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First-episode schizophrenia: II. Premorbid patterns by gender
T K Larsen1, T H McGlashan, J O Johannessen
1Psychiatric Hospital of Rogaland, Stavanger, Norway.
Schizophrenia Bulletin
|January 1, 1996
Summary
This study on first-episode schizophrenia in Norway found significant gender differences in premorbid functioning, with males showing poorer adjustment and faster decline. These patterns suggest a prolonged deficit before psychosis onset, particularly in males.
Area of Science:
- Psychiatry
- Neuroscience
- Clinical Psychology
Background:
- Premorbid functioning is crucial for understanding schizophrenia onset and progression.
- The Premorbid Adjustment Scale (PAS) assesses functioning before the onset of psychosis.
- Gender differences in schizophrenia presentation and outcomes are well-documented.
Purpose of the Study:
- To apply the Premorbid Adjustment Scale to Norwegian individuals with first-episode schizophrenia.
- To investigate gender differences in premorbid functioning and their relationship with clinical variables.
- To explore patterns of premorbid adjustment preceding psychosis onset.
Main Methods:
- Utilized the Premorbid Adjustment Scale on a cohort of Norwegian first-episode schizophrenia patients.
- Analyzed functioning across developmental periods, changes over time, and distinct patterns.
- Examined correlations with gender, duration of untreated psychosis (DUP), age at onset, symptom presentation, and onset type.
Main Results:
- Males exhibited poorer premorbid adjustment and more rapid deterioration than females, especially near psychosis onset.
- Males had a significantly longer duration of untreated psychosis (DUP).
- Poorer premorbid functioning was associated with insidious onset and negative symptoms, replicating previous findings.
Conclusions:
- Premorbid patterns suggest a significant asymptomatic deficit phase preceding psychosis, particularly in males.
- Active symptom formation may not always initiate the deteriorative process leading to schizophrenia.
- Findings highlight the importance of considering gender and premorbid trajectories in schizophrenia research and clinical practice.