Memory in functional psychosis

S U M MARY Acute schizophrenic, chronic schizophrenic, and depressive patients (20 of each) were compared with normal subjects and six groups of patients with organic brain disease. They were given tests of verbal learning (left hemisphere type function) and pattern recognition memory (right hemisphere type function). All functional psychotics showed impaired memory. Acute schizophrenics were, however, only impaired on the verbal task, suggesting left hemisphere dysfunction, while chronic schizophrenics and depressives were impaired on both tasks, suggesting bilateral dysfunction. Global impairment of memory is regarded traditionally as a characteristic of those psychiatric disorders where organic brain damage is present. There is, however, increasing evidence that memory is not intact in the functional psychoses. Johnstone et al. (1978) reported severe memory impairment in chronic schizophrenics in long-stay wards. Flor-Henry (1976) and Koh (1978) identi-fied poor performances on some memory tasks in acute schizophrenics. A depressive pseudo-dementia is recognised clinically, and Larner (1977), Miller and Lewis (1977) and Stromgren (1977) have confirmed that memory impairment is a regular feature of depressive illness. It has generally been assumed that memory impairment in the course of a functional psychosis is not central to the disease process itself but is a secondary phenomenon attributable to some other factor. Such factors include pre-existing brain damage as in the schizophrenia-like psychoses of epilepsy (Slater et al., 1963); the side effects of treatment-leucotomy, medication, electro-convulsive therapy (ECT); and psychological factors-apathy induced by institutionalism, in-attention through preoccupation with psychotic experiences. In the case of the chronic schizo-phrenics studied by Johnstone et al., equivalent hospitalisation for a physical illness did not lead to impairment of memory, some patients with