Decline in working memory in stable schizophrenia may be related to attentional impairment: mediating effects of negative symptoms

Abstract

Objective: Cognitive deficits and negative symptoms are prevalent in individuals with schizophrenia and are crucial indicators of functional recovery. However, the specific relationship between attention, working memory, and negative symptoms in stable schizophrenia remains unclear. This study aims to explore these associations and provide valuable insights for the subsequent treatment of schizophrenia. Methods: We conducted a comprehensive assessment of 145 patients with stable schizophrenia using the Chinese Brief Neurocognitive Suite of Tests (C-BCT) and the Positive and Negative Symptom Scale (PANSS). Results: Patients with abnormal cognition exhibited significantly higher PANSS total scores, cognitive symptom scores, and negative symptom scores than those with normal cognition（P<0.05）.Pearson's correlation analysis revealed significant positive correlations between digital breadth and sustained operation（r=0.389，P<0.001）,as well as a significant negative correlation between digital breadth and negative symptoms（r=-0.291，P<0.001）.Moreover, continuous manipulation showed a negative correlation with negative symptoms（r=-0.173，P<0.05）.However, no significant correlations were found between the digital breadth conformity score and persistent manipulation or negative symptoms（r=0.148，P>0.05；r=-0.068，P>0.05）. Notably, negative symptoms were identified as a mediator in the relationship between attention and working memory (effect size=0.024). Conclusion: Our findings highlight significant associations between working memory, attention, and negative symptoms in individuals with stable-phase schizophrenia. Moreover, attention not only directly impacts working memory but also indirectly influences it through negative symptoms. Addressing cognitive deficits and negative symptoms in the treatment of schizophrenia may lead to improved overall outcomes for affected individuals.