Trajectories of premorbid childhood and adolescent functioning in schizophrenia-spectrum psychoses: A first-episode study

Horton, Leslie E.; Tarbox, Sarah I.; Olino, Thomas M.; Haas, Gretchen L.

doi:10.1016/j.psychres.2015.02.013

Cited by 34 publications

(31 citation statements)

References 53 publications

(72 reference statements)

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“…Similar to Horton et al (2015), we did not observe in this CHR sample the poor- deteriorating pattern where individuals start out with poor premorbid functioning that continues to deteriorate over time. Our third hypothesis was supported in that these three groups differed in their clinical and functional profiles such that the deteriorating group had more severe disorganization than the other two groups, and worse negative symptoms and poorer social functioning than the stable-intermediate group.…”

Section: Discussionsupporting

confidence: 67%

Patterns of premorbid functioning in individuals at clinical high risk of psychosis

Lyngberg

Buchy

Liu

et al. 2015

Schizophrenia Research

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In schizophrenia, four typical patterns of premorbid functioning have been observed: stable-good, stable-intermediate, poor-deteriorating and deteriorating. However, it is unknown whether similar patterns exist in those who are at clinical high risk (CHR) of psychosis. The aim of this study was to examine patterns of premorbid functioning in a large sample of individuals at CHR of psychosis and its association with symptoms, functioning, and conversion to psychosis. One-hundred sixty people at CHR of psychosis were assessed on premorbid functioning using the Premorbid Adjustment Scale. Poorer premorbid functioning was significantly correlated with worse negative symptom severity and lower social functioning. Cluster analysis was used to identify patterns of premorbid functioning. Results indicated three patterns of premorbid functioning in our CHR sample: stable-intermediate, stable-good, and deteriorating. The deteriorating group had more severe disorganization, worse negative symptoms and poorer social functioning than the other groups. Participants who made the conversion to psychosis had significantly poorer premorbid functioning during adolescence compared to those who did not convert. These results suggest that those at a clinical high risk for psychosis display similar patterns in premorbid functioning as have been observed in those with a psychotic illness and that poor premorbid functioning may be a predictor of psychosis.

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Section: Discussionsupporting

confidence: 67%

Patterns of premorbid functioning in individuals at clinical high risk of psychosis

Lyngberg

Buchy

Liu

et al. 2015

Schizophrenia Research

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“…Quee et al (2014) identified six clusters based on social and academic PMA, ranging from "normal" to "overall impaired." Horton et al (2015) found three clusters of PMA trajectories in a sample of first-episode patients. The "stable poor" group had lower overall functioning at baseline and more severe negative symptoms at 1-year follow-up than the "stable good" group, and the "deteriorating" group did not differ from either of the other groups (Horton et al, 2015).…”

Section: Introductionmentioning

confidence: 90%

“…Horton et al (2015) found three clusters of PMA trajectories in a sample of first-episode patients. The "stable poor" group had lower overall functioning at baseline and more severe negative symptoms at 1-year follow-up than the "stable good" group, and the "deteriorating" group did not differ from either of the other groups (Horton et al, 2015). To our knowledge, there has not been a cluster analysis performed on a BD sample.…”

Section: Introductionmentioning

confidence: 90%

Premorbid adjustment trajectories in schizophrenia and bipolar disorder: A transdiagnostic cluster analysis

Chan

Shanahan

Ospina

et al. 2019

Psychiatry Research

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Despite the overlap between schizophrenia and bipolar disorder, neurodevelopmental abnormalities are thought to be associated primarily with schizophrenia. Transdiagnostic and empirical identification of subgroups based on premorbid adjustment (PMA) may enhance understanding of illness trajectories. 160 patients with bipolar I or II disorder (BD; n = 104) or schizophrenia or schizoaffective disorder (SZ; n = 56) were assessed on PMA course from childhood to late adolescence and current symptoms and functioning. A hierarchical cluster analysis was performed using social and academic PMA scores, resulting in three optimal clusters. Cluster 1 (n = 28 SZ, 65 BD) had normal social and academic PMA, the most education, and mildest current symptoms. Cluster 2 (n = 15 SZ, 24 BD) had normal social PMA but an impaireddeclining academic course and had a greater proportion of males than Cluster 1. Cluster 3 (n = 13 SZ, 15 BD) had an impaired-stable social PMA and an impaired-declining academic course and the most severe current negative symptoms and childhood trauma. The proportions of SZ and BD diagnoses, current neurocognition, and functioning did not differ between clusters. These findings suggest shared neurodevelopmental abnormalities between SZ and BD, with subgroups exhibiting distinct PMA trajectories that cut across disorders.

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“…Similarly, when examining developmental trajectories of overall premorbid adjustment, patients who had a deteriorating course from childhood to adulthood developed prodromal syndromes approximately 5 years earlier, achieved a lower level of education (1.5 years less), and had more severe impairments in processing speed and psychosocial functioning (Cole, Apud, Weinberger, & Dickinson, 2012). Similar classification methods have demonstrated associations with various premorbid social impairment trajectories and both positive and negative symptom severity in patients with schizophrenia (Addington & Addington, 2005;Addington, van Mastrigt, & Addington, 2003;Chang et al, 2013;Horton, Tarbox, Olino, & Haas, 2015;Strauss et al, 2012;Walder et al, 2013); however, associations with positive symptoms were found less consistently (Addington & Addington, 2005;Addington et al, 2003;Walder et al, 2013). Taken together, once present, premorbid social impairments in early childhood appear to either persist or progress throughout development and are closely associated with symptom severity and functional outcomes (Childers & Harding, 1990).…”

Section: Premorbid Social Dysfunction In Psychosis Populationsmentioning

confidence: 99%

Early childhood social communication deficits in youth at clinical high-risk for psychosis: Associations with functioning and risk

2019

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Effective social functioning requires a broad range of social communication skills that are impaired in psychosis populations. However, little is known about early childhood (4- to 5-year period) social communication during the premorbid (pre-illness) stage of psychosis. The present study utilized retrospective parent reports to examine total early childhood social communication deficits, as well as deficits in two distinct domains, reciprocal social interaction (social smiling/eye gaze) and communication (social chat/gesture), in youth at clinical high-risk (CHR) for psychosis (ages 13–21; 37.2% female). Furthermore, associations between early childhood social communication and CHR youth's current functioning (social, academic/work), symptoms (positive/negative), and risk for conversion to psychosis were examined. Compared to healthy controls, CHR individuals had greater deficits in total and communication-specific early childhood social communication. Early childhood total, communication, and reciprocal social interaction deficits were associated with worse current functioning and greater current negative symptom severity (amotivation/anhedonia) in CHR youth. Early childhood total and reciprocal social interaction deficits were also associated with increased risk for conversion. These findings inform the field's understanding of the etiology and pathophysiology of psychosis by extending the current developmental literature on premorbid deficits in psychosis populations to specific domains of social behavior in a critical developmental period.

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Trajectories of premorbid childhood and adolescent functioning in schizophrenia-spectrum psychoses: A first-episode study

Cited by 34 publications

References 53 publications

Patterns of premorbid functioning in individuals at clinical high risk of psychosis

Patterns of premorbid functioning in individuals at clinical high risk of psychosis

Premorbid adjustment trajectories in schizophrenia and bipolar disorder: A transdiagnostic cluster analysis

Early childhood social communication deficits in youth at clinical high-risk for psychosis: Associations with functioning and risk

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