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Patients with bipolar disorders share similar but attenuated prospective memory impairments with patients with schizophrenia

  • R. C. K. Chan (a1), S. S. Y. Lui (a1) (a2) (a3), Y. Wang (a1), A. C. Y. Liu (a3), W. W. H. Chui (a3), D. H. K. Shum (a4) and E. F. C. Cheung (a3)...



Prospective memory (PM) refers to the ability to remember to carry out an intended action in the future. PM is consistently found to be impaired in individuals with schizophrenia. Bipolar disorder and schizophrenia may represent conditions along a continuum, and share similar neurocognitive and genetic architecture. This study aimed to compare the nature and extent of PM impairment in individuals with schizophrenia and bipolar disorder.


Participants were 38 out-patients with schizophrenia and 40 out-patients with bipolar disorder in an early psychosis intervention programme, and 37 healthy controls. Time-, event- and activity-based PMs were assessed using a dual-task laboratory paradigm. Self-reported PM performance was gauged using the Prospective and Retrospective Memory Questionnaire. Analysis of covariance (ANCOVA), with intelligence quotient (IQ) and education included as covariates, was used to examine group difference on various types of PM. Repeated measures of ANCOVA were used to examine the group × PM type interaction effect. Correspondence between laboratory and self-reported PM measures was examined using correlational analysis.


The group × PM type interaction effect was not significant, but the main effect of group was significant. Patients with schizophrenia and patients with bipolar disorder both performed more poorly than healthy participants in PM. The two clinical groups did not significantly differ in PM. Laboratory and self-reported PM measures did not correlate significantly with each other.


Patients with bipolar disorder shared a similar PM impairment with those with schizophrenia. Findings of this study extended the similarity in neurocognitive impairments between the two psychiatric disorders to PM.


Corresponding author

*Address for correspondence: Professor R. C. K. Chan, Institute of Psychology, Chinese Academy of Sciences, 4A Datun Road, Beijing 100101, People's Republic of China. (Email:


