The relationship of early premorbid adjustment with negative symptoms and cognitive functions in first-episode schizophrenia: A prospective three-year follow-up study
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- 作者：Wing Chung Chang ; Jennifer Yee Man Tang ; Christy Lai Ming Hui ; Gloria Hoi Yan Wong ; Sherry Kit Wa Chan ; Edwin Ho Ming Lee ; Eric Yu Hai Chen
- 关键词：Premorbid adjustment ; First-episode psychosis ; Schizophrenia ; Negative symptoms ; Cognitive functions
- 刊名：Psychiatry Research
- 出版年：2013
- 出版时间：30 October, 2013
- 年：2013
- 卷：209
- 期：3
- 页码：353-360
- 全文大小：239 K
文摘
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.