Avraham Calev

Cognitive functioning in post-traumatic stress disorder

Twelve Post-Traumatic Stress Disorder (PTSD) patients, 12 psychiatric patients matched for severity of psychopathology, and 12 normal controls were assessed for cognitive functioning by means of a comprehensive test battery. Both patient groups felt subjectively more impaired than normals. Performance on measures of intelligence, organicity, verbal fluency, memory, and attention was significantly poorer in patients than in normals. The performance of the PTSD patients and that of the psychiatric controls was, however, very similar. The premorbid intelligence of both the PTSD patients and the psychiatric controls was average and had deteriorated significantly by the time of current testing. These cognitive problems were not secondary to alcohol, drug abuse, or head injury. The results suggest a cognitive impairment in post-traumatic patients.

Recall and recognition in mildly disturbed schizophrenics: the use of matched tasks

Unlike previous studies, this study shows that in controlled conditions non-chronic schizophrenics receiving neuroleptic medication show no disparity between recall and recognition. Patients receiving both neuroleptic and anticholinergic drugs show this disparity, performing less well on recall than on recognition. These patients also seem more severely disturbed. The importance of task matching, drugs and chronicity are discussed.

Verbal and non-verbal recall by depressed and euthymic affective patients

This study uses matched-tasks methodology in order to test memory function in depressed and euthymic patients with major affective disorder. Neither drug-free depressed patients nor lithium-treated euthymic patients show a differential deficit in verbal versus non-verbal recall. However, while euthymic patients show no memory impairment, drug-free depressives do show poor memory functioning. The results support the view that memory deficits observed in affective patients in the depressed state are transient, secondary manifestations of depression and are neither indicative of underlying organic pathology, nor of abnormal hemispheric laterality. This suggests that memory impairment in depression can be treated by treating depressive symptoms, both chemically and behaviourally. The results also support the view that prophylactic lithium treatment has no adverse effects on these memory tasks.

Neuroendocrine responses in chronic schizophrenia: Evidence for serotonergic dysfunction

Neuroendocrine and mood responses to a 60 mg oral dose of the serotonin-releasing agent, fenfluramine, were assessed in ten neuroleptic-free, chronic schizophrenic patients and in age- and sex-matched normal control subjects. The prolactin (PRL) response to fenfluramine was significantly blunted in the schizophrenic subjects. Growth hormone and cortisol levels were not differentially affected by the challenge. There was no significant effect of fenfluramine on mood in either group. The blunted PRL response in the schizophrenic group suggests serotonergic dysfunction; possible mechanisms of this finding and implications for treatment are considered.

Verbal and visuospatial recall by younger and older subjects: Use of matched tasks.

In this study, 18 older (over age 65, M = 75.61 years) and 18 younger (below age 40 and over age 17, M = 26.44 years) healthy volunteers were tested on verbal and visuospatial recall. Tasks were matched on discriminating power. Older Ss performed worse than younger Ss on both tasks. The older Ss also showed a larger deficit in visuospatial than in verbal recall, relative to the younger Ss. These results are consistent with the theory of aging according to which verbal tasks are more resistant to deterioration than are nonverbal tasks. A psychological explanation based on lifetime experience with verbal material is preferred over the physiological explanation advocating faster aging of the right hemisphere.

Distinct memory impairments following electroconvulsive therapy and imipramine

Memory functioning was assessed in 26 unmedicated patients with major depressive disorder (DSM-III) who were then administered either bilateral electroconvulsive therapy (ECT) (N = 16) or imipramine 200 mg per day (N = 10). The subjects were retested following seven ECT administrations or 21 days of imipramine treatment respectively. The retrograde memory tasks included recall of public and autobiographic events. The anterograde memory tasks included an immediate memory task, a verbal paired-associates recall task, and a non-verbal figure reproduction task. Depression was significantly improved in the ECT-treated subjects but not in those administered imipramine. Both ECT- and imipramine-treated patients showed a deficit in recent anterograde memory relative to their pretreatment performance, but no deficit in immediate memory. ECT-treated patients also had a significant and well-characterized impairment in retrograde remote memory. By contrast, imipramine-treated patients did not show a retrograde memory impairment which could be explained by treatment. The results suggest qualitatively different memory deficits produced by ECT and imipramine.

Remote and recent memory in long-hospitalized chronic schizophrenics.

This study shows that chronic, long-hospitalized schizophrenics perform (tested by the Famous Events Questionnaire) at a higher level on remote memory than they do on word list recall. A post hoc, matched-tasks check suggested that this finding was not due to differences in the discriminating power of the tasks. Relative to normals, patients showed no differential performance on the three time periods (1973/74, 1979/80, 1984) represented in the remote memory questionnaire, thus giving no evidence for an amnesic gradient. The findings are discussed in relation to amnesia and dementia hypotheses in chronic schizophrenia.