Premorbid Social Underachievement in Schizophrenia

Abstract

In an investigation of the timing and precursors of social decline in schizophrenia and affective psychosis, 195 subjects from the Camberwell Collaborative Psychosis Study were currently of lower social class than were their fathers. A comparison between father's occupation and proband's best premorbid occupational level indicated underachievement confined to DSM-III schizophrenia, there being no such effect in affective psychosis. Decline in social status following onset of psychosis, analysed by comparing best premorbid occupation with current occupation, was marked in both schizophrenia and affective psychosis, indicating a non-specific effect. Schizophrenic patients who failed to achieve their fathers' social status had poorer educational qualifications than those who equalled or bettered their paternal social class, despite similar premorbid IQ (NART) scores and age at onset of psychosis. These results indicate that schizophrenia may be manifest before the onset of psychosis, and lend weight to the notion of a developmental origin to this disorder.

Specificity of Cognitive Deficits in Bipolar Disorder versus Schizophrenia

“…A similar result has been reported using another reading test (Wide Range Achievement Test – Revised [48]) in stable schizophrenic and bipolar patients [39,40,41]. In contrast, some studies have found that bipolar patients had a better premorbid IQ than schizophrenic patients, when measured with the NART [37,49,50,51]. Three of these studies [37, 50, 51] have large effect sizes (range: d = 0.77–1.06) indicating powerful results.…”

Effect of social class at birth on risk and presentation of schizophrenia: case-control study

“…By the time they have contact with psychiatric services, patients have often moved into a lower social class. 4 5 However, this does not exclude the possibility that low social class increases the risk of later schizophrenia. 6 7 Evidence is accumulating that the origins of the disorder lie in early life, and various environmental factors have been shown to be associated with an increased risk of later schizophrenia 8.…”

Social and sexual functioning in schizophrenic men who commit serious sex offences against women

“…Studies indicate that non-offender patients with schizophrenia are more socially impaired after the onset of their disorder than normal control subjects or people with other types of psychiatric disorder (Goodman et al, 1969;Harrow et al, 1997), and their level of premorbid social adjustment is lower than either of these two groups (Lewine at al., 1980;Jones et al, 1993).…”