Impairments in memory functions are among the most robust correlates of schizophrenia and of poor functional outcomes in individuals with psychotic disorders. Prospective, longitudinal studies are crucial to determining the meaning of these deficits in relation to mechanisms associated with the onset and course of these disorders.

The objective of this review is to examine the literature concerning premorbid memory impairments during the prodromal phase of psychosis to address three primary questions 1) are memory impairments present among individuals with a clinical high risk syndrome? 2) are memory deficits in clinical high risk cases predictive of future conversion to psychosis? and 3) what are the underlying neural correlates of memory impairment in clinical high risk individuals and are they also predictive of future conversion?

PubMed and Google Scholar databases were systematically searched. The primary inclusion criteria were to select studies that 1) were original research articles published in a peer-reviewed journal in the past 25 years, 2) studied subjects at clinical high risk for psychosis or in the prodromal phase of illness, and 3) included examinations into verbal memory performance in those at clinical high risk for psychosis.

64 articles were identified and screened for eligibility. The review included 34 studies investigating verbal memory impairment in clinical high risk individuals compared to controls. The average effect size of verbal learning total recall was .58, indicating a moderate level of impairment in verbal learning among individuals at clinical high risk for psychosis as compared to healthy controls. Of studies that predicted time to conversion, indices of memory, particularly declarative and verbal working memory, were especially predictive of future conversion. Finally, when examining investigations of the neural correlates of memory dysfunction in the clinical high risk state, findings suggest altered activation and functional connectivity among medial temporal lobe regions may underlie differences in memory performance between clinical high risk individuals and healthy controls.

Findings to date strongly indicate that memory impairments are present during the premorbid phase of psychosis and that verbal memory impairment in particular is predictive of future conversion to psychosis. Evidence from fMRI studies is fairly consistent in showing greater activation of memory-related regions during retrieval among clinical high risk cases who convert, with less consistent evidence of altered functional connectivity in the encoding phase. These findings support the use of verbal learning and memory measures in the psychosis prediction and prevention field.

记忆功能受损是精神分裂症和精神病患者功能不良的最有力相关因素之一。前瞻性纵向研究对于确定与这些疾病的发病和病程相关的机制相关的这些缺陷的含义至关重要。

本综述的目的是检查有关精神病前驱期病前记忆障碍的文献，以解决三个主要问题 1) 临床高危综合征患者是否存在记忆障碍？2) 临床高危病例中的记忆缺陷是否预示着未来会转变为精神病？3) 临床高危个体记忆障碍的潜在神经关联是什么，它们是否也能预测未来的转变？

系统地搜索了 PubMed 和 Google Scholar 数据库。主要纳入标准是选择以下研究：1) 是过去 25 年发表在同行评审期刊上的原创研究文章，2) 研究的受试者具有临床精神病高风险或处于疾病的前驱期，以及 3) 包括精神病临床高危人群的言语记忆能力检查。

确定并筛选了 64 篇文章的资格。该评价包括 34 项研究，调查临床高风险个体与对照组相比的语言记忆障碍。言语学习总回忆的平均效应大小为 0.58，表明与健康对照相比，具有精神病临床高风险的个体在言语学习方面存在中等程度的损害。在预测转换时间的研究中，记忆指数，特别是陈述性和语言工作记忆，尤其能预测未来的转换。最后，在检查临床高危状态下记忆功能障碍的神经相关性研究时，

迄今为止的研究结果有力地表明，在精神病的病前阶段存在记忆障碍，特别是语言记忆障碍是未来转变为精神病的预测。来自 fMRI 研究的证据相当一致地表明，在转换的临床高风险病例中，在检索过程中记忆相关区域的激活更大，而编码阶段功能连接改变的证据则不太一致。这些发现支持在精神病预测和预防领域使用语言学习和记忆措施。