Patterns of Premorbid Functioning in Individuals at Clinical High Risk of Psychosis

Overview

Journal Schizophr Res

Specialty Psychiatry

Date 2015 Nov 22

PMID 26589390

Citations 12

Authors

Kristina Lyngberg

Lisa Buchy

Lu Liu

Diana Perkins

Scott Woods

Jean Addington

Affiliations

Soon will be listed here.

Abstract

In schizophrenia, four typical patterns of premorbid functioning have been observed: stable-good, stable-intermediate, poor-deteriorating and deteriorating. However, it is unknown whether similar patterns exist in those who are at clinical high risk (CHR) of psychosis. The aim of this study was to examine patterns of premorbid functioning in a large sample of individuals at CHR of psychosis and its association with symptoms, functioning, and conversion to psychosis. One-hundred sixty people at CHR of psychosis were assessed on premorbid functioning using the Premorbid Adjustment Scale. Poorer premorbid functioning was significantly correlated with worse negative symptom severity and lower social functioning. Cluster analysis was used to identify patterns of premorbid functioning. Results indicated three patterns of premorbid functioning in our CHR sample: stable-intermediate, stable-good, and deteriorating. The deteriorating group had more severe disorganization, worse negative symptoms, and poorer social functioning than the other groups. Participants who made the conversion to psychosis had significantly poorer premorbid functioning during adolescence compared to those who did not convert. These results suggest that those at a clinical high risk for psychosis display similar patterns in premorbid functioning as have been observed in those with a psychotic illness and that poor premorbid functioning may be a predictor of psychosis.

Citing Articles

Longitudinal Trajectories of Premorbid Social and Academic Adjustment in Youth at Clinical High Risk for Psychosis: Implications for Conversion.

Cowan H, Mittal V, Addington J, Bearden C, Cadenhead K, Cornblatt B Schizophr Bull. 2024; 51(1):54-66.

PMID: 38706103 PMC: 11661946. DOI: 10.1093/schbul/sbae050.

GDNF and miRNA-29a as biomarkers in the first episode of psychosis: uncovering associations with psychosocial factors.

Szwajca M, Kazek G, Smierciak N, Mizera J, Pomierny-Chamiolo L, Szwajca K Front Psychiatry. 2024; 15:1320650.

PMID: 38645418 PMC: 11027163. DOI: 10.3389/fpsyt.2024.1320650.

The impact of early factors on persistent negative symptoms in youth at clinical high risk for psychosis.

Devoe D, Lui L, Cannon T, Cadenhead K, Cornblatt B, Keshavan M Front Psychiatry. 2023; 14:1125168.

PMID: 37293402 PMC: 10244495. DOI: 10.3389/fpsyt.2023.1125168.

Long-term outcomes of the recovery approach in a high-security mental health setting: a 20 year follow-up study.

Thomson L, Rees C Front Psychiatry. 2023; 14:1111377.

PMID: 37252143 PMC: 10213922. DOI: 10.3389/fpsyt.2023.1111377.

Patient-Reported Outcome Measures in Clinical High Risk for Psychosis: A Systematic Review.

Addington J, Chao A, Braun A, Miller M, Farris M Schizophr Bull Open. 2023; 4(1):sgad006.

PMID: 37025755 PMC: 10069322. DOI: 10.1093/schizbullopen/sgad006.

References

Hafner H, Riecher-Rossler A, Maurer K, Fatkenheuer B, Loffler W . First onset and early symptomatology of schizophrenia. A chapter of epidemiological and neurobiological research into age and sex differences. Eur Arch Psychiatry Clin Neurosci. 1992; 242(2-3):109-18. DOI: 10.1007/BF02191557. View

Tarbox S, Addington J, Cadenhead K, Cannon T, Cornblatt B, Perkins D . Premorbid functional development and conversion to psychosis in clinical high-risk youths. Dev Psychopathol. 2013; 25(4 Pt 1):1171-86. PMC: 4356489. DOI: 10.1017/S0954579413000448. View

Haim R, Rabinowitz 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(10):791-5. DOI: 10.1097/01.nmd.0000240158.39929.e3. View

Tikka M, Luutonen S, Ilonen T, Tuominen L, Kotimaki M, Hankala J . Childhood trauma and premorbid adjustment among individuals at clinical high risk for psychosis and normal control subjects. Early Interv Psychiatry. 2012; 7(1):51-7. DOI: 10.1111/j.1751-7893.2012.00391.x. View

