Trajectories of premorbid childhood and adolescent functioning in schizophrenia-spectrum psychoses: A first-episode study

Psychiatry Res. 2015 Jun 30;227(2-3):339-46. doi: 10.1016/j.psychres.2015.02.013. Epub 2015 Mar 2.

Abstract

Evidence of social and behavioral problems preceding the onset of schizophrenia-spectrum psychoses is consistent with a neurodevelopmental model of these disorders. Here we predict that individuals with a first episode of schizophrenia-spectrum psychoses will evidence one of three patterns of premorbid adjustment: an early deficit, a deteriorating pattern, or adequate or good social adjustment. Participants were 164 (38% female; 31% black) individuals ages 15-50 with a first episode of schizophrenia-spectrum psychoses. Premorbid adjustment was assessed using the Cannon-Spoor Premorbid Adjustment Scale. We compared the fit of a series of growth mixture models to examine premorbid adjustment trajectories, and found the following 3-class model provided the best fit with: a "stable-poor" adjustment class (54%), a "stable-good" adjustment class (39%), and a "deteriorating" adjustment class (7%). Relative to the "stable-good" class, the "stable-poor" class experienced worse negative symptoms at 1-year follow-up, particularly in the social amotivation domain. This represents the first known growth mixture modeling study to examine premorbid functioning patterns in first-episode schizophrenia-spectrum psychoses. Given that the stable-poor adjustment pattern was most prevalent, detection of social and academic maladjustment as early as childhood may help identify people at increased risk for schizophrenia-spectrum psychoses, potentially increasing feasibility of early interventions.

Keywords: First-episode schizophrenia (FEP); Premorbid adjustment; Psychosis; Schizophrenia-spectrum; Social amotivation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Female
  • Humans
  • Male
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / epidemiology*
  • Schizophrenia / diagnosis
  • Schizophrenia / epidemiology*
  • Schizophrenic Psychology*
  • Social Adjustment