Premorbid academic and social functioning in patients with schizophrenia and its associations with negative symptoms and cognition (original) (raw)
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Differential patterns of premorbid academic and social deterioration in patients with schizophrenia
Schizophrenia Research, 2005
Schizophrenia is a neurodevelopmental disorder that is characterized by a number of behavioral abnormalities that are present prior to onset. These premorbid abnormalities may serve as unique markers for the disorder. The current study examines academic and social functioning prior to schizophrenia onset in a group of 58 males diagnosed with schizophrenia. The pattern of deterioration for social and academic functioning was examined across three age periods including childhood, early adolescence, and late adolescence, using the retrospective Premorbid Adjustment Scale (PAS). Results indicated that while increasing deterioration was present for both social and academic adjustment across age periods, there was a significant difference in deterioration between academic and social functioning ( pb.05) during late adolescence, with greater deterioration in academic functioning. Results of the current study suggest that premorbid academic functioning is particularly susceptible to deterioration during late adolescence, with accelerating deterioration as schizophrenia onset becomes imminent. When considered together with results from other studies, the present findings suggest that deterioration in premorbid academic functioning from early to late adolescence may be a unique premorbid marker for schizophrenia. D
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.
Biological Psychiatry, 1998
The purpose of this study was to examine the association of educational attainment with phenomenology and neurobehavioral measures assessing brain structure and function in schizophrenia. One hundred sixty-two patients with schizophrenia were divided into two groups on the basis of educational attainment: > or = 13 years of education was the cutoff between the high and low groups. The two education groups were compared on symptomatology, functioning, and subsamples on neuropsychological profile, brain volume by magnetic resonance imaging, and brain metabolism by fluorodeoxyglucose positron-emission tomography. The patients with more education had lower levels of psychotic symptomatology than their counterparts with less education. This was most evident for affective flattening, alogia, avolition, and bizarre behavior. The higher education group also had better ratings on premorbid adjustment, and the engagement and vocational factors of the Quality of Life Scale. Patients in the high education group also performed better on the neuropsychological battery. There were no brain volume differences or differences in brain metabolism between the two education groups. Education is an important indicator of premorbid function and is related to the clinical presentation 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.
Symptoms, cognitive and social functioning in recent-onset schizophrenia: A longitudinal study
Schizophrenia Research, 1996
The relationships among symptoms, cognitive functioning and social functioning were investigated in patients with schizophrenia over a period of 15 months. Patients with a mood disorder, a normal control group and a sample of parents of the schizophrenic patients also completed the cognitive tests. In the schizophrenia sample, only disorganisation was correlated with cognitive performance, which was interpreted as further evidence that disorganisation is a separate symptom dimension of schizophrenia. Against expectations, with two of three measurements no significant correlations were found between negative symptoms and cognitive performance. With these two measurements, however, a curvilinear association between negative symptoms and cognitive performance was observed, suggesting that negative symptoms are not a unitary concept. Finally, tentative evidence could be obtained for speed of information processing and selective attention as markers for vulnerability, although the latter is not specific for 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.
Schizophrenia Research, 2007
Introduction: Approximately one third of schizophrenia patients show partial or no response to pharmacotherapy. Despite intensive investigations, the phenomenological and biological characteristics of such patients are far from elucidated. This study examined the premorbid behavioral and intellectual functioning of schizophrenia patients who showed poor response to antipsychotic treatment. Method: One hundred twenty-nine schizophrenia patients who showed poor response to treatment were ascertained from a national register and matched by gender, age and education to 129 patients who showed adequate response. The groups were compared on premorbid measures of behavioral and intellectual functions. Results: As a group, treatment-resistant male patients had significantly lower (worse) social functioning [p = 0.002], and individual autonomy [p b 0.0001] scores before the onset of the illness compared to treatment non-resistant patients. Male and female treatment-resistant patients did not differ from non-resistant patients in premorbid intellectual functioning [p N 0.1]. Conclusions: Low premorbid social functioning and individual autonomy, but not intellectual functioning, could serve as predictors of poor treatment response in schizophrenia.
Schizophrenia Research: Cognition, 2015
Neurocognitive dysfunction is common in schizophrenia but its course and determinants remain uncertain. Our aim was to analyse if premorbid school performance and the severity of illness and functioning predict change in cognition in schizophrenia in a general population sample. The sample included cases with schizophrenia spectrum disorder from the Northern Finland Birth Cohort 1966. Data on school marks at the age of 16 years, educational level at the age of 34 years, severity of symptoms and occupational functioning around first episode and after years of illness were gained from national registers, hospital notes and interviews. Change of verbal and visual learning and memory and executive functioning were examined between ages 34 and 43 years. The number of cases varied in analyses from 29 to 41, depending on missing data in particular cognitive tests. Lower school marks at age 16 years and lower education at age 34 years predicted more decline of cognition. Measures of severity of illness or functioning were not associated statistically significantly with change of cognition. Premorbid school performance, but not later course of schizophrenia, related to change of cognition in midlife. Poor premorbid scholastic performance and post-onset cognitive decline may represent related processes as part of an endophenotype of schizophrenia.
Premorbid adjustment in schizophrenia and schizoaffective disorder
Psychiatry research, 2009
There is evidence that premorbid adjustment can differentiate schizophrenia from schizoaffective disorder. We recruited 41 patients with schizophrenia and 24 patients with schizoaffective disorder without substance abuse 6 months before the assessment. Diagnoses were based on the Structured Clinical Interview for DSM-IV. Psychotic symptoms were rated with the Positive and Negative Syndrome Scale, the Calgary Depression Scale was used to assess depressive symptoms, and the Global Assessment of Functioning Scale was used to rate global psychosocial functioning. Premorbid adjustment was evaluated with the Premorbid Adjustment Scale. Patients with schizophrenia showed worse premorbid adjustment compared with the patients with schizoaffective disorder. The areas of "peer relationships" and "scholastic performance" showed deficits in schizophrenia. Significant associations were found between premorbid adjustment life periods and symptom severity in both groups. Differences found between groups may be related to an earlier illness onset in the schizophrenic group. Premorbid adjustment may be a useful clinical feature to differentiate schizoaffective disorder from schizophrenia.