P Bucci1, S Galderisi1, A Mucci1, A Rossi2, P Rocca3, A Bertolino4, E Aguglia5, M Amore6, I Andriola4, A Bellomo7, M Biondi8, A Cuomo9, L dell'Osso10, A Favaro11, F Gambi12, G M Giordano1, P Girardi13, C Marchesi14, P Monteleone15, C Montemagni3, C Niolu16, L Oldani17, F Pacitti2, F Pinna18, R Roncone19, A Vita20,21, P Zeppegno22, M Maj1. 1. Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy. 2. Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy. 3. Section of Psychiatry, Department of Neuroscience, University of Turin, Turin, Italy. 4. Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy. 5. Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy. 6. Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy. 7. Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy. 8. Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy. 9. Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy. 10. Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. 11. Department of Neurosciences, Psychiatric Clinic, University of Padua, Padua, Italy. 12. Chair of Psychiatry, Department of Neuroscience and Imaging, G. d'Annunzio University, Chieti, Italy. 13. Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy. 14. Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy. 15. Chair of Psychiatry, Department of Medicine and Surgery, University of Salerno, Salerno, Italy. 16. Chair of Psychiatry, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy. 17. Department of Psychiatry, University of Milan, Milan, Italy. 18. Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy. 19. Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy. 20. Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy. 21. Department of Mental Health, Spedali Civili Hospital, Brescia, Italy. 22. Psychiatric Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.
Abstract
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.
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.
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