Am J Psychiatry 1992; 149:1543-1548
Copyright © 1992 by American Psychiatric Association
Deterioration in premorbid functioning in schizophrenia: a developmental model of negative symptoms in drug-free patients
ME Kelley, M Gilbertson, A Mouton and DP van Kammen
Highland Drive Department of Veterans Affairs Medical Center, Pittsburgh, PA 15206.
OBJECTIVE: The authors examined the relationship between negative symptoms
and premorbid variables in drug-free schizophrenic patients. METHOD: The
authors studied 63 clinically stable male schizophrenic inpatients who were
not receiving any psychoactive medication. The patients were classified as
having negative, positive, or mixed symptoms, and their premorbid
functioning during childhood, early adolescence, and late adolescence was
assessed by using the Premorbid Adjustment Scale. Correlational analyses
were applied to the classification and developmental models. RESULTS:
Patients with negative symptoms had significantly lower levels of premorbid
functioning during late adolescence and significantly greater premorbid
deterioration between childhood and early adolescence. Correlational
analysis revealed significant positive relationships between premorbid
variables and negative symptoms. CONCLUSIONS: The data suggest that a
deterioration in social and intellectual functioning between childhood and
adolescence is associated with the development of a negative symptom
syndrome in schizophrenia. The premorbid deterioration appears to be an
early prodrome of the disorder. Whether this residual negative symptom
syndrome is in some way related to the deficit syndrome of schizophrenia
awaits a prospective study.
