Association of premorbid adjustment with symptom profile and quality of life in first episode psychosis in a tertiary hospital in Tehran, Iran

ABSTRACT

Poor premorbid adjustment has been reported to be a predictor of more severe psychotic symptoms and poor quality of life in such psychotic disorders as schizophrenia. However, most studies were performed on chronic schizophrenic patients, and proposed the likelihood of recall biases and the effect of chronicity. The aim of this study was to investigate these factors in a sample of first episode psychotic patients, as a part of Roozbeh first episode psychosis project [RooF]. Premorbid adjustment was assessed using Premorbid Adjustment Scale [PAS] in 48 patients with the first psychotic episode who were admitted to Roozbeh Psychiatric Hospital. The severity of symptoms was measured using Positive and Negative Scale [PANSS] in three subgroups of positive, negative and general subscales. Quality of life was measured using WHO QOL, and Global Assessment of Functioning [GAF] was also measured. The mean age was 24 years. Poor Premorbid adjustment in late adolescence was significantly associated with more severe symptoms according to PANSS negative symptoms [p=0.019, r=0.44]. Furthermore, sociability and peer relationship domains had a positive correlation with PANSS negative subscale scores [r=0.531, p=0.002 and r=0.385, p=0.03, respectively]. There were no significant differences between males and females in premorbid adjustment. Furthermore, this study failed to show any differences between affective and non-affective psychosis in premorbid functioning. Our study confirms poor premorbid adjustment association with more severe negative symptoms and poor quality of life in a sample of Iranian first episode psychotic patients