Impairment of verbal memory and learning in antipsychotic-naı ¨ve patients with first-episode schizophrenia S. Kristian Hill a, * , Sue R. Beers b , Julie A. Kmiec b , Matcheri S. Keshavan b , John A. Sweeney a a Center for Cognitive Medicine, University of Illinois at Chicago, 912 South Wood Street, Suite 235, Chicago, IL 60612, USA b Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213, USA Received 23 December 2001; received in revised form 8 April 2003; accepted 9 April 2003 Abstract Background: Verbal memory deficits are of interest in schizophrenia because of the potential relationship to functional and anatomic mesial temporal lobe pathology in this disorder. The goal of this study was to characterize the nature of verbal memory impairments in antipsychotic-naı ¨ve schizophrenic patients early in the course of illness. Methods: Neuroleptic-naı ¨ve patients with schizophrenia (n = 62) and healthy individuals (n = 67), matched on IQ, age, sex, and parental socioeconomic status, were administered the California Verbal Learning Test (CVLT). Results: Schizophrenia participants performed significantly worse than healthy individuals on measures of verbal learning, short- and long-term memory, and immediate attention. Deficits in recall were related to reduced use of organizational strategies to facilitate verbal encoding and retrieval. No group differences were found in rate of forgetting or susceptibility to proactive or retroactive interference. Memory deficits had minimal relation to positive or negative symptom severity. Conclusions: Schizophrenia is characterized by significant verbal memory dysfunction early in the course of illness prior to treatment with antipsychotic medications. Deficits in consistency of learning over several trials, as well as a strong relationship between semantic organizational strategies and reduced learning capacity, implicate prefrontal dysfunction as a contributor to verbal memory deficits in schizophrenia. D 2003 Elsevier B.V. All rights reserved. Keywords: Schizophrenia; Verbal memory; Learning; Neuropsychology; Frontal lobes 1. Introduction Verbal memory deficits are well-established in schizophrenia (Calev, 1984; Goldberg et al., 1989; Saykin et al., 1991). Some neuropsychological studies have found verbal memory deficits in schizophrenia to be more severe than those evident in other neuro- psychological domains (Censits et al., 1997; Dick- erson et al., 1991; Saykin et al., 1994). Interest in verbal memory dysfunction has increased in recent years because neuroimaging and post-mortem studies have implicated left temporolimbic cortex as a site of neurophysiologic and neuroanatomic abnormalities in schizophrenia (Barta et al., 1990; Keshavan et al., 1998; Shenton et al., 1992). Indeed, verbal memory deficits have been linked to physiological abnormal- ities of mesial temporal cortex in schizophrenia 0920-9964/$ - see front matter D 2003 Elsevier B.V. All rights reserved. doi:10.1016/S0920-9964(03)00125-7 * Corresponding author. Tel.: +1-312-996-2107; fax: +1-312- 413-8837. E-mail address: shill@psych.uic.edu (S.K. Hill). www.elsevier.com/locate/schres Schizophrenia Research 68 (2004) 127 – 136