Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain; Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Boi de Llobregat, Barcelona, Spain; Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Esplugues de Llobregat, Barcelona, Spain; Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Esplugues de Llobregat, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.
Schizophr Res. 2013 Dec;151(1-3):252-8. doi: 10.1016/j.schres.2013.10.027. Epub 2013 Nov 17.
The dimensionality of premorbid adjustment (PA) has been a debated issue, with attempts to determine whether PA is a unitary construct or composed of several independent domains characterized by a differential deterioration pattern and specific outcome correlates.
This study examines the factorial structure of PA, as well as, the course and correlates of its domains.
Retrospective study of 84 adult patients experiencing first-episode psychosis (FEP) (n=33) and individuals with schizophrenia (SCH) (n=51). All patients were evaluated with a comprehensive battery of instruments including clinical, functioning and neuropsychological variables. A principal component analysis accompanied by a varimax rotation method was used to examine the factor structure of the PAS-S scale. Paired t tests and Wilcoxon rank tests were used to assess the changes in PAS domains over time. Bivariate correlation analyses were performed to analyse the relationship between PAS factors and clinical, social and cognitive variables.
PA was better explained by three factors (71.65% of the variance): Academic PA, Social PA and Socio-sexual PA. The academic domain showed higher scores of PA from childhood. Social and clinical variables were more strongly related to Social PA and Socio-sexual PA domains, and the Academic PA domain was exclusively associated with cognitive variables.
This study supports previous evidence, emphasizing the validity of dividing PA into its sub-components. A differential deterioration pattern and specific correlates were observed in each PA domains, suggesting that impairments in each PA domain might predispose individuals to develop different expressions of psychotic dimensions.
病前适应（PA）的维度一直是一个有争议的问题，试图确定 PA 是否是一个单一的结构，还是由几个独立的领域组成，这些领域的特点是不同的恶化模式和特定的结果相关性。
本研究检验了 PA 的因子结构，以及其各领域的发展和相关性。
对 84 名首次发作精神分裂症（FEP）（n=33）和精神分裂症（SCH）（n=51）的成年患者进行回顾性研究。所有患者均接受了全面的评估工具，包括临床、功能和神经心理学变量。采用主成分分析和方差最大旋转法来检验 PAS-S 量表的因子结构。采用配对 t 检验和 Wilcoxon 秩检验来评估 PAS 各领域随时间的变化。进行了双变量相关分析，以分析 PAS 因子与临床、社会和认知变量之间的关系。
PA 由三个因素更好地解释（71.65%的方差）：学术 PA、社会 PA 和社会-性 PA。学术领域表现出更高的 PA 分数从童年开始。社会和临床变量与社会 PA 和社会-性 PA 领域的关系更为密切，而学术 PA 领域仅与认知变量相关。
本研究支持了先前的证据，强调了将 PA 划分为其子成分的有效性。在每个 PA 领域都观察到了不同的恶化模式和特定的相关性，这表明每个 PA 领域的损伤可能使个体易患不同的精神病维度表现。
