Cognitive Asymmetry Patterns in Schizophrenia: Active and Withdrawn Syndromes and Sex Differences as Moderators

Recognition memory for words and faces was examined in male and female schizophrenia patients for evidence of associations between putative left-right hemisphere asymmetry patterns and active (positive) versus withdrawn (negative) syndromes. Ninety-five normal controls and 104 schizophrenia patients with active, withdrawn, and mixed syndromes or in symptom remission were examined, including an unmedicated subgroup. Memory was poorer in patients than controls, while the remitted group had superior memory to psychotic patients. Active and withdrawn patients showed the hypothesized syndrome-dependent cognitive asymmetries: active (word > faces); withdrawn (faces > words), except active females who showed a word deficit. The results support selective lateralized temporoparietal impairment of either hemisphere in schizophrenia, with laterality related to active (face memory/right-sided impairment) and withdrawn (word memory/left-sided impairment) syndromes, except active syndrome females. These syndrome-related asymmetries moderated the sexually dimorphic asymmetries found in normal subjects. Consideration of individual differences both in sex and syndromes based on activity and withdrawal, and of left and right hemisphere memory modality, may assist in unraveling heterogeneity in schizophrenic cognition. The superior memory of recovered patients indicates that some memory impairment in schizophrenia is functional.