Patients with schizophreniform disorder use verbal descriptions for the representation of visual categories

Neuropsychological impairment is a common finding in schizophrenia. However, a significant proportion of patients are not impaired in conventional neuropsychological tests. In this study, we investigated whether remitted patients with schizophreniform disorder exhibited dysfunctions in specific cognitive tasks.

Twenty remitted, highly functioning patients with schizophreniform disorder and 20 control subjects participated in the study. In addition to background neuropsychological evaluation (WAIS-R IQ, Wisconsin Card Sorting Test (WCST), Trail Making B, Rey Osterrieth Complex Figure), subjects received a category learning task. The categories consisted of geometric shapes systematically changing in shape and size. Training included the sequential presentation of category members (visual learning) and verbal description of categories.

The patients with schizophreniform disorder had normal IQ, executive functions/psychomotor speed (WCST and Trail Making B) and visual memory (Rey-Osterrieth Complex Figure). In contrast, they displayed impaired categorization performances after visual learning. The performance of the patients improved markedly after verbal description of categories. Verbal knowledge about categories positively correlated with categorization performance in the patients, but not in the controls.

Category learning functions, which include decision-making under uncertainty and feature integration, are impaired in patients with schizophreniform disorder who display normal executive functions and visual memory. These patients may use verbal knowledge as a compensatory strategy in visual tasks.