TY - JOUR
T1 - Pathways to functional outcomes in schizophrenia
T2 - The role of premorbid functioning, negative symptoms and intelligence
AU - Brill, N.
AU - Levine, S. Z.
AU - Reichenberg, A.
AU - Lubin, G.
AU - Weiser, M.
AU - Rabinowitz, J.
N1 - Funding Information:
This study was kindly funded by: NARSAD, the German Federal Ministry of Education and Research (BMBF) within the framework of German Israeli Project Cooperation, the Elie Wiesel Chair and Hanacy Scholarship at Bar Ilan University. Dr Stephen Z. Levine was supported by a Grant from The Israel Foundations Trustees (2008–2009).
PY - 2009/5
Y1 - 2009/5
N2 - Background: Social and intellectual premorbid functioning are generally estimated retrospectively, and related to clinical or hospitalization outcomes in schizophrenia. Yet the relationship between premorbid functioning assessed prior to psychiatric hospitalization and postmorbid functional outcomes has not been examined. Objectives: To test competing models of the relationship between (a) functional outcomes with (b) premorbid functioning assessed on nationally administered tests prior to psychiatric hospitalization, postmorbid intellectual functioning and symptomatology using a historical prospective design. Methods: Ninety one inpatient and outpatient males with schizophrenia or schizoaffective disorder, aged 19 to 35, were examined using the Positive and Negative Syndrome Scale, the WAIS-III and Strauss and Carpenter social and occupational functional outcome scale. Premorbid intelligence and social functioning data were obtained from national standardized tests administered during high school prior to first hospitalization for schizophrenia. Results: Path modeling showed that premorbid intelligence and behavioral functioning directly predicted postmorbid IQ and negative symptoms, and indirectly predicted postmorbid social and occupational functioning via negative symptoms. Item level analysis indicated that better social and occupational outcomes occurred in a group with few negative symptoms. Conclusions: Premorbid functioning, postmorbid IQ and negative symptoms are related, yet the relationship between premorbid functioning and postmorbid functional outcomes appears to be mediated by postmorbid negative symptoms.
AB - Background: Social and intellectual premorbid functioning are generally estimated retrospectively, and related to clinical or hospitalization outcomes in schizophrenia. Yet the relationship between premorbid functioning assessed prior to psychiatric hospitalization and postmorbid functional outcomes has not been examined. Objectives: To test competing models of the relationship between (a) functional outcomes with (b) premorbid functioning assessed on nationally administered tests prior to psychiatric hospitalization, postmorbid intellectual functioning and symptomatology using a historical prospective design. Methods: Ninety one inpatient and outpatient males with schizophrenia or schizoaffective disorder, aged 19 to 35, were examined using the Positive and Negative Syndrome Scale, the WAIS-III and Strauss and Carpenter social and occupational functional outcome scale. Premorbid intelligence and social functioning data were obtained from national standardized tests administered during high school prior to first hospitalization for schizophrenia. Results: Path modeling showed that premorbid intelligence and behavioral functioning directly predicted postmorbid IQ and negative symptoms, and indirectly predicted postmorbid social and occupational functioning via negative symptoms. Item level analysis indicated that better social and occupational outcomes occurred in a group with few negative symptoms. Conclusions: Premorbid functioning, postmorbid IQ and negative symptoms are related, yet the relationship between premorbid functioning and postmorbid functional outcomes appears to be mediated by postmorbid negative symptoms.
KW - Functional outcomes
KW - Historical prospective linkage design
KW - Intelligence
KW - Premorbid functioning
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=67349230927&partnerID=8YFLogxK
U2 - 10.1016/j.schres.2009.02.016
DO - 10.1016/j.schres.2009.02.016
M3 - Article
C2 - 19297133
AN - SCOPUS:67349230927
SN - 0920-9964
VL - 110
SP - 40
EP - 46
JO - Schizophrenia Research
JF - Schizophrenia Research
IS - 1-3
ER -