Nieman D, Ruhrmann S, Dragt S, Soen F, van Tricht M, Koelman J . Psychosis prediction: stratification of risk estimation with information-processing and premorbid functioning variables. Schizophr Bull. 2013; 40(6):1482-90. PMC: 4193687. DOI: 10.1093/schbul/sbt145. View

Haas G, Sweeney J . Premorbid and onset features of first-episode schizophrenia. Schizophr Bull. 1992; 18(3):373-86. DOI: 10.1093/schbul/18.3.373. View

Quijada Y, Tizon J, Artigue J, Kwapil T, Barrantes-Vidal N . Attachment style predicts 6-month improvement in psychoticism in persons with at-risk mental states for psychosis. Early Interv Psychiatry. 2012; 6(4):442-9. DOI: 10.1111/j.1751-7893.2012.00342.x. View

Salokangas R, Heinimaa M, From T, Loyttyniemi E, Ilonen T, Luutonen S . Short-term functional outcome and premorbid adjustment in clinical high-risk patients. Results of the EPOS project. Eur Psychiatry. 2013; 29(6):371-80. DOI: 10.1016/j.eurpsy.2013.10.003. View

Carrion R, McLaughlin D, Goldberg T, Auther A, Olsen R, Olvet D . Prediction of functional outcome in individuals at clinical high risk for psychosis. JAMA Psychiatry. 2013; 70(11):1133-42. PMC: 4469070. DOI: 10.1001/jamapsychiatry.2013.1909. View

10.

Bailer J, Brauer W, Rey E . Premorbid adjustment as predictor of outcome in schizophrenia: results of a prospective study. Acta Psychiatr Scand. 1996; 93(5):368-77. DOI: 10.1111/j.1600-0447.1996.tb10662.x. View

11.

Addington J, van Mastrigt S, Addington D . Patterns of premorbid functioning in first-episode psychosis: initial presentation. Schizophr Res. 2003; 62(1-2):23-30. DOI: 10.1016/s0920-9964(02)00408-5. View

12.

Birchwood M, Smith J, Cochrane R, Wetton S, Copestake S . The Social Functioning Scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. Br J Psychiatry. 1990; 157:853-9. DOI: 10.1192/bjp.157.6.853. View

13.

Dragt S, Nieman D, Veltman D, Becker H, van de Fliert R, de Haan L . Environmental factors and social adjustment as predictors of a first psychosis in subjects at ultra high risk. Schizophr Res. 2010; 125(1):69-76. DOI: 10.1016/j.schres.2010.09.007. View

14.

Larsen T, McGlashan T, Johannessen J . First-episode schizophrenia: II. Premorbid patterns by gender. Schizophr Bull. 1996; 22(2):257-69. DOI: 10.1093/schbul/22.2.257. View

15.

Addington J, Cornblatt B, Cadenhead K, Cannon T, McGlashan T, Perkins D . At clinical high risk for psychosis: outcome for nonconverters. Am J Psychiatry. 2011; 168(8):800-5. PMC: 3150607. DOI: 10.1176/appi.ajp.2011.10081191. View

16.

Horton L, Tarbox S, Olino T, Haas G . Trajectories of premorbid childhood and adolescent functioning in schizophrenia-spectrum psychoses: A first-episode study. Psychiatry Res. 2015; 227(2-3):339-46. PMC: 4430364. DOI: 10.1016/j.psychres.2015.02.013. View

17.

Addington J, Penn D, Woods S, Addington D, Perkins D . Social functioning in individuals at clinical high risk for psychosis. Schizophr Res. 2007; 99(1-3):119-24. PMC: 2292799. DOI: 10.1016/j.schres.2007.10.001. View

18.

Walder D, Holtzman C, Addington J, Cadenhead K, Tsuang M, Cornblatt B . Sexual dimorphisms and prediction of conversion in the NAPLS psychosis prodrome. Schizophr Res. 2013; 144(1-3):43-50. PMC: 4045468. DOI: 10.1016/j.schres.2012.11.039. View

19.

Addington J, Addington D . Patterns of premorbid functioning in first episode psychosis: relationship to 2-year outcome. Acta Psychiatr Scand. 2005; 112(1):40-6. DOI: 10.1111/j.1600-0447.2005.00511.x. View

20.

Silverstein M, Mavrolefteros G, Turnbull A . Premorbid factors in relation to motor, memory, and executive functions deficits in adult schizophrenia. Schizophr Res. 2003; 61(2-3):271-80. DOI: 10.1016/s0920-9964(02)00312-2. View