Patterns of premorbid functioning in first episode psychosis: relationship to 2-year outcome.
OBJECTIVE
To determine how different patterns of premorbid functioning relate to outcome longitudinally.


METHODS
Premorbid adjustment was assessed in 194 first-episode of psychosis subjects. Positive and negative symptoms, depression, substance misuse and social and cognitive functioning were assessed over 2 years.


RESULTS
Four patterns of premorbid adjustment: stable-good, stable-intermediate, poor-deteriorating and deteriorating were identified. Relative to the stable-good group, the deteriorating and poor-deteriorating groups had significantly more positive symptoms at 1-year follow-up but not at 2-year follow-up and significantly more negative symptoms and significantly poorer social functioning at both 1 and 2-years. Only verbal fluency and memory differentiated between the groups with the stable-good group having a superior performance.


CONCLUSIONS
Those who demonstrated poor or deteriorating functioning prior to the onset of acute psychosis have a poorer outcome up to at least 2 years in terms of negative symptoms and social functioning.
Addington
J
J
Department of Psychiatry, University of Toronto, ON, Canada. jean_addinton@camh.net
Addington
D
D
D000293:Adolescent; D000328:Adult; D002648:Child; D016000:Cluster Analysis; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D012720:Severity of Illness Index; D012917:Social Adjustment; D012919:Social Behavior; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome