T105. VERBAL MEMORY MEASUREMENT TOWARDS DIGITAL PERSPECTIVES IN FIRST-EPISODE PSYCHOSIS: A SYSTEMATIC REVIEW STUDY
Authors: Kilciksiz Can , Torous John 
Published: May 2020

Abstract

Background
Psychosis is a clinical syndrome which can have detrimental effects on patients in different aspects of functioning such as thought, behavior, and cognition. Even in early phases psychotic spectrum illnesses like schizophrenia, patients can experience cognitive decline prior to overt classical symptoms like delusions and hallucinations. Early detection and reducing the duration of untreated psychosis through early intervention can prevent or slow the progress of cognitive symptoms and the entire illness. Although cognition research in early psychosis has demonstrated that verbal memory is one the first cognitive domains impacted in first-episode of psychosis and continuously declines after the first-episode, it is still not clear which tests are most widely used to measure verbal memory and which may be most amenable to being translated to a digital format. In this systematic review, we assessed which verbal memory assessments are most widely used in first-episode psychosis and may be potentially applied via digital technologies (smartphone applications, telepsychiatry, chatbots, etc.) for use in early detection in the future.

Methods
From September to November 2019, we searched studies measured verbal memory in first-episode psychosis or schizophrenia over the past 10 years on PubMed and PsycINFO. We screened abstracts of these studies and we excluded review studies and duplicates. We downloaded full-texts of included studies to identify the verbal memory measurement tests used, follow-up frequencies, and sample sizes.

Results
We screened 233 papers and found that 121 original research studies measured verbal memory in first-episode psychosis over the past 10 years. Of these 121 studies, 32(%26) used Rey Auditory Verbal Learning Test (RAVLT), 29(24%) used California Verbal Learning Test (CVLT), 27(22%) used Weschler Memory Scale (WMS), 14(12%) used Hopkins Verbal Learning Test (HVLT), 4(3%) used both WMS and CVLT, 3(2%) used both WMS and RAVLT, and 12(%10) used other tests to measure verbal memory. Four (3%) of these studies specified that they used a computer, 23(20%) used paper-pen, 2(2%) studies used both, and 92(76%) studies did not specify their verbal measurement application tools. Thirty-six (30%) studies had follow-up measurements of verbal memory, while 85(70%) studies had only a single time point verbal memory measurement during the study period. Study sample sizes range from 6 to 498.

Discussion
We found that four main tests to measure verbal memory in first-episode psychosis are RAVLT, CVLT, WMS, and HVLT although they are not often administered via technology. Of these four verbal memory measurement tests, RAVLT is the most widely used and HVLT is easier to administer while CVLT appears able to assess a broader range of verbal memory domains. There is an emerging opportunity to apply RAVLT, CVLT, WMS, and HVLT via digital technologies for expanding access to early detection of cognitive decline in clinical high risk and first-episode psychosis.