Part IV. Some Biological Approaches to Research on Premorbid Functioning in Schizophrenia*

The Prediction of Outcome in Chronic Schizophrenia

“…3,46 (3) A specific outcome criterion may be most effectively predicted by its corresponding premorbid variable.8,33'46 (4) Cross-sectional psychopathology alone (and diagnosis based primarily on cross-sectional symp¬ toms) has limited prognostic value. Conversely, diagnosis greater outcome predictive power.810·4750 (5) Symptoms are useful in predicting the profile of recurring psychopatholgy in any individual patient.8,33…”

“…They are (1) hospitalization (proportion of time spent in hospital since discharge), (2) work (proportion of time employed full-time since discharge), (3) social (frequency of weekly contacts with friends over the entire follow-up period), (4) intimacy (closeness of interpersonal contacts over the past year of follow-up), (5) symp¬ toms (proportion of time symptomatic since discharge), and (6) global (global functioning since discharge). They were rated on five-point scales with 0 representing the worst functioning and 4 representing the best functioning in all cases.…”

Measurement of Premorbid Adjustment in Chronic Schizophrenia

“…Further, it has not always been clear which aspects of premorbid life are most characteristic and have most predictive value in a rating scale. The most thoroughly studied premorbid scales, such as the Phillips Scale (Phillips 1953), the Elgin Prognostic Scale (Wittman 1941), the Premorbid Asocial Adjustment Scale (Gittelman-Klein and Klein 1969), and the Premorbid Adjustment Survey (Goldstein 1977), have shown poor premorbid adjustment to be related to various parameters including outcome of therapy, duration of hospitalization, and types of symptoms (Goldstein, Held, and Cromwell 1968;Klorman, Strauss, and Kokes 1977;Kokes, Strauss, and Klorman 1977). Most of these scales, however, were developed a number of years ago.…”