Monte Ralph C, Goulding Sandra M, Compton Michael T
Argosy University Atlanta, Department of Clinical Psychology, Atlanta, Georgia 30328, USA.
Schizophr Res. 2008 Sep;104(1-3):206-13. doi: 10.1016/j.schres.2008.06.009. Epub 2008 Jul 26.
Motivated by a previous study among male veterans [Allen, D.N., Frantom, L.V., Strauss, G.P., van Kammen, D.P., 2005. Differential patterns of premorbid academic and social deterioration in patients with schizophrenia. Schizophr. Res. 75, 389-397], the present analysis examined: (1) patterns of premorbid academic and social functioning during childhood, early adolescence, and late adolescence, and (2) associations between these premorbid functioning dimensions and a number of clinical variables.
Data on premorbid functioning were collected using the Premorbid Adjustment Scale (PAS) in 95 hospitalized first-episode patients. Analyses were similar to those conducted by Allen and colleagues (2005).
Deterioration was evident in both academic and social functioning from childhood to early adolescence, along with a pronounced/accelerated deterioration in academic functioning from early adolescence to late adolescence, occurring in both male and female patients. Age at onset of prodromal symptoms was predicted by childhood/early adolescent/late adolescent academic functioning scores, and age at onset of psychotic symptoms was significantly associated only with childhood academic functioning. Severity of negative symptoms was predicted by childhood and late adolescent social functioning scores, and severity of general psychopathology symptoms was predicted by late adolescent academic functioning, as well as childhood and late adolescent social functioning scores.
Consistent with prior findings, deterioration in premorbid functioning appears to be more pronounced in the academic than social dimension of the PAS. Some PAS scores are predictive of ages at onset of prodrome/psychosis and severity of psychotic symptoms. Ongoing research on premorbid adjustment in schizophrenia may have implications for future prevention goals.
受先前一项针对男性退伍军人的研究[艾伦，D.N.，弗兰托姆，L.V.，施特劳斯，G.P.，范·卡门，D.P.，2005年。精神分裂症患者病前学业和社会功能衰退的差异模式。《精神分裂症研究》75，389 - 397]的启发，本分析研究了：（1）童年期、青春期早期和青春期晚期病前学业和社会功能的模式，以及（2）这些病前功能维度与一些临床变量之间的关联。
使用病前适应量表（PAS）收集了95名住院首发患者的病前功能数据。分析方法与艾伦及其同事（2005年）所采用的方法相似。
从童年到青春期早期，学业和社会功能均出现衰退，并且从青春期早期到青春期晚期，学业功能出现明显/加速衰退，男性和女性患者均如此。前驱症状发作年龄可由童年期/青春期早期/青春期晚期学业功能得分预测，而精神病性症状发作年龄仅与童年期学业功能显著相关。阴性症状严重程度可由童年期和青春期晚期社会功能得分预测，一般精神病理学症状严重程度可由青春期晚期学业功能以及童年期和青春期晚期社会功能得分预测。
与先前研究结果一致，病前功能衰退在PAS的学业维度似乎比社会维度更为明显。一些PAS得分可预测前驱期/精神病发作年龄以及精神病性症状严重程度。正在进行的关于精神分裂症病前适应的研究可能对未来的预防目标具有启示意义。
