The British Journal of Psychiatry (2006) 189: 31-35. doi: 10.1192/bjp.bp.105.013276
© 2006 The Royal College of Psychiatrists
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Premorbid functioning and treatment response in recent-onset schizophrenia

Jonathan Rabinowitz, PhD

Bar Ilan University

Philip D. Harvey, PhD

Mount Sinai School of Medicine, New York, USA

Marielle Eerdekens, MD

Johnson & Johnson Pharmaceutical Research and Development, Beerse, Belgium

Michael Davidson, MD

Chaim Sheba Medical Centre, Tel Hashomer, Israel

Correspondence: Dr Jonathan Rabinowitz, Bar Ilan University, Ramat Gan, Israel. Fax +972 9 740 1318; email: jr827{at}columbia.edu

Declaration of interest None.

Background Investigating the relationship between premorbid functioning and treatment response in schizophrenia is relevant to understanding the illness and predicting treatment outcomes.

Aims To examine the relationship between premorbid characteristics and treatment response of people with recent-onset schizophrenia.

Method Data came from a large, double-blind trial of recent-onset psychosis treated with a flexible dose of risperidone or haloperidol. Median treatment length was 206 days. Premorbid functioning was categorised using the Cannon-Spoor Premorbid Adjustment Scale.

Results There were significant differences between the premorbid groups on change on the Positive and Negative Syndrome Scale, Clinical Global Impression severity and cognitive functioning and Extrapyramidal Symptoms Rating Scale. Patients in the `stable-good' premorbid group (n=251) improved more than those in the'stable-poor' (n=198) and 'declining' (n=81) groups. The `stable-good' group received the lowest doses of antipsychotic and had the least extrapyramidal symptoms. Patients in the 'declining' group had the highest dosages and the most extrapyramidal symptoms.

Conclusions In first-episode psychosis good premorbid functioning is associated with better response to treatment and fewer extrapyramidal symptoms.


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