journal of Neuropsychology, 5, 56 – 72.
(2013). Verbal memory functioning in recurrent depression during partial remission and remission-Brief report. Frontiers in Psychology, 4, 652.
(2000). WMS-R. Wechsler Gedächtnistest – Revidierte Fassung. Deutsche Adaptation der revidierten Fassung der Wechsler Memory Scale. Bern: Huber.
(2012). Cognitive deficits in the remitted state of unipolar depressive disorder. Neuropsychology, 26, 642 – 651.
(2001). Stability and course of neuropsychological deficits in schizophrenia. Archives of General Psychiatry, 58, 24 – 32.
(1998). Neurocognitive deficit in schizophrenia: A quantitative review of the evidence. Neuropsychology, 12, 426 – 445.
(2001). VLMT – Verbaler Lern- und Merkfähigkeitstest. Göttingen: Beltz Test.
(2007). Predictive value of cognition for different domains of outcome in recent-onset schizophrenia. Psychiatry Research, 149, 71 – 80.
(2006). Neurocognitive deficits and disability in major depressive disorder. Psychiatry Research, 145, 39 – 48.
(2009). Verbal working memory impairment in patients with current episode of unipolar major depressive disorder and in remission. Clinical Neuropharmacology, 32, 346 – 347.
(1964). Perception of speech in schizophrenia. British Journal of Psychiatry, 110, 375 – 380.
(1980). Contextual constraint and the recall of verbal material in schizophrenia: The effect of thought disorder. British Journal of Psychiatry, 137, 69 – 73.
(1997). Context memory in schizoaffective and schizophrenic disorders. Schizophrenia Research, 26, 153 – 161.
(1950). Verbal context and the recall of meaningful material. American Journal of Psychology, 176 – 185.
(2001). An analysis of the specificity and the syndromal correlates of verbal memory impairments in schizophrenia. Psychiatry Research, 101, 23 – 31.
(2010). Cognitive training in affective disorders improves memory: A preliminary study using the NEAR approach. Journal of Affective Disorders, 121, 258 – 262.
(1997). Is it possible to be schizophrenic yet neuropsychologically normal? Neuropsychology, 11, 437 – 446.
(2013). Cognitive remediation as a treatment for major depression: A rationale review of evidence and recommendations for future research. Australian and New Zealand Journal of Psychiatry, 47, 1165 – 1175.
(2008). Verbal memory, negative symptomatology and prediction of psychosocial functioning in schizophrenia. Psychiatry Research, 158, 11 – 17.
(2009). Neuropsychological function and dysfunction in schizophrenia and psychotic affective disorders. Schizophrenia Bulletin, 35, 1022 – 1029.
(2013). Cognitive impairment in depression: A systematic review and meta-analysis. Psychological Medicine, 29, 1 – 12.
(2010). Is it really robust? Reinvestigating the robustness of ANOVA against violations of the normal distribution assumption. Methodology: European Journal of Research Methods for the Behavioral and Social Sciences, 6, 147 – 151.
(2006). Cost of depression in Europe. Journal of Mental Health Policy and Economics, 9, 87 – 98.
(1997). A preliminary profile of neuropsychological deficits associated with major depression. Journal of Clinical and Experimental Neuropsychology, 19, 587 – 603.
(2004). Brief cognitive assessment in schizophrenia: Normative data for the Repeatable Battery for the Assessment of Neuropsychological Status. Schizophrenia Research, 70, 175 – 186.
(2007). Fractionation of verbal memory impairment in schizophrenia and schizophreniform psychosis. Australian and New Zealand Journal of Psychiatry, 41, 732 – 739.
(