Premorbid social functioning in schizophrenia and bipolar disorder: similarities and differences (original) (raw)
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IOSR Journals , 2019
Objective of the study was to compare the premorbid social adjustment in patients with schizophrenia, bipolar affective disorder and healthy controls. Method: Maternal recall was used to assess the premorbid adjustment of patient with schizophrenia, bipolar affective disorder recruited from a survey of consecutive hospital admission for schizophrenia, bipolar affective disorder and healthy controls drawn from same catchment area. Results: In the study there was significant difference in poor social functioning in childhood and adult psychosis. Conclusion: The results of the study showed there was significant difference in premorbid sociability, and school functioning between patients with schizophrenia, bipolar patients exhibited poorer social impairment though to a lesser degree than subjects with schizophrenia.
Premorbid Social Functioning in Schizophrenia and Healthy Controls – A Comparative Study
Objective of the study is to compare the premorbid social adjustment in patients with schizophrenia and healthy controls. Method: Maternal recall was used to assess the premorbid adjustment of patients with schizophrenia recruited from a survey of consecutive hospital admission for schizophrenia and healthy controls drawn from the same catchment area. Results: In the study there is significant difference in premorbid sociability and school functioning between subject with schizophrenia and healthy controls. These results are comparable to the previous studies on premorbid functioning in schizophrenia. Conclusion: The results of this study showed the association between poor social functioning in childhood and adult schizophrenia. In our study there is significant difference in premorbid sociability and school functioning between subjects with schizophrenia and healthy controls.
Childhood antecedents of schizophrenia and affective illness: social adjustment at ages 7 and 11
Bmj, 1994
Objective : To investigate the social adjustment in childhood of people who as adults have psychiatric disorders. Design-Subjects in a prospectively followed up cohort (the national child development study) who had been admitted as adults to psychiatric hospitals were compared with the rest of the cohort on ratings of social behaviour made by teachers at the ages of 7 and 11 years. Subjects : 40 adult patients with schizophrenic illnesses, 35 with affective psychoses, and 79 with neurotic illness who had been admitted for psychiatric reasons by the age of 28. 1914 randomly selected members of the cohort who had never been admitted for psychiatric treatment. Main outcome measures : Overall scores and scores for overreaction (externalising behaviour) and underreaction (internalising behaviour) with the Bristol social adjustment guide at ages 7 and 11. Results : At the age of 7 children who developed schizophrenia were rated by their teachers as manifesting more social maladjustment than controls (overall score 4.3 (SD 2.4) v 3.1 (2.0); P <0.01). This was more apparent in the boys (5 (2.6)) than the girls underreactive behaviour. At both ages prepsychotic (affective) children differed little from normal controls. By the age of 11 preneurotic children, particularly the girls, had an increased rating of maladjustment (including overreactions and underreactions). Conclusion : Abnormalities of social adjustment are detectable in childhood in some people who develop psychotic illness. Sex and the rate of development of different components of the capacity for social interaction are important determinants of the risk of psychosis and other psychiatric disorders in adulthood. Clinical implications Clinical implications Maladjusted social behaviour in some children could be an early sign of psychotic illness in adulthood Overreactivity that can be detected by teachers-that is, anxiety for acceptance, hostility, and inconsequential behaviour-is uncommon in 7 and 11 year old boys in general but was common at these ages in those who developed schizophrenia in adult life Girls who developed schizophrenia did not behave abnormally at the age of 7 but had become noticeably withdrawn (rather than overreactive) by the age of 11 The rate of development of the capacity for social interaction may be important in determining the risk of psychosis and other psychiatric disorder in adulthood.
Schizophrenia Research, 2012
Numerous studies indicate that social dysfunction is associated with negative symptoms of schizophrenia during the chronic phase of illness. However, it is unclear whether social abnormalities exist during the premorbid phase in people who later develop schizophrenia with prominent negative symptoms, or whether social functioning becomes progressively worse in these individuals from childhood to late adolescence. The current study examined differences in academic and social premorbid functioning in people with schizophrenia meeting criteria for deficit (i.e., primary and enduring negative symptoms) (DS: n=74) and non-deficit forms of schizophrenia (ND: n=271). Premorbid social and academic functioning was assessed for childhood, early adolescence, and late adolescence developmental periods on the Premorbid Adjustment Scale (PAS). Results indicated that both DS and ND participants showed deterioration in social and academic functioning from childhood to late adolescence. However, while ND schizophrenia demonstrated greater deterioration of academic compared to social premorbid functioning from childhood to late adolescence, the DS group exhibited comparable deterioration across both premorbid domains, with more severe social deterioration than the ND group. Findings suggest that people with DS show poorer social premorbid adjustment than those with ND as early as childhood, and are particularly susceptible to accelerated deterioration as the onset of schizophrenia becomes imminent. Thus, poor premorbid social adjustment and significant social deterioration from childhood to adolescence may be a hallmark feature of people who later go on to develop prominent negative symptoms and a unique marker for the DS subtype of schizophrenia.
