Immediate memory, attention and communication disturbances in schizophrenia patients and their relatives

BACKGROUND: Schizophrenia has been defined in part by disturbances of thought and language. The non-schizophrenic relatives of patients also have been found to show subtle disturbances of language that may be associated with vulnerability. Investigators have hypothesized that these phenomena in patients and their relatives are, at least in part, the result of weaknesses in facets of attention and memory. METHODS: The present study assessed some neuropsychological process correlates of three different measures of thought and language symptoms in 55 stable out-patients, using tests of immediate auditory memory impairment and auditory distractability, and carefully controlling for generalized deficit effects. A parallel assessment was made of referential communication disturbances in 59 non-schizophrenic relatives of patients and 24 control subjects matched to the relatives. RESULTS: In patients, formal thought disorder, disorganization, and referential communication disturbances were all associated with each other and with auditory distractability. In addition, as expected, referential communication disturbances were associated with immediate auditory memory impairment. Referential disturbance ratings for relatives were similar in magnitude to those for the stable out-patients, and much higher than for controls. However, the relatives' language ratings were not associated specifically with weaknesses in attention or memory as measured. CONCLUSIONS: Impairments in immediate auditory memory and attention are associated differentially with different types of communication disturbances in schizophrenia patients. The cognitive substrate for referential communication disturbances in relatives appears to differ qualitatively from that for patients.