Premorbid adjustment in first-episode non-affective psychosis: Distinct patterns of pre-onset course

Abstract

BackgroundKnowledge about premorbid development in psychosis can shed light upon theories about aetiology and schizophrenic heterogeneity, and form a basis for early detection initiatives.AimsTo identify and validate patterns of premorbid functioning in first-episode psychosis.MethodThe Premorbid Adjustment Scale was used to examine 335 patients.ResultsSocial and academic function constituted fairly independent dimensions. Cluster analysis identified groups varying both in level and course. Patients with a stable social course compared with a deteriorating one had a shorter duration of untreated psychosis, were older, had more friends and less negative symptoms. Good childhood academic function correlated with more education, more meaningful activities and better working memory. Patients with a stable academic course were older at admission.ConclusionsPatterns of premorbid development suggest both neuro-developmental and neuroregressive pathways to illness.