Official journal of the Pacific Rim College of Psychiatrists ORIGINAL ARTICLE A novel method for assessing patients with schizophrenia and their first‐degree relatives by increasing cognitive load of visuo‐spatial working memory Sunaina Soni PhD 1 | Suriya Prakash Muthukrishnan MD 1 | Mamta Sood MD 2 | Simran Kaur MD 1 | Nalin Mehta MD 1 | Ratna Sharma PhD 1 1 Department of Physiology, All India Institute of Medical Sciences, New Delhi, India 2 Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India Correspondence Ratna Sharma, PhD, Department of Physiology, All India Institute of Medical Sciences, Room No. 6004, Convergence Block, Ansari Nagar, New Delhi 110029, India. Email: ratnaaiims@gmail.com Funding information Innovation in Science Pursuit for Inspired Research (INSPIRE) Fellowship, Department of Science and Technology (DST), Grant/Award Number: IF140138 Abstract Introduction: In patients with schizophrenia, social and functional outcome is deter- mined by the cognitive impairment. Assessment of visuo‐spatial working memory (VSWM) which can simulate the day‐to‐day activities by simultaneous involvement of various elements of working memory may reflect disorganized thinking and frag- mentation of thoughts in schizophrenia. Methods: Thirty‐six patients with schizophrenia, 29 first‐degree relatives of patients, and 25 healthy controls performed a VSWM task with three memory loads (comprising three pairs, six pairs, and eight pairs of abstract pictures). They were administered Hindi version of the Mini Mental State Examination, Scale for the Assessment of Negative Symptoms and Scale for the Assessment of Positive Symptoms, and Edinburgh handedness inventory. Results: Patients (mean age 27.29(5.98) years) committed significantly higher number of errors than healthy controls (mean age 26.76(6.08) years) in load 3 (P = 0.012) and total errors (P = 0.018). Within all the groups, errors in load 3 were significantly higher than in load 2. Significant correlation was observed between years of education (r = -0.388, P = 0.021), treatment duration (r = -0.880, P < 0.001), negative symptoms scores (r = 0.345, P = 0.039), and the total errors committed by patients. Discussion: Visuo‐spatial working memory was impaired in schizophrenia with increasing cognitive load with no difference in search time between the groups. KEYWORDS cognitive impairment, first‐degree relative, memory load, schizophrenia, working memory 1 | INTRODUCTION Cognitive impairment in patients with schizophrenia is considered to be the core feature of the disease pathology (R. S. E. Keefe, Eesley, & Poe, 2005; R. S. E. Keefe & Fenton, 2007). It has been shown to be independent of clinical symptoms (Addington, Addington, & Maticka‐Tyndale, 1991; R. S. Keefe et al., 2006) and occurs prior to the onset of psychosis in schizophrenia. It is also best correlated with measurable brain dysfunction than the symptoms/treatment for the illness (R. S. E. Keefe & Fenton, 2007). The work and social functioning of patients with schizophrenia is determined by the cognitive ability rather than clinical symptoms (McGurk & Meltzer, 2000). Hence, Received: 9 March 2018 Revised: 17 May 2018 Accepted: 2 August 2018 DOI: 10.1111/appy.12333 Asia‐Pacific Psychiatry. 2018;e12333. https://doi.org/10.1111/appy.12333 © 2018 John Wiley & Sons Australia, Ltd wileyonlinelibrary.com/journal/appy 1 of 7