A 45-year follow-up study of adolescent schizophrenia. Part I: Premorbid values of psychological and relational indicators in the context of illness course and long-term social functioning of patients.

OBJECTIVES

Research on predictors of adolescent schizophrenia, especially those based on long-term follow-up studies, is rare in the literature. In our analysis, we examine the relationship between the premorbid functioning of the respondents and clinical and social indicators of the illness course.

METHODS

69 patients at the average age of 16 years (time point 0), hospitalized due to schizophrenia (retrospectively re-diagnosed according to ICD-10 criteria) and re-examined 5 years later (time point 1 - personal examination of 41 individuals), were re-evaluated for clinical and social parameters 45 yearsafter their initial hospitalization (time point 2 -personal examination of 21 individuals).

RESULTS

Premorbid indicators of mood, life drive, emotional expression, level of social withdrawal, intelligence, anxiety, development of sexual and aggressive drive, and family and extra-family relational life revealed numerous and various correlations with both the symptomatic picture and clinical course of schizophrenia as well as distant social functioning of the subjects. Variables of the greatest prognostic value were: the emotional attitude of "moving away from" people and the world, and rich relational life outside the family of origin. These variables revealed opposite correlations, especially with the severity of negative symptoms, the level of late insight and regression, the quality of professional life and GAF scores, with the correlations of rich relational lifeto be assessed as positive and the correlations of attitude of "moving away from" as negative. The harmonious development of drive as well as high intelligence also proved to be significant. The correlations of both of these variables have proved beneficial both in clinical and social terms.

CONCLUSIONS

The so-called premorbid personality described by several indicators turns out to be an important prognostic factor in juvenile schizophrenia.