Premorbid functioning of patients with first-episode nonaffective psychosis: A comparison of deterioration in academic and social performance, and clinical correlates of Premorbid Adjustment Scale scores

Background: Motivated by a previous study among male veterans [Allen, D.N., Frantom, L.V, Strauss, G.P., van Kammen, D.P., 2005. Differential patterns of premorbid academic and social deterioration in patients with schizophrenia. Schizophr. Res. 75, 389-397]7 the present analysis examined: (I) patterns of premorbid academic and social funnctioning during childhood, early adolescence, and late adolescence, and (2) associations between these premorbid functioning dimensions and a number of clinical variables. Methods: Data oil premorbid functioning were collected Using the Premorbid Adjustment Scale (PAS) in 95 hospitalized first-episode patients. Analyses were similar to those conducted by Allen and colleagues (2005). Results: Deterioration,vas evident in both academic and social functioning front childhood to early adolescence, along with a pronounced/accelerated deterioration in academic functioning front early adolescence to late adolescence, occurring in both male and female patients. Age at onset of prodromal symptoms was predicted by childhood/carly adolescent/late adolescent academic functioning scores, and age at onset of psychotic symptoms was significantly associated only with childhood academic functioning. Severity of negative symptoms was predicted by childhood and late adolescent social functioning scores, and severity of general psychopathology symptoms was predicted by late adolescent academic functioning, as well as childhood and late adolescent social functioning scores. Conclusions: Consistent with prior findings, deterioration in premorbid Functioning appears to be more pronounced in the academic than social dimension of the PAS. Sonic PAS scores are predictive of ages at onset of prodrome/psychosis and severity of psychotic symptoms. Ongoing research on premorbid adjustment in schizophrenia may have implications for future prevention goals. (C) 2008 Elsevier B.V. All rights reserved.