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


Jean Addington, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario, M5T 1R8, Canada.


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.