Premorbid academic and social functioning in patients with schizophrenia and its associations with negative symptoms and cognition

Bucci, P.;Galderisi, S.;Mucci, A.;Rossi, A.;Rocca, P.;Bertolino, A.;Aguglia, E.;Amore, M.;Andriola, I.;Bellomo, A.;Biondi, M.;Cuomo, A.;dell'Osso, L.;Favaro, A.;Gambi, F.;Giordano, G. M.;Girardi, P.;Marchesi, C.;Monteleone, P.;Montemagni, C.;Niolu, C.;Oldani, L.;Pacitti, F.;Pinna, F.

Writing – Review & Editing

;Roncone, R.;Vita, A.;Zeppegno, P.;Maj, M.;Patriarca, Sara;Pietrafesa, Daria;Aiello, Carmen;Longo, Luisa;Barone, Marina;Romano, Raffaella;Atti, Anna Rita;Barlati, Stefano;Deste, Giacomo;Valsecchi, Paolo;Carpiniello, Bernardo

Membro del Collaboration Group

;Tusconi, Massimo;Puddu, Laura;Signorelli, Maria Salvina;Cannavò, Dario;Minutolo, Giuseppe;Corbo, Mariangela;Montemitro, Chiara;Baroni, Gaia;Altamura, Mario;La Montagna, Maddalena;Carnevale, Raffaella;Murri, Martino Belvederi;Calcagno, Pietro;Bugliani, Michele;Pizziconi, Giulia;Logozzo, Francesca;Rossi, Rodolfo;Giusti, Laura;Salza, Anna;Malavolta, Maurizio;Orsenigo, Giulia;Grassi, Silvia;De Bartolomeis, Andrea;Gramaglia, Carla;Gattoni, Eleonora;Gambaro, Eleonora;Tenconi, Elena;Ferronato, Luisa;Collantoni, Enrico;Tonna, Matteo;Ossola, Paolo;Gerra, Maria Lidia;Carmassi, Claudia;Cremone, Ivan Mirko;Carpita, Barbara;Buzzanca, Antonio;Girardi, Nicoletta;Frascarelli, Marianna;Del Casale, Antonio;Comparelli, Anna;Corigliano, Valentina;Siracusano, Alberto;Di Lorenzo, Giorgio;Ribolsi, Michele;Corrivetti, Giulio;Bartoli, Luca;Del Buono, Gianfranco;Fagiolini, Andrea;Bolognesi, Simone;Goracci, Arianna;Mancini, Irene;Bava, Irene;Cardillo, Simona

2018-01-01

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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.