Association of Premorbid Adjustment with Symptom Profile and Quality of Life in First Episode Psychosis in a Tertiary Hospital in Tehran, Iran
Abstract
Objective: Poor premorbid adjustment has been reported to be a predictor of more severe psychotic symptoms and poor quality of life in such psychotic disorders as schizophrenia. However, most studies were performed on chronic schizophrenic patients, and proposed the likelihood of recall biases and the effect of chronicity. The aim of this study was to investigate these factors in a sample of first episode psychotic patients, as a part of Roozbeh first episode psychosis project (RooF).
Method: Premorbid adjustment was assessed using Premorbid Adjustment Scale (PAS) in 48 patients with the first psychotic episode who were admitted to Roozbeh Psychiatric Hospital. The severity of symptoms was measured using Positive and Negative Scale (PANSS) in three subgroups of positive, negative and general subscales. Quality of life was measured using WHO QOL ,and Global Assessment of Functioning (GAF) was also measured.
Results: The mean age was 24 years. Poor Premorbid adjustment in late adolescence was significantly associated with more severe symptoms according to PANSS negative symptoms (p=0.019, r=0.44). Furthermore, sociability and peer relationship domains had a positive correlation with PANSS negative subscale scores (r=0.531, p=0.002 and r=0.385, p=0.03, respectively). There were no significant differences between males and females in premorbid adjustment. Furthermore, this study failed to show any differences between affective and non-affective psychosis in premorbid functioning.
Conclusion: Our study confirms poor premorbid adjustment association with more severe negative symptoms and poor quality of life in a sample of Iranian first episode psychotic patients.
Haim R, Rabinnowitz J, Bromet E. The relationship of premorbid functioning to illness course in schizophrenia and psychotic mood disorders during two years following first hospitalization. J Nerv Ment Dis 2006; 194: 791-795.
Schmael C, Georgi A, Krumm B, Buerger C, Deschner M, Nothen MM, et al. Premorbid adjustment in schizophrenia- an important aspect of phenotype definition. Schizophr Res 2007; 92: 50-62.
Rabinowitz J, De Smedt G, Harvey PD, Davidson M. Relationship between premorbid functioning and symptom severity as assessed at first episode of psychosis. Am J Psychiatry 2002; 159: 2021-2026
Torgalsboen AK. Full recovery from schizophrenia: the prognostic role of premorbid adjustment, symptoms at first admission, precipitating events and gender. Psychiatry Res 1999; 88: 143-152.
Addington J, Addington D. Patterns of premorbid functioning in first episode psychosis: relationship to 2-year outcome. Acta Psychiatr Scand 2005; 112: 40-46.
Addington J, van Mastrigt S, Addington D. Patterns of premorbid functioning in first episode psychosis: initial presentation. Schizophr Res 2003; 62: 23-30.
Allen DN, Kelley ME, Miyatake RK, Gurklis JA Jr, Kammen DP. Confirmation of a two-factor model of premorbid adjustment in males with aschizophrenia. Schizophr Bull 2001; 27:39- 46.
Strous RD, Alvir JM, Robinson D, Gal G, Sheitman B, Chakos M, et al. Premorbid functioning in schizophrenia: Relation to baseline symptoms, treatment response, and medication side effects. Schizophr Bull 2004; 30:265-278.
Rabinowitz J, Levine S, Brill N, Bromet E. The Premorbid Adjustment Scale Structured Interview (PAS-SI): Preliminary findings. Schizophr Res 2007; 90: 255-257.
Cannon-Spoor HE, Potkin SG, Wyatt RJ. Measurment of premorbid adjustment in chronic schizophrenia. Schizophr Bull 1982; 8: 470-484.
Silverstein ML, Mavrolefteros G, Close D. Premorbid adjustment and neuropsychological performance in schizophrenia. Schizophr Bull 2002; 28: 157-165.
Norman RM, Malla AK, Manchanda R, Townsend L. Premorbid adjustment in first episode schizophrenia and schizoaffective disorders: a comparison of social and academic domains. Acta Psychiatr Scand 2005; 112:30-39.
MacBeth A, Gumley A. Premorbid adjustment, symptom development and quality of life in first episode psychosis: a systematic review and critical reappraisal. Acta Psychiatr Scand 2008; 117:85-99.
Kelly ME, Gilbertson M, Mouton A, Van Kammen DP. Deterioration in premorbid functioning in schizophrenia: a developmental model of negative symptoms in drug-free patients. Am J Psychiatry 1992; 149: 1543- 1548.
Amminger GP, Resch F, Mutschlechner R, Fredrich MH, Ernst E. Premorbid adjustment and remission of positive symptoms in first episode psychosis. Eur Child Adolesc Psychiatry 1997; 6: 212-218.
Vyas NS, Hadjulis M, Vourdas A, Byrne P, Frangou S. The Maudsley early onset schizophrenia study. Predictors of psychosocial outcome at 4-year follow-up. Eur Child Adolesc Psychiatry 2007; 16: 465-470 .
Yamazawa R, Nemoto T, Kobayashi H, Chino B, Kashima H, Mizuno M. Association between duration of untreated psychosis, premorbid functioning, and cognitive performance and the outcome of first episode schizophrenia in Japanese patients: prospective study. Aust N Z J Psychiatry 2008; 42: 159-165.
Simonsen E, Friis S, Haahr U, Johannessen JO, Larsen TK, Melle I, et al. Clinical epidemiologic first episode psychosis: 1-year outcome and predictors. Acta Psychiatr Scand 2007; 116:54-61.
Malmberg A, Lewis G, David A, Allebeck P. Premorbid adjustment and personality in people with schizophrenia. Br J Psychiatry 1998; 172: 308-313.
Files | ||
Issue | Vol 5 No 1 (2010) | |
Section | Articles | |
Keywords | ||
Psychological adaptation Psychotic disorders Quality of Life Recovery of function Symptoms |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |