Declarative memory and WCST-64 performance in subjects with schizophrenia and healthy controls.

The Wisconsin Card Sorting Test (WCST) is a set-switching task used extensively to study impaired executive functioning in schizophrenia. Declarative memory deficits have also been associated with schizophrenia and may affect WCST performance because continued correct responding depends on remembering the outcome of previous responses. This study examined whether performance in visual and verbal declarative memory tasks were associated with WCST performance. Subjects comprised 30 patients with schizophrenia or schizoaffective disorder (SCZ) and 30 demographically matched healthy controls (CON) who were tested on the WCST, the Benton Visual Retention Test (BVRT), the California Verbal Learning Test (CVLT), and the Continuous Performance Test (CPT). SCZ subjects showed significant correlations between visual and verbal declarative memory and performance on the WCST-64 that were in the hypothesized direction such that worse memory performance was associated with worse performance on the WCST. CON subjects did not show a significant relationship between visual or verbal memory and WCST-64 performance. Fisher's r to z transformations indicated that the associations between declarative memory and WCST-64 performance in the SCZ subjects differed significantly from those of CON subjects. The findings suggest that interpretations of WCST-64 scores for subjects with schizophrenia should be considered in light of their declarative memory functioning.

Pain management after Hurricane Katrina: outcomes of veterans enrolled in a New Orleans VA pain management program.

OBJECTIVE: To evaluate Hurricane Katrina's impact on patients with pre-existing chronic pain. Design. Review of literature about Hurricane Katrina and chronic pain or pain management and a qualitative interview of all identified patients enrolled in a behavioral pain management program. SETTING: Southeast Louisiana Veterans Healthcare System, Mental Health Service Line. SUBJECTS: In total, 42 of the 53 (79%) veterans enrolled in a chronic pain program prior to Hurricane Katrina were able to be contacted and evaluated with interviews and a review of their available medical records. OUTCOME MEASURES: Major impediments and facilitative factors in delivering pain management services were identified. CONCLUSIONS: Health care planning for large-scale emergencies must take into the need for prompt continuation of pain management services in patients with chronic pre-existing pain. Coordination between emergency clinics and pain management specialists, as well as the availability of electronic medical records, is an important factor in continuing established pain management services after a regional disaster.