Schizophrenia Research, 2013
The assessment of premorbid adjustment in schizophrenia has received considerable attention because of models suggesting that schizophrenia is a neurodevelopmental disorder characterized by abnormalities in functioning prior to onset of the disorder. Some studies suggest that premorbid adjustment is best viewed as a multidimensional construct where different areas of functioning might be differentially impacted by the illness and sex. The current study examined these matters using of Premorbid Adjustment Scale (PAS) in a sample of 421 individuals with schizophrenia. Confirmatory factory analyses conducted for three developmental periods (childhood, early adolescence, late adolescence) and for males and females separately, indicated that the PAS consists of academic and social factors that are invariant across developmental period and sex. However, differences in severity of academic and social premorbid impairment were present between males and females across developmental periods. Findings suggest important differences between males and females in the course of premorbid deterioration prior to onset of schizophrenia.
Psychiatry Research, 2015
Evidence of social and behavioral problems preceding the onset of schizophrenia-spectrum psychoses is consistent with a neurodevelopmental model of these disorders. Here we predict that individuals with a first episode of schizophrenia-spectrum psychoses will evidence one of three patterns of premorbid adjustment: an early deficit, a deteriorating pattern, or adequate or good social adjustment. Participants were 164 (38% female; 31% black) individuals ages 15-50 with a first episode of schizophrenia-spectrum psychoses. Premorbid adjustment was assessed using the Cannon-Spoor Premorbid Adjustment Scale. We compared the fit of a series of growth mixture models to examine premorbid adjustment trajectories, and found the following 3-class model provided the best fit with: a "stable-poor" adjustment class (54%), a "stable-good" adjustment class (39%), and a "deteriorating" adjustment class (7%). Relative to the "stable-good" class, the "stable-poor" class experienced worse negative symptoms at 1-year follow-up, particularly in the social amotivation domain. This represents the first known growth mixture modeling study to examine premorbid functioning patterns in first-episode schizophreniaspectrum psychoses. Given that the stable-poor adjustment pattern was most prevalent, detection of social and academic maladjustment as early as childhood may help identify people at increased risk for schizophrenia-spectrum psychoses, potentially increasing feasibility of early interventions.
Schizophrenia research, 2012
Individuals with schizophrenia have significant deficits in premorbid social and academic adjustment compared to individuals with non-psychotic diagnoses. However, it is unclear how severity and developmental trajectory of premorbid maladjustment compare across psychotic disorders. This study examined the association between premorbid functioning (in childhood, early adolescence, and late adolescence) and psychotic disorder diagnosis in a first-episode sample of 105 individuals: schizophrenia (n=68), schizoaffective disorder (n=22), and mood disorder with psychotic features (n=15). Social and academic maladjustment was assessed using the Cannon-Spoor Premorbid Adjustment Scale. Worse social functioning in late adolescence was associated with higher odds of schizophrenia compared to odds of either schizoaffective disorder or mood disorder with psychotic features, independently of child and early adolescent maladjustment. Greater social dysfunction in childhood was associated with hig...
Social functioning in young people at risk for schizophrenia
Psychiatry Research, 2007
Deficits in social functioning are potential risk factors for schizophrenia. Social functioning was assessed in 55 individuals "at risk" for schizophrenia, 16 first episode patients with schizophrenia and 45 normal comparison subjects. The Social Adjustment Inventory for Children and Adolescents (SAICA) was administered to adolescents <18 and the Social Adjustment Scale (SAS-SR) to young adults >17. The at risk and first episode groups significantly differed from the normal subjects on measures of social functioning in the domains of peer, family, work and school relationships. Individuals at risk for schizophrenia have significant functional deficits which may be potential indicators of increased vulnerability for psychosis.
Adult Outcome of Social Function in Adolescent-Onset Schizophrenia and Affective Psychosis
Journal of the American Academy of Child & Adolescent Psychiatry, 2003
Objective: To examine and compare the adult outcome in a representative sample of hospitalized adolescent-onset psychoses including occupational and social aspects. Method: A total of 81 patients with a first episode of early-onset psychosis (before age 19 years) presenting to the University Hospital of Lund, Sweden, between 1982 and 1993 were followed up an average of 10.5 years (range 5.1-18.2) after admission. Initial diagnosis was assessed from records and consisted of DSM-IV schizophrenia (n = 32), schizoaffective disorder (n = 7), bipolar disorder (n = 25), and major depressive disorder with psychotic features (n = 17). All could be traced and assigned a major outcome group. Results: Earlyonset schizophrenia spectrum disorder suffered a chronic course with a poor outcome in 79% of the cases, while early-onset affective psychosis in 74% showed a good or intermediate outcome. The poor outcome (26%) in the affective group was connected to mental retardation in 7% and to progression to a schizoaffective disorder in 12%. A particularly severe outcome was seen for schizophrenia spectrum patients with a family history of nonaffective psychosis. Conclusions: Early-onset schizophrenia spectrum disorder showed a severe course while affective psychoses had a much more benign functional outcome.