Premorbid adjustment predictors of cognitive dysfunction in schizophrenia. (September 2018)

• Record Type: Journal Article
• Authors: Stefanatou, Pentagiotissa; Karatosidi, Chrysovalado-Sofia; Tsompanaki, Evgenia; Kattoulas, Emmanouil; Stefanis, Nicholas C.; Smyrnis, Nikolaos
• Is Part Of: Psychiatry research. Volume 267(2018)
• Page Start: 249
• Page End: 255
• Publication Date: 2018-09
• Subjects: Psychosis -- Premorbid adjustment scale -- Neuropsychological measures -- Cognitive impairment -- IQ decline -- Executive function -- Canonical correlation analysis; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2018.06.029
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: Academic Premorbid malAdjustment (APA) predicts cognitive dysfunction in schizophrenia. Deteriorating APA predicts post-onset IQ decline, poorer executive function and verbal learning. A premorbid cognitive dysmaturational process (CDP) in schizophrenia is suggested. CDP differentially impedes the developmental progression of various cognitive functions. Premorbid CDP leads to a pronounced cognitive decline post-diagnosis. Abstract: Premorbid adjustment (PA) in academic and social domain is a key-predictor of cognitive performance in schizophrenia. Prior studies provided inconsistent findings regarding the differential relationships of PA domains with post-illness cognition. Multivariate associations of academic and social PA in each developmental stage (childhood, early and late adolescence) with post-onset cognitive variables were explored. Furthermore, possible differential relationships of PA domain deterioration courses with post-onset cognitive dysfunction were investigated. Seventy-five schizophrenia patients were evaluated with Premorbid Adjustment Scale (PAS). General cognitive ability, verbal IQ, verbal memory and learning, processing speed, working memory, executive function and premorbid IQ were assessed. Canonical Correlation Analyses revealed that poorer academic PA across childhood and early adolescence was related to worse post-onset verbal IQ, working memory, verbal learning and executive function, while academic PA deterioration between early and late adolescence was associated with poorer verbal learning and executive function and, as further analysis indicated, predicts IQ decline. Academic PA was exclusively associated with post-onset cognitive impairment. New evidence emerged for the specificity of each developmental period in constructing academic PA in its relation to post-illness cognition. Early premorbid academic maladjustment possibly constitutes the onset of a cognitive dysmaturational process which results to post-diagnosis impaired cognition.