Cognitive Impairment in Schizophrenia — MRCPsych Paper B MCQ

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ModerateRehabilitationCognitive Impairment in SchizophreniaMRCPsych Paper B

A 40-year-old man with schizophrenia is undergoing neuropsychological assessment as part of vocational rehabilitation. His general intellectual ability is within the average range. Which pair of cognitive domains is repeatedly identified in systematic reviews as showing particularly marked impairment in schizophrenia?

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Correct answer: C — Verbal memory and working memory

Explanation lettering: E = shown as A · A = shown as B · B = shown as C · C = shown as E

B is correct. Cognitive impairment in schizophrenia is broad, but an umbrella review of 63 systematic reviews identified particularly marked impairment in processing speed, verbal memory and working memory. B is therefore the only offered pair in which both domains belong to this repeatedly prominent group. Average IQ does not exclude specific impairment: meta-analysis demonstrates large working-memory deficits that are not simply attributable to lower IQ. Language and visuospatial construction can be affected but are not the characteristic prominent pair described here. Crystallised knowledge is generally less vulnerable, while procedural learning and motor-skill retention are not the core cognitive profile. These deficits are clinically important in rehabilitation because they are associated with impaired everyday and occupational functioning.

Reference: Gebreegziabhere Y, Habatmu K, Mihretu A, Cella M, Alem A. Cognitive impairment in people with schizophrenia: an umbrella review. European Archives of Psychiatry and Clinical Neuroscience. 2022;272:1139–1155. https://pubmed.ncbi.nlm.nih.gov/35633394/