title: The relationship of early premorbid adjustment with negative symptoms and cognitive functions in first-episode schizophrenia: a prospective three-year follow-up study.
abstract: Premorbid adjustment is an important prognostic factor of schizophrenia. The relationships between sub-components of premorbid adjustment and outcomes on symptoms and cognition in first-episode schizophrenia were under-studied. In the current study, we prospectively followed up 93 patients aged 18-55 years presenting with first-episode schizophrenia-spectrum disorder. Psychopathological and cognitive assessments were conducted at baseline, clinical stabilization, 12, 24 and 36 months. Premorbid adjustment was sub-divided into discrete functional domains, developmental stages and premorbid-course types based on ratings of the Premorbid Adjustment Scale (PAS). The study focused on early developmental stages to minimize contamination by prodromal symptoms. Results indicated that gender differences in premorbid functioning were primarily related to early-adolescence adjustment and academic domain. Social domain was more strongly related to negative symptoms, while academic domain was more consistently linked to cognitive outcome (Wisconsin Card Sorting test and verbal fluency). Patients with stable-poor premorbid course had more severe negative symptoms and cognitive impairment. In conclusion, in a Chinese cohort of first-episode schizophrenia-spectrum disorder, sub-components of early premorbid adjustment were shown to be differentially related to clinical and cognitive measures. The results highlighted the importance of applying a more refined delineation of premorbid functioning in studying illness outcome.
authors.affiliation: Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong. Electronic address: changwc@hku.hk.
authors.forename: Wing Chung
authors.initials: WC
authors.lastname: Chang
authors.forename: Jennifer Yee Man
authors.initials: JY
authors.lastname: Tang
authors.forename: Christy Lai Ming
authors.initials: CL
authors.lastname: Hui
authors.forename: Gloria Hoi Yan
authors.initials: GH
authors.lastname: Wong
authors.forename: Sherry Kit Wa
authors.initials: SK
authors.lastname: Chan
authors.forename: Edwin Ho Ming
authors.initials: EH
authors.lastname: Lee
authors.forename: Eric Yu Hai
authors.initials: EY
authors.lastname: Chen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D055815:Young Adult
keywords: Cognitive functions; First-episode psychosis; Negative symptoms; Premorbid adjustment; Schizophrenia