¹Dokkyo Medical University School of Medicine, Department of Psychiatry, Mibu, Japan, ²Gifu University Graduate School of Medicine, Department of Psychiatry, Gifu, Japan, ³National Institute of Mental Health, National Center of Neurology and Psychiatry, Department of Pathology of Mental Diseases, Tokyo, Japan, ⁴Medical Corporation Foster, Life Grow Brilliant Mental Clinic, Osaka, Japan, ⁵Osaka University, Graduate School of Medicine, Department of Psychiatry, Osaka, Japan, ⁶Japan Community Health Care Organization Osaka Hospital, Department of Psychiatry, Osaka, Japan, ⁷School of Medicine, Iwate Medical University, Department of Neuropsychiatry, Iwate, Japan, ⁸The Jikei University School of Medicine, Department of Psychiatry, Tokyo, Japan

Background: Memory function impairment is severe in patients with schizophrenia, but improving memory function remains challenging. The use of benzodiazepines and anticholinergics, which are not recommended by pharmacological therapy guidelines for schizophrenia, has been associated with worsened cognitive function. However, it remains unclear whether better adherence by psychiatrists to pharmacological therapy guidelines for schizophrenia is associated with improved memory function.

Aims & Objectives: We aimed to investigate the relationship between psychiatrists’ adherence and memory function in patients with schizophrenia.

Method: To evaluate the associations between psychiatrists’ adherence to pharmacological therapy guidelines and memory function, we utilized the Individual Fitness Score (IFS), which includes multiple quality indicators, to assess each psychiatrist’s adherence to these guidelines in treating each patient. Memory function was measured using the Wechsler Memory Scale-Revised in a total of 351 patients, including 40 patients with treatment-resistant schizophrenia (TRS) and 311 patients with non-TRS.

Results: We found that psychiatrist adherence was significantly positively correlated with verbal memory (β = 0.145, p =6.45 ×10^-3), attention/concentration (β =0.138, p =0.010), and delayed recall (β =0.167, p =1.57 ×10^-3) in all patients with schizophrenia. Additionally, a nominal positive correlation was observed with visual memory (β =0.124, p =0.019). In non-TRS patients, the adherence of psychiatrists was significantly positively correlated with delayed recall (β =0.166, p =3.17 ×10-3) and nominally positively correlated with verbal memory (β =0.141, p =0.013) and attention/concentration (β =0.114, p =0.044) functions. In contrast, no significant associations were observed between the psychiatrists’ adherence and any memory functions in patients with TRS.

Discussion & Conclusions: These findings suggest that enhancing guideline education for psychiatrists might improve cognitive impairments in patients with schizophrenia.