Premorbid academic and social functioning in patients with schizophrenia and its associations with negative symptoms and cognition

Objective The study aimed to explore premorbid academic and social functioning in patients with schizophrenia, and its associations with the severity of negative symptoms and neurocognitive impairment. Method Premorbid adjustment (PA) in patients with schizophrenia was compared to early adjustment i...

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Published in:Acta psychiatrica Scandinavica 2018-09, Vol.138 (3), p.253-266
Main Authors: Bucci, P., Galderisi, S., Mucci, A., Rossi, A., Rocca, P., Bertolino, A., Aguglia, E., Amore, M., Andriola, I., Bellomo, A., Biondi, M., Cuomo, A., dell'Osso, L., Favaro, A., Gambi, F., Giordano, G. M., Girardi, P., Marchesi, C., Monteleone, P., Montemagni, C., Niolu, C., Oldani, L., Pacitti, F., Pinna, F., Roncone, R., Vita, A., Zeppegno, P., Maj, M., Patriarca, Sara, Pietrafesa, Daria, Aiello, Carmen, Longo, Luisa, Barone, Marina, Romano, Raffaella, Atti, Anna Rita, Barlati, Stefano, Deste, Giacomo, Valsecchi, Paolo, Carpiniello, Bernardo, Tusconi, Massimo, Puddu, Laura, Signorelli, Maria Salvina, Cannavò, Dario, Minutolo, Giuseppe, Corbo, Mariangela, Montemitro, Chiara, Baroni, Gaia, Altamura, Mario, La Montagna, Maddalena, Carnevale, Raffaella, Murri, Martino Belvederi, Calcagno, Pietro, Bugliani, Michele, Pizziconi, Giulia, Logozzo, Francesca, Rossi, Rodolfo, Giusti, Laura, Salza, Anna, Malavolta, Maurizio, Orsenigo, Giulia, Grassi, Silvia, Bartolomeis, Andrea, Gramaglia, Carla, Gattoni, Eleonora, Gambaro, Eleonora, Tenconi, Elena, Ferronato, Luisa, Collantoni, Enrico, Tonna, Matteo, Ossola, Paolo, Gerra, Maria Lidia, Carmassi, Claudia, Cremone, Ivan Mirko, Carpita, Barbara, Buzzanca, Antonio, Girardi, Nicoletta, Frascarelli, Marianna, Casale, Antonio, Comparelli, Anna, Corigliano, Valentina, Siracusano, Alberto, Lorenzo, Giorgio, Ribolsi, Michele, Corrivetti, Giulio, Bartoli, Luca, Buono, Gianfranco, Fagiolini, Andrea, Bolognesi, Simone, Goracci, Arianna, Mancini, Irene, Bava, Irene, Cardillo, Simona
Format: Article
Language:English
Subjects:
avolition
Basal ganglia
Central nervous system diseases
Cognition
Cognition & reasoning
Cognitive ability
cognitive functioning
Emotional behavior
Mental disorders
Movement disorders
poor emotion expression
premorbid adjustment
primary negative symptoms
Psychopathology
Schizophrenia
Short term memory
Social interactions
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Summary:Objective The study aimed to explore premorbid academic and social functioning in patients with schizophrenia, and its associations with the severity of negative symptoms and neurocognitive impairment. Method Premorbid adjustment (PA) in patients with schizophrenia was compared to early adjustment in unaffected first‐degree relatives and healthy controls. Its associations with psychopathology, cognition, and real‐life functioning were investigated. The associations of PA with primary negative symptoms and their two factors were explored. Results We found an impairment of academic and social PA in patients (P ≤ 0.000001) and an impairment of academic aspects of early adjustment in relatives (P ≤ 0.01). Patients with poor PA showed greater severity of negative symptoms (limited to avolition after excluding the effect of depression/parkinsonism), working memory, social cognition, and real‐life functioning (P ≤ 0.01 to ≤0.000001). Worse academic and social PA were associated with greater severity of psychopathology, cognitive impairment, and real‐life functioning impairment (P ≤ 0.000001). Regression analyses showed that worse PA in the academic domain was mainly associated to the impairment of working memory, whereas worse PA in the social domain to avolition (P ≤ 0.000001). Conclusion Our findings suggest that poor early adjustment may represent a marker of vulnerability to schizophrenia and highlight the need for preventive/early interventions based on psychosocial and/or cognitive programs.
ISSN:0001-690X
1600-0447
DOI:10.1111/acps.12938