Objective: The study aimed to explore premorbid academic and social functioning in patients with schizophrenia, and its associations with the severity of negative symptoms and neurocognitive impairment. Method: Premorbid adjustment (PA) in patients with schizophrenia was compared to early adjustment in unaffected first-degree relatives and healthy controls. Its associations with psychopathology, cognition, and real-life functioning were investigated. The associations of PA with primary negative symptoms and their two factors were explored. Results: We found an impairment of academic and social PA in patients (P ≤ 0.000001) and an impairment of academic aspects of early adjustment in relatives (P ≤ 0.01). Patients with poor PA showed greater severity of negative symptoms (limited to avolition after excluding the effect of depression/parkinsonism), working memory, social cognition, and real-life functioning (P ≤ 0.01 to ≤0.000001). Worse academic and social PA were associated with greater severity of psychopathology, cognitive impairment, and real-life functioning impairment (P ≤ 0.000001). Regression analyses showed that worse PA in the academic domain was mainly associated to the impairment of working memory, whereas worse PA in the social domain to avolition (P ≤ 0.000001). Conclusion: Our findings suggest that poor early adjustment may represent a marker of vulnerability to schizophrenia and highlight the need for preventive/early interventions based on psychosocial and/or cognitive programs.

Premorbid academic and social functioning in patients with schizophrenia and its associations with negative symptoms and cognition / Bucci, P.; Galderisi, S.; Mucci, A.; Rossi, A.; Rocca, P.; Bertolino, Andrea; Aguglia, E.; Amore, Mario; Andriola, I.; Bellomo, A.; Biondi, M.; Cuomo, Alessia; Dell'Osso, L.; Favaro, A.; Gambi, F.; Giordano, G. M.; Girardi, P.; Marchesi, C.; Monteleone, Pasquale; Montemagni, C.; Niolu, C.; Oldani, L.; Pacitti, F.; Pinna, F.; Roncone, R.; De Vita, Alessandro; Zeppegno, P.; Maj, M.; Patriarca, Sara; Pietrafesa, Daria; Aiello, Carmen; Longo, Luisa; Barone, Marina; Romano, Raffaella; Atti, Anna Rita; Barlati, Stefano; Deste, Giacomo; Valsecchi, Paolo; Carpiniello, Bernardo; Tusconi, Massimo; Puddu, Laura; Signorelli, Maria Salvina; Cannavò, Dario; Minutolo, Giuseppe; Corbo, Mariangela; Montemitro, Chiara; Baroni, Gaia; Altamura, Mario; La Montagna, Maddalena; Carnevale, Raffaella; Murri, Martino Belvederi; Calcagno, Pietro; Bugliani, Michele; Pizziconi, Giulia; Logozzo, Francesca; Rossi, Rodolfo; Giusti, Maria Laura; Salza, Anna; Malavolta, Maurizio; Orsenigo, Giulia; Grassi, Silvia; De Bartolomeis, Andrea; Gramaglia, Carla; Gattoni, Eleonora; Gambaro, Eleonora; Tenconi, Elena; Ferronato, Luisa; Collantoni, Enrico; Tonna, Matteo; Ossola, Paolo; Gerra, MARIA LIDIA; Carmassi, Claudia; Cremone, Ivan Mirko; Carpita, Barbara; Buzzanca, Antonio; Girardi, Nicoletta; Frascarelli, Marianna; Del Casale, Antonio; Comparelli, Anna; Corigliano, Valentina; Siracusano, Alberto; DI LORENZO, Giorgio; Ribolsi, Michele; Corrivetti, Giulio; Bartoli, Luca; Del Buono, Gianfranco; Fagiolini, Andrea; Bolognesi, Simone; Goracci, Arianna; Mancini, Irene; Bava, Irene; Cardillo, Simona. - In: ACTA PSYCHIATRICA SCANDINAVICA. - ISSN 0001-690X. - 138:3(2018), pp. 253-266.

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