First-episode schizophrenia: II. Premorbid patterns by gender

This article describes the application of the Premorbid Adjustment Scale to Norwegian subjects with first-episode schizophrenia. The scale measures premorbid functioning from several perspectives: functioning at different developmental periods, change of functioning over time, and distinctive patterns of functioning over time. Gender differences were striking, with males scoring poorer and deteriorating faster than females, especially closer to onset. While the duration of untreated psychosis (DUP) was significantly longer in males, correlations between DUP and premorbid functioning within gender were largely nonsignificant, as were the analyses of premorbid functioning and age at onset. On the other hand, we replicated studies that found associations between poorer premorbid functioning and insidious onset and negative symptoms. Overall, our premorbid patterns suggest that a process of asymptomatic premorbid deficit formation precedes onset by some period, especially among males. The patterns also suggest that active symptom formation does not always precede this deteriorative process.