Association of Premorbid Adjustment with Symptom Profile and Quality of Life in First Episode Psychosis in a Tertiary Hospital in Tehran, Iran

By Mahmoodi-Gharaei, Javad; Basirnia, Anahita et al. | Iranian Journal of Psychiatry, Winter 2010 | Go to article overview

Association of Premorbid Adjustment with Symptom Profile and Quality of Life in First Episode Psychosis in a Tertiary Hospital in Tehran, Iran


Mahmoodi-Gharaei, Javad, Basirnia, Anahita, Abedi, Neda, Shadloo, Behrang, Jafari, Sara, Salesian, Niloofar, Djalali, Mohsen, Sharifi, Vandad, Iranian Journal of Psychiatry


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.

Keywords: Psychological adaptation, Psychotic disorders, Symptoms, Quality of Life, Recovery of function

Iran J Psychiatry 2010; 5:23-27

Premorbid psychosocial adjustment has attracted great attention in studies that tried to find factors associated with different clinical course and outcome of patients who were affected by schizophrenia. Kraepelin and Bleuler were the first to note that there are certain social and intellectual impairment in schizophrenic patients long prior to the onset of the psychotic symptoms (1, 2). Since then there has been extensive evidence that poor childhood and adolescent psychosocial adjustment is manifested in many, but not all, patients with schizophrenia (3).

Premorbid adjustment is defined as the ability of a person to make social and intimate relationships as well as their academic achievements before the onset of psychotic symptoms (4). Poor premorbid functioning has been reported to have positive correlation with early and insidious onset, male sex, poor clinical outcome, negative symptoms, neurocognitive deficits, and poor response to treatment (2, 5-7). Poor premorbid functioning has also been reported to be the strongest overall predictor of outcome (4).

Premorbid psychosocial adjustment proposed neurodevelopmental nature of schizophrenia (7). Some studies suggested that schizophrenic patients with poor premorbid adjustment may represent a special biological subtype of the disorder by some characteristics such as early age of onset, negative symptoms, and poor response to treatment. Data proposed that poor premorbid adjustment reflects the impact of schizophrenia susceptibility genes and might be considered as an intermediate phenotype marker of schizophrenia (2).

Many studies investigated the relationship between premorbid functioning and different aspects of schizophrenia on a sample of chronic schizophrenic patients with a long period of years passed from their illness onset. Gathering information after such a long time increased the likelihood of potential bias and therefore the data became inaccurate and incomplete (8). Thus, it is not yet clear whether the reported association of poor premorbid with poor response to treatment or negative signs is a real association. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Association of Premorbid Adjustment with Symptom Profile and Quality of Life in First Episode Psychosis in a Tertiary Hospital in Tehran, Iran
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.