Relationship Between Premorbid Functioning and Symptom Severity as Assessed at First Episode of Psychosis

Rabinowitz, Jonathan; Smedt, Goedele De; Harvey, Philip D.; Davidson, Michael

doi:10.1176/appi.ajp.159.12.2021

Cited by 82 publications

(53 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Predictors of better treatment response include higher cognitive functioning at baseline, 5,6,19 better premorbid functioning, 6,20 and an absence of a schizophrenia diagnosis, 1 whereas higher baseline PANSS scores predicted poorer treatment response, extending previous research to up to 2 years. 1 The current sample size, however, is insufficient to compute trajectories separately for each diagnostic group.…”

Section: Discussionmentioning

confidence: 56%

Treatment Response Trajectories and Their Antecedents in Recent-Onset Psychosis

Levine

Rabinowitz²,

Case³

et al. 2010

Journal of Clinical Psychopharmacology

Self Cite

View full text Add to dashboard Cite

Based on clinical trial data, treatment response in early episode psychosis seems to be characterized by amelioration and ongoing change. Premorbid functioning, cognitive functioning, and early symptom severity have prognostic value in predicting treatment response trajectories. Across trajectory studies, approximately 16% of patients experience a dramatic treatment response trajectory characterized by approximately a 60% to 80% symptom reduction.

show abstract

Section: Discussionmentioning

confidence: 56%

Treatment Response Trajectories and Their Antecedents in Recent-Onset Psychosis

Levine

Rabinowitz²,

Case³

et al. 2010

Journal of Clinical Psychopharmacology

Self Cite

View full text Add to dashboard Cite

show abstract

“…The use of an injectable antipsychotic, and the fact that almost 90% of injections were given on time, controls for treatment adherence which could not be eliminated as an intervening variable in previous studies. 1,2,4 In addition, because 86% of the patients completed all study visits, results were not likely to have been effected by biases introduced by attrition. 24 A further enhancement over previous studies was The results regarding prediction of attaining and maintaining remission symptom criteria are noteworthy.…”

Section: Discussionmentioning

confidence: 99%

Premorbid Functioning and Treatment Response in Recent-Onset Schizophrenia

Rabinowitz¹,

Napryeyenko²,

Burba³

et al. 2011

Journal of Clinical Psychopharmacology

Self Cite

View full text Add to dashboard Cite

Premorbid functioning may be associated with treatment response, but this is confounded by a lack of prospective longitudinal data and controls for medication compliance. This study tested the hypothesis that good premorbid functioning will be associated with better antipsychotic treatment response after controlling for drug adherence by using a long-acting injectable antipsychotic. This was a 6-month, open label, multicenter, phase IV trial in recent-onset schizophrenia treated with flexible doses of risperidone long-acting injectable (25-50 mg every 14 days). Premorbid functioning was assessed with the Premorbid Adjustment Scale (PAS)-Structured Interview; efficacy was evaluated with clinician-rated Positive and Negative Syndrome Scale, Clinical Global Impression scale of Severity of Illness, Clinical Global Impression scale of Change, Global Assessment of Functioning Scale, and trial participant completed SF-36. Analyses controlled for baseline scores and demographics. With the use of a priori PAS scoring criteria, the participants' premorbid functioning was categorized as stable-good (n = 142), stable-poor (n = 116), and deteriorating (n = 36). At baseline, the stable-good group had the best functioning on most efficacy measures. All groups showed significant improvement on efficacy measures with treatment. Improvement was significantly higher for the stable-good group. The PAS global assessment of highest level of functioning scale (excellent, n = 75; good, n = 117; fair, n = 78; and poor, n = 31) showed a strong association with baseline functioning and improvement and had a significant linear association with meeting Remission in Schizophrenia Working Group symptom criteria at baseline (P = 0.003) and attained and sustained remission for 3 months during study (47.7%, 49.3%, 29.6%, and 22.2%; P = 0.006). Good premorbid functioning corresponds with better treatment response in recent-onset psychosis as captured on both clinician and patient-reported measures.

show abstract

“…A recent review by Schmael et al (2007) synthesized previous findings. Premorbid adjustment has been related to sex, with males showing generally worse premorbid adjustment (e.g., Bailer, Brauer, & Rey, 1996; Rabinowitz, Smedt, Harvey, & Davidson, 2002). Poor premorbid adjustment has also been linked to earlier age of onset (e.g., Krauss, Marwinski, Held, Rietschel, & Freyberger, 1998; Allen, Frantom, Strauss, & van Kammen, 2005).…”

Section: Introductionmentioning

confidence: 99%

Using latent class growth analysis to form trajectories of premorbid adjustment in schizophrenia.

Cole¹,

Apud²,

Weinberger³

et al. 2012

Journal of Abnormal Psychology

View full text Add to dashboard Cite

Premorbid adjustment varies widely among individuals with schizophrenia, and has been shown to bear significantly on prodrome and onset characteristics, and on cognition, symptoms, and functioning after onset. The current analysis focused on the Premorbid Adjustment Scale (PAS), a retrospective measure assessing social and academic function at several time points from early childhood to illness onset. In an effort to explore discrete developmental subtypes, we applied latent class growth analysis (LCGA) to data from the PAS in our sample of individuals with schizophrenia (N = 208), finding three latent trajectory classes. The first of these classes showed consistently adequate-to-good social and academic functioning prior to onset; the second showed initially good function and deterioration with time until onset; the third showed poor functioning in childhood that deteriorated further during the years up to diagnosis. The classes differed significantly in terms of age of onset, processing speed, and functioning after onset. There were no significant differences in symptomatology. Our findings illustrate a potentially powerful methodological approach to the problem of heterogeneity in schizophrenia research, and add weight to the notion that aspects of premorbid history may be useful for subtyping schizophrenia patients. The potential implications of this subtyping strategy, including those pertaining to potential genetics studies, are discussed.

show abstract

Relationship Between Premorbid Functioning and Symptom Severity as Assessed at First Episode of Psychosis

Cited by 82 publications

References 15 publications

Treatment Response Trajectories and Their Antecedents in Recent-Onset Psychosis

Treatment Response Trajectories and Their Antecedents in Recent-Onset Psychosis

Premorbid Functioning and Treatment Response in Recent-Onset Schizophrenia

Using latent class growth analysis to form trajectories of premorbid adjustment in schizophrenia.

Contact Info

Product

Resources

About