Verbal learning and its impact on symptoms in adolescents with schizophrenia

Verbal learning develops substantially during adolescence and is consistently impaired in schizophrenia. Despite the severity of cognitive deficits in early-onset schizophrenia (EOS), verbal learning has not been systematically examined in adolescent patients. Understanding these impairments is essential due to their impact on academic, social, and functional outcomes.

106 adolescents (12-17 years) with schizophrenia or schizophreniform disorder (DSM-5) were recruited from inpatient and outpatient services in Mexico City. Assessments included the MINI-KID, Hopkins Verbal Learning Test-Revised (HVLT-R), and Positive and Negative Syndrome Scale (PANSS). Descriptive analyzes, repeated-measures ANOVA, Cochran's Q test, and Pearson correlations were used to evaluate verbal learning performance and its associations with symptoms.

Participants showed incremental learning across HVLT-R trials but low overall performance, recalling on average seven of 36 words. Intrusions and perseverations were infrequent yet related to poorer recall. Total correct words correlated negatively with negative symptoms, while semantic intrusions correlated positively with positive symptoms. Associations among HVLT-R variables indicated deficits in encoding, organization, and retrieval.

Adolescents with schizophrenia exhibit significant verbal learning deficits linked to both negative, positive and general psychopathology symptoms. Early identification of these impairments is crucial for guiding targeted cognitive interventions. Larger, controlled studies are needed to refine these findings and support culturally relevant assessment and rehabilitation strategies.