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Altgassen, M, Kliegel, M, Rendell, P, Henry, JD, Zollig, J (2008). Prospective memory in schizophrenia: the impact of varying retrospective-memory load. Journal of Clinical and Experimental Neuropsychology 30, 777788.
Arts, B, Jabben, N, Krabbendam, L, van Os, J (2008). Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives. Psychological Medicine 38, 771785.
Braff, DL (1993). Information processing and attention dysfunctions in schizophrenia. Schizophrenia Bulletin 19, 233259.
British Medical Association and Royal Pharmaceutical Society of Great Britain (2009). British National Formulary: 58: September 2009. British Medical Association and Royal Pharmaceutical Society of Great Britain: London.
Burgess, PW, Shallice, T (1996 a). Response suppression, initiation and strategy use following frontal lobe lesions. Neuropsychologia 34, 263273.
Burgess, PW, Shallice, T (1996 b). Bizarre responses, rule detection, and frontal lobe lesions. Cortex 32, 241259.
Chan, RCK, Chen, EYH, Cheung, EFC, Chen, RYL, Cheung, HK (2006 a). The components of executive functioning in a cohort of patients with chronic schizophrenia: a multiple single-case study design. Schizophrenia Research 81, 173189.
Chan, RCK, Chen, EYH, Cheung, EFC, Cheung, HK (2004). Executive dysfunctions in schizophrenia: relationships to clinical manifestations. European Archives of Psychiatry and Clinical Neuroscience 254, 256262.
Chan, RCK, Chen, EYH, Law, CW (2006 b). Specific executive dysfunction in patients with first-episode medication-naïve schizophrenia. Schizophrenia Research 82, 5164.
Chan, RCK, Wang, Y, Ma, Z, Hong, X, Yuan, Y, Yu, X, Li, Z, Shum, D, Qong, QY (2008). Objective measures of prospective memory do not correlate with subjective complaints in schizophrenia. Schizophrenia Research 103, 229239.
Crow, T (1986). The continuum of psychosis and its implication for the structure of the gene. British Journal of Psychiatry 149, 419429.
Einstein, GO, McDaniel, MA (1990). Normal aging and prospective memory. Journal of Experimental Psychology Learning Memory and Cognition 16, 717726.
Einstein, GO, McDaniel, MA (1996). Retrieval processes in prospective memory: theoretical approaches and some new empirical findings. In Prospective Memory: Theory and Applications (ed. Brandimonte, M. A., Einstein, G. O. and McDaniel, M. A.), pp. 115142. Lawrence Erlbaum Associates: Mahwah, NJ.
Ellis, JA (1996). Prospective memory or the realization of delayed intentions: a conceptual framework for research. In Prospective Memory: Theory and Applications (ed. Brandimonte, M. A., Einstein, G. O. and McDaniel, M. A.), pp. 122. Lawrence Erlbaum Associates: Mahwah, NJ.
Ellison-Wright, I, Bullmore, E (2010). Anatomy of bipolar disorder and schizophrenia: a meta-analysis. Schizophrenia Research 117, 112.
Elvevag, B, Maylor, EA, Gilbert, AL (2003). Habitual prospective memory in schizophrenia. BMC Psychiatry 3, 9.
Glahn, DC, Bearden, CE, Barguil, M, Barrett, J, Reichenberg, A, Bowden, CL, Soares, JC, Velligan, DI (2007). The neurocognitive signature of psychotic bipolar disorder. Biological Psychiatry 62, 910916.
Glahn, DC, Bearden, CE, Cakir, S, Barrett, JA, Najt, P, Monkul, ES, Maples, N, Velligan, DI, Soares, JC (2006). Differential working memory impairment in bipolar disorder and schizophrenia: effects of lifetime history of psychosis. Bipolar Disorder 8, 117123.
Gold, JM, Carpenter, C, Randolph, C, Goldberg, TE, Weinberger, DR (1997). Auditory working memory and Wisconsin Card Sorting Test performance in schizophrenia. Archives of General Psychiatry 54, 159165.
Gong, YX (1992). Manual of Wechsler Adult Intelligence Scale–Chinese Version. Chinese Map Press: Changsha.
Gottesman, II, Gould, TD (2003). The endophenotype concept in psychiatry: etymology and strategic intentions. American Journal of Psychiatry 160, 636645.
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry 23, 5662.
Heaton, RK, Gladsjo, JA, Palmer, BW, Kuck, J, Marcotte, TD, Jeste, DV (2001). Stability and course of neuropsychological deficits in schizophrenia. Archives of General Psychiatry 58, 2432.
Heinrichs, RW, Zakzanis, KK (1998). Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 12, 426445.
Hill, SK, Harris, MS, Herbener, ES, Pavuluri, M, Sweeney, JA (2008). Neurocognitive allied phenotypes for schizophrenia and bipolar disorder. Schizophrenia Bulletin 34, 743759.
Hung, GBK (2007). A comparison of two methods in calculating total antipsychotics dosage. Hong Kong Journal of Psychiatry 17, 8790.
Ivleva, EI, Morris, DW, Moates, AF, Suppes, T, Thaker, GK, Tamminga, CA (2010). Genetics and intermediate phenotypes of the schizophrenia–bipolar disorder boundary. Neuroscience, Biobehavioral Reviews 34, 897921.
Kay, SR, Fiszbein, A, Opler, LA (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261276.
Keshavan, MS, Morris, DW, Sweeney, JA, Pearlson, G, Thaker, G, Seidman, LJ, Eack, SM, Tamminga, C (2011). A dimensional approach to the psychosis spectrum between bipolar disorder and schizophrenia: the Schizo-Bipolar Scale. Schizophrenia Research 12, 250254.
Kliegel, M, Altgassen, M, Hering, A, Rose, NS (2011). A process-model based approach to prospective memory impairment in Parkinson's disease. Neuropsychologia 49, 21662177.
Kliegel, M, Jager, T, Altgassen, M, Shum, D (2008 a). Clinical neuropsychology of prospective memory. In Prospective Memory: Cognitive, Neuroscience, Developmental, and Applied Perspectives (ed. Kliegel, M., McDaniel, M. A. and Einstein, G. O.), pp. 283308. Lawrence Erlbaum Associates: New York.
Kliegel, M, Jager, T, Phillips, LH (2008 b). Adult age differences in event-based prospective memory: a meta-analysis on the role of focal versus nonfocal cues. Psychology and Aging 23, 203208.
