Premorbid adjustment in first-episode non-affective psychosis: distinct patterns of pre-onset course.
BACKGROUND
Knowledge about premorbid development in psychosis can shed light upon theories about aetiology and schizophrenic heterogeneity, and form a basis for early detection initiatives.


OBJECTIVE
To identify and validate patterns of premorbid functioning in first-episode psychosis.


METHODS
The Premorbid Adjustment Scale was used to examine 335 patients.


RESULTS
Social 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.


CONCLUSIONS
Patterns of premorbid development suggest both neurodevelopmental and neuroregressive pathways to illness.
Larsen
Tor K
TK
Psychiatric Clinic, Armauer Hansensv. 20, PO Box 8100, N-4068 Stavanger, Norway. tklarsen@online.no
Friis
Svein
S
Haahr
Ulrik
U
Johannessen
Jan Olav
JO
Melle
Ingrid
I
Opjordsmoen
Stein
S
Rund
Bjørn Rishovd
BR
Simonsen
Erik
E
Vaglum
Per Vaglum
PV
McGlashan
Thomas H
TH
D000223:Adaptation, Psychological; D000328:Adult; D016000:Cluster Analysis; D004522:Educational Status; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000523:psychology*; D012917:Social Adjustment