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Premorbid Social Functioning With Schizophrenia and Bipolar Disorder

To the Editor: Recently, Mary Cannon, M.Sc., and colleagues (1) reported significantly poorer premorbid adjustment in the childhood and adolescence of schizophrenic patients and, to a lesser degree, in patients with bipolar disorder compared with healthy subjects. However, the researchers did not discuss the possible impact of different levels of expressed emotion (2) that inevitably exist in at least some schizophrenic families on the mothers' recall of their children's behavior in childhood, especially when we consider schizophrenia and bipolar disorder as long-term and chronic illnesses.

Using the Five-Minute Speech Sample (3), a brief variant of the Camberwell Family Interview (4), together with the adapted Premorbid Social Adjustment Scale (5), instead of the simple telephone interviewing that was done in the study would probably complicate the overall study procedure and the analysis of collected data a little but could undoubtedly benefit the appropriate rating of affected families and the more precise estimation of received information.

REFERENCES

1. Cannon M, Jones P, Gilvarry C, Rifkin L, McKenzie K, Foerster A, Murray RM: Premorbid social functioning in schizophrenia and bipolar disorder: similarities and differences. Am J Psychiatry 1997; 154:1544–1550
2. Brown GW, Birley JL, Wing JK: The influence of family life on the course of schizophrenic disorders: a replication. Br J Psychiatry 1972; 156:357–362[Abstract/Free Full Text]
3. Magana AB, Goldstein JM, Karno M, Miklowitz DJ, Jenkins J, Falloon IR: A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry Res 1986; 17:203–212[Medline]
4. Vaughn CE, Leff J: The measurement of expressed emotion in the families of psychiatric patients. Br J Soc Clin Psychol 1976; 15:157–165[Medline]
5. Cannon-Spoor H, Potkin SG, Wyatt RJ: Measurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull 1982; 8:471–474

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