Kvavilashvili, L (1992). Remembering intentions: a critical review of existing experimental paradigms. Applied Cognitive Psychology 6, 507524.
Kvavilashvili, L, Ellis, JA (1996). Variety of intentions: some distinctions and classifications. In Prospective Memory: Theory and Applications (ed. Brandimonte, M. A., Einstein, G. O. and McDaniel, M. A.), pp. 2352. Lawrence Erlbaum: Mahwah, NJ.
Lee, E, Xiang, YT, Man, D, Au, RWC, Shum, D, Tang, WK, Chiu, HFK, Wong, P, Ungvari, GS (2010). Prospective memory deficits in patients with bipolar disorder: a preliminary study. Archives of Clinical Neuropsychology 25, 640647.
Linscott, RJ, van Os, J (2010). Systematic review of categorical versus continuum model in psychosis: evidence for discontinuous subpopulations underlying a psychometric continuum. Implications for DSM-V, DSM-VI and DSM-VII. Annual Review of Clinical Psychology 6, 391419.
Lui, SSY, Wang, Y, Liu, ACY, Chui, WWH, Gong, Q-Y, Shum, D, Cheung, EFC, Chan, RCK (2011). Prospective memory in patients with first-onset schizophrenia and their non-psychotic siblings. Neuropsychologia 49, 22172224.
Martin, M, Jones, GV (1983). Cognitive failures in everyday life. In Everyday Memory, Actions and Absent–mindedness (ed. Harris, J. E. and Morris, P. E.), pp. 173190. Academic Press: London.
Norman, DA, Shallice, T (1986). Attention to action: willed and automatic control of behaviour. In Consciousness and Self-Regulation: Advances in Research and Theory, vol. 4 (ed. Davidson, R. J., Schwartz, G. E. and Shapiro, D.), pp. 118. Plenum: New York.
Potash, JB, Bienvenu, OJ (2009). Neuropsychiatric disorders: shared genetics of bipolar disorder and schizophrenia. Nature Reviews Neurology 5, 299300.
Potash, JB, Willour, VL, Chiu, YF, Simpson, SG, MacKinnon, DF, Pearlson, GD, Depaulo, JR, Mcinnis, MG (2001). The familial aggregation of psychotic symptoms in bipolar disorder pedigrees. American Journal of Psychiatry 158, 12581264.
Potash, JB, Zandi, PP, Willour, VL, Lan, T-H, Huo, Y, Avramopoulos, D, Shugart, YY, MacKinnon, DF, Dean, F, Simpson, SG, McMahon, FJ, Depaulo, JR, McInnis, MG (2003). Suggestive linkage to chromosomal regions 13q31 and 22q12 in families with psychotic bipolar disorder. American Journal of Psychiatry 160, 680686.
Shifman, S, Bronstein, M, Sternfeld, M, Pisante, A, Weizman, A, Reznik, I, Spivak, B, Grisaru, N, Karp, L, Schiffer, R, Kotler, M, Strous, RD, Swartz-Vanetik, M, Knobler, HY, Shinar, E, Yakir, B, Zak, NB, Darvasi, A (2004). COMT: a common susceptibility gene in bipolar disorder and schizophrenia. American Journal of Medical Genetics Part B 128B, 6164.
Shum, D, Ungvari, GS, Tang, WK, Leung, JP (2004). Performance of schizophrenia patients on time-, event-, and activity-based prospective memory tasks. Schizophrenia Bulletin 30, 693701.
Smith, G, della Sala, S, Logie, RH, Maylor, EA (2000). Prospective memory and retrospective memory in normal ageing and dementia: a questionnaire study. Memory 8, 311321.
Smith, RE (2003). The cost of remembering to remember in event-based prospective memory: investigating the capacity demands of delayed intention performance. Journal of Experimental Psychology: Learning, Memory, and Cognition 29, 347361.
Spreen, O, Strauss, E (1991). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. Oxford University Press: New York.
Stip, E, Caron, J, Renaud, S, Pampoulova, T, Lecomte, Y (2003). Exploring cognitive complaints in schizophrenia: the subjective scale to investigate cognition in schizophrenia. Comprehensive Psychiatry 44, 331340.
Tamlyn, D, McKenna, PJ, Mortimer, AM, Lund, CE, Hammond, S, Baddeley, AD (1992). Memory impairment in schizophrenia: its extent, affiliations and neuropsychological character. Psychological Medicine 22, 101115.
Wang, Y, Chan, RCK, Cui, J, Deng, Y, Huang, J, Li, H, Yan, C, Xu, T, Ma, Z, Hong, X, Li, Z, Shi, H, Shum, D (2010). Prospective memory in non-psychotic first-degree relatives of patients with schizophrenia. Psychiatry Research 179, 285290.
Wang, Y, Chan, RCK, Hong, X, Ma, Z, Yang, T, Guo, L, Yu, X, Li, Z, Yuan, Y, Qong, GY, Shum, D (2008 a). Prospective memory in schizophrenia: further clarification of nature of impairment. Schizophrenia Research 105, 114124.
Wang, Y, Chan, RCK, Yu, X, Shi, C, Cui, J, Deng, Y (2008 b). Prospective memory deficits in subjects with schizophrenia spectrum disorders: a comparison study with schizophrenic subjects, psychometrically defined schizotypal subjects, and healthy controls. Schizophrenia Research 106, 7080.
Wang, Y, Cui, J, Chan, RCK, Deng, Y, Shi, H, Hong, X, Li, Z, Yu, X, Qong, GY, Shum, D (2009). Meta-analysis of prospective memory in schizophrenia: nature, extent, and correlates. Schizophrenia Research 114, 6470.
WHO (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.
Young, RC, Biggs, JT, Ziegler, VE, Meyer, DA (1978). A rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry 133, 429435.
Yu, K, Cheung, C, Leung, M, Li, Q, Chua, S, McAlonan, G (2010). Are bipolar disorder and schizophrenia neuroanatomically distinct? An anatomical likelihood meta-analysis. Frontiers in Human Neuroscience 4, 189.
Zeintl, M, Kliegel, M, Hofer, SM (2007). The role of processing resources in age-related prospective and retrospective memory within old age. Psychology and Aging 22, 826834.
Zhou, F, Xiang, Y, Wang, C, Dickerson, F, Au, RCK, Zhou, J, Shum, DHK, Chiu, HFK, Man, D, Lee, EHM, Yu, X, Chan, RCK, Ungvari, GS (2012). Characteristics and clinical correlates of prospective memory performance in first-episode schizophrenia. Schizophrenia Research 135, 3439.



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