Patterns of premorbid functioning in first episode psychosis: relationship to 2-year outcome

Acta Psychiatr Scand. 2005 Jul;112(1):40-6. doi: 10.1111/j.1600-0447.2005.00511.x.


Objective: To determine how different patterns of premorbid functioning relate to outcome longitudinally.

Method: Premorbid adjustment was assessed in 194 first-episode of psychosis subjects. Positive and negative symptoms, depression, substance misuse and social and cognitive functioning were assessed over 2 years.

Results: Four patterns of premorbid adjustment: stable-good, stable-intermediate, poor-deteriorating and deteriorating were identified. Relative to the stable-good group, the deteriorating and poor-deteriorating groups had significantly more positive symptoms at 1-year follow-up but not at 2-year follow-up and significantly more negative symptoms and significantly poorer social functioning at both 1 and 2-years. Only verbal fluency and memory differentiated between the groups with the stable-good group having a superior performance.

Conclusion: Those who demonstrated poor or deteriorating functioning prior to the onset of acute psychosis have a poorer outcome up to at least 2 years in terms of negative symptoms and social functioning.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cluster Analysis
  • Cognition Disorders / diagnosis
  • Cognition Disorders / etiology
  • Depression / diagnosis
  • Depression / epidemiology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Follow-Up Studies
  • Humans
  • Interview, Psychological
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / epidemiology*
  • Psychotic Disorders / psychology
  • Severity of Illness Index
  • Social Adjustment
  • Social Behavior*
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology
  • Time Factors
  • Treatment Outcome