Verbal Fluency in Male and Female Schizophrenia Patients: Different Patterns of Association With Processing Speed, Working Memory Span, and Clinical Symptoms

Objective: Decreased processing speed in schizophrenia patients has been identified as a major impairment factor in various neuropsychological domains. Working memory span has been found to be involved in several deep or effortful cognitive processes. We investigated the impact that these 2 cognitive functions may have on phonological and semantic fluency in schizophrenia patients and healthy participants. Method: Fifty-five patients with schizophrenia and 60 healthy participants were administered a neuropsychological battery including phonological and semantic fluency, working memory, and cognitive and motor speed. Results: Regression analyses revealed that motor speed was related to phonological fluency in female patients, whereas cognitive speed was related to semantic fluency in male patients. In addition, working memory span was related to verbal fluency in women from both the patient and the healthy control groups. Decreased processing speed, but not decreased working memory span, accounted for the verbal fluency deficit in patients. Verbal fluency was inversely related to attention deficit in female patients and to negative symptoms in male patients. Conclusions: Decreased processing speed may be the main factor in verbal fluency impairment of patients. Further, the cognitive and clinical predictors of verbal fluency efficiency are different in men and women.