Memory impairment in this type of disorder causes many problems. A person may lose professional skills, forget their past, lose the ability to speak and walk or become a little forgetful. It depends on the nature of the damage to the brain. Memory in schizophrenia almost always suffers but depends on the type of psychopathology – to varying degrees. Let’s consider the causes and consequences of amnesia developing against the background of the schizophrenic process.
Features of memory and amnesia
First of all, it is worth understanding the concept of memory. This term usually refers to the ability to remember information. Some researchers include the process of forgetting it as well. There are two main types of memory – short-term and long-term. The first is the responsible hippocampus – one of the departments of the brain (there is in each hemisphere). It controls the transition of new information into long-term information. This organ also ensures orientation in space and concentration of attention.
Short-term memory is also called working memory. It contains about seven objects on which we concentrate. The likelihood that information that has entered the mind will end up in long-term memory depends on many factors:
- The size of the hippocampus;
- The presence/absence of damage;
- The importance of the information;
- Emotional context, etc.
In general, everything we can do and know is a consequence of memory work. It is not just a question of erudition or knowledge of the language. Even movements, the ability to chew food, and other habitual behaviors result from memory and the formation of behavioral algorithms.
See Alo: Dementia in Schizophrenia
In severe memory disorders, a person may forget how to move. In such cases, there are lesions in the parts of the brain responsible for long-term memory. Dementia and its wide varieties lead to such consequences.
Short-term memory disorders cause forgetfulness. It is often related to concentration problems. People cannot hold anything in their minds for long, so new information does not make it into long-term memory.
The hippocampus works selectively and sifts out information that it does not think is useful. For this reason, we may forget where we put the car keys if the brain is more concerned with information about an important meeting or purchase when thinking about the keys. They are more likely to end up in long-term memory.
Short-term memory storage does not last more than 30 seconds.
This kind of forgetfulness is common, and everyone has encountered it. It is not indicative of pathology, especially schizophrenic. However, in schizophrenia, such disorders occur almost constantly. Let’s look at the main features of this pathology and learn how it relates to memory.
Schizophrenia is a chronic mental illness manifested by impaired thinking. It develops for unknown reasons, usually against the background of genetic predisposition, and proceeds in various forms, of which there are more than a dozen, not counting unofficial ones.
The symptoms of schizophrenia are many. The type of psychopathology determines the clinical picture. But in general terms, it is possible to divide all of its signs into two types:
- Positive: delusions, hallucinations, catatonic syndrome.
- Negative: apathy, depression, anhedonia, abulia, desire for loneliness.
Usually, negative signs first appear, testifying to the passivity of the mental apparatus. They may have varying degrees of severity. For some people, schizophrenia proceeds in a latent or lethargic form for years and decades, making itself known only by symptoms of the depressive type.
During an exacerbation (attack), the patient’s psyche is active. In such cases, delusions, hallucinations, and movement disorders develop. Often in this condition, the person ends up in the clinic.
Schizophrenia can also occur without hallucinations.
If we talk about memory problems and other cognitive disorders, they can be both during the active and passive phases of the disease.
Schizophrenia mainly affects short-term memory, which is necessary for orientation in space and remembering current affairs and states. In simple terms, the patient becomes forgetful and distracted. When talking to him, it may seem as if he is not listening. He is either thinking about something else, or he cannot grasp the meaning of the phrases you are saying. It affects the decision-making process in the moment. The person can’t be able to learn or work at all.
Cryptomnesia is sometimes seen with schizophrenia, where a person cannot distinguish between memories and dreams, fiction, or other people’s stories.
Two types of memory have been described above. But other classifications divide it into types. There are quite a few of them. In schizophrenia, the following varieties are affected:
- Episodic – the patient cannot remember how he appeared in a particular place or episodes of yesterday’s events (memory lapses);
- Verbal – impaired ability to remember verbal information, resulting in a person reproducing it in a distorted form;
- Non-verbal – problems with remembering auditory, visual, olfactory, or tactile information, which is aggravated by the presence of the patient’s hallucinations;
- Associative – inability to make associations between phenomena, events, and facts.
Semantic and implicit types of memory are impaired to a lesser degree. The first provides the ability to remember and store generalized concepts about the world in the head. The second is involuntary memory, like cutting bread or brushing one’s teeth. We usually don’t try to keep it in our heads, but we remember it anyway.
Mechanism of impairment development
The exact cause of memory loss in the development of schizophrenia is still unknown. There is an assumption that it is related to the work of the dorsolateral prefrontal cortex. But previously, no one has been able to prove this. American scientists, together with Columbian researchers, decided to check this assumption.
They developed tasks with different difficulty levels, which people with schizophrenia and healthy people subsequently performed. The process and results of the test were recorded using MRI. But no reactions in the prefrontal cortex area were revealed by the specialists.
Then they decided to complicate the tasks and created a test consisting of 8 levels of difficulty. After repeating the experiment, it turned out that in healthy subjects, this area of the brain is in the mode of increased activity during problem-solving. In patients with schizophrenia, it was very weakly manifested. And reactions were least evident in patients who poorly coped with the task.
Confabulation – a memory disorder in which false memories are substituted for true ones – can be observed in schizophrenia.
This discovery may be an important step in solving the problem, as it will form the basis for developing effective treatments for schizophrenia or eliminating its symptoms, including cognitive impairment.
Dementia can act as an independent disease or a symptom of another pathology. There is a close connection between dementia and schizophrenic disorders. As medical practice shows, the risk of its development in schizophrenia is quite high.
However, in these cases, transient dementia is often referred to when the patient suffers cognitive impairment during an exacerbation of the disease, but later on, memory and intelligence return. Such brain lesions are irreversible in cases of dementia.
In general, not all scientists consider schizophrenic dementia to be dementia in its usual sense, but there is certainly a connection between the two, as dementia is found in at least ⅓ of people with schizophrenia.
Even common forgetfulness, which can be observed in healthy people, can lead to many problems at work, school, or at home. A person may forget to turn in a report or close the apartment door when going on vacation. With a schizophrenic diagnosis, everything becomes more complicated.
It is possible to distinguish several typical consequences of memory impairment in a schizophrenic person:
- Inability to act with purpose;
- Inadequate behavior;
- Failure to perform one’s duties;
- Dismissal or expulsion from an educational institution;
- Difficulty making decisions.
A patient who is worse at remembering information has decreased motivation, which is dangerous in schizophrenia. The person needs to socialize and learn to relate to society. Memory impairment does not contribute to this.
Schizophrenia is treated with antipsychotics and psychotherapy. But in this case, we are discussing combating active symptoms and rehabilitation. There are no specific drugs to improve memory in schizophrenia if they can help here, only psychotherapeutic techniques.
Tactics used by specialists in mnemotechnics – fast memorization of information in large volumes – are not used in schizophrenia. Promoting the patient’s concentration and motivation is necessary to develop psychopathology. It can also be done by the patient’s relatives, for example, while watching TV or taking a walk, suggesting that the patient concentrate on something interesting.
Treatment of schizophrenia is carried out constantly, not only during exacerbation. Once in remission, medications should be taken and should make visits to the psychiatrist. In many ways, group sessions help to rehabilitate and enter society. The more the patient communicates productively with other people will restore more quickly his health and some cognitive functions.