Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-19T02:27:08.864Z Has data issue: false hasContentIssue false

Premorbid Personality in First-Onset Psychosis

Published online by Cambridge University Press:  02 January 2018

Tim Dalkin*
Affiliation:
Westminster House, Mapperley Hospital, Nottingham
Patrice Murphy
Affiliation:
St Leonard's Hospital, Mullingar, Ireland
Cris Glazebrook
Affiliation:
Queen's Medical Centre, Nottingham
Ian Medley
Affiliation:
Mandala Centre, Nottingham
Glynn Harrison
Affiliation:
Queen's Medical Centre, Nottingham
*
Correspondence

Abstract

The data presented are those from a two-year prospective study of 69 patients identified in the Nottingham field centre of the WHO Study of Determinants of Outcome of Severe Mental Disorders. Premorbid personality, childhood adjustment and adolescent adjustment were assessed at the patients' first presentation to psychiatric services with a psychotic illness. Ratings were made blind to diagnosis. Premorbid explosive and paranoid traits were commoner in patients with schizophrenia than in patients with other non-organic psychoses, and these traits were associated with later onset of schizophrenia. Premorbid schizoid traits were significantly commoner in patients with schizophrenia compared to patients with other psychoses, but only in those patients for whom a parent was the informant. Schizoid traits were no commoner in men with schizophrenia than in women, and were not associated with earlier age of onset. The findings suggest that premorbid personality, in men and women, may shape the expression of symptoms produced during an illness episode.

Type
Papers
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1.

A report from the UK Field Research Centre of the World Health Organization Collaborative Study on Determinants of Outcome of Severe Mental Disorders.

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Andreasen, N. C., Ehrhardt, J. C., Swayze, V. W., et al (1990) Magnetic resonance imaging of the brain in schizophrenia. Archives of General Psychiatry, 47, 3544.10.1001/archpsyc.1990.01810130037006CrossRefGoogle ScholarPubMed
Bleuler, E. (1911) Dementia Praecox or the Group of Schizophrenias. Leipzig: Deutsche (transl. 1950); New York: International University Press.Google Scholar
Childers, S. E. & Harding, C. M. (1990) Gender, premorbid social functioning, and long-term outcome in DSM–III schizophrenia. Schizophrenia Bulletin, 16, 309318.10.1093/schbul/16.2.309CrossRefGoogle ScholarPubMed
Cooper, J. E., Goodhead, D., Craig, T., et al (1987) The incidence of schizophrenia in Nottingham. British Journal of Psychiatry, 151, 619626.10.1192/bjp.151.5.619CrossRefGoogle ScholarPubMed
Cutting, J. (1985) The Psychology of Schizophrenia. London: Churchill Livingstone.Google Scholar
Foerster, A., Lewis, G., Owen, M., et al (1991) Premorbid adjustment and personality in psychosis: effects of sex and diagnosis. British Journal of Psychiatry, 158, 171176.10.1192/bjp.158.2.171CrossRefGoogle ScholarPubMed
Goldstein, J. M. & Link, B. G. (1988) Gender and the expression of schizophrenia. Journal of Psychiatric Research, 22, 141155.10.1016/0022-3956(88)90078-7CrossRefGoogle ScholarPubMed
Hafner, H., Riecher, A., Maurer, K., et al (1989) How does gender influence age at first hospitalisation for schizophrenia? Psychological Medicine, 19, 903918.10.1017/S0033291700005626CrossRefGoogle ScholarPubMed
Jablensky, A., Sartorius, N., Ernberg, G., et al (1991) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization Ten-Country Study. Psychological Medicine (monograph suppl. 20).CrossRefGoogle Scholar
Kety, S. S., Rosenthal, D., Wender, P. H., et al (1968) The types and prevalence of mental illness in the biological and adoptive families of adopted schizophrenics. In The Transmission of Schizophrenia (eds Rosenthal, D. & Kety, S. S.), pp. 345362. Oxford: Pergamon Press.Google Scholar
Kraepelin, E. (1919) Dementia Praecox and Paraphrenia. Edinburgh: E. and S. Livingstone.Google Scholar
Kretschmer, E. (1921) Physique and Character (transl. 1936). London: Kegan Paul.Google Scholar
Lewis, S. (1992) Sex and schizophrenia: vive la différence. British Journal of Psychiatry, 161, 445450.10.1192/bjp.161.4.445CrossRefGoogle ScholarPubMed
McGlashan, T. H. & Bardenstein, K. K. (1990) Gender differences in affective, schizoaffective, and schizophrenic disorders. Schizophrenia Bulletin, 16, 319329.10.1093/schbul/16.2.319CrossRefGoogle ScholarPubMed
Mednick, S. A., Parnas, J. & Schalsinger, F. (1987) The Copenhagen High Risk Project, 1962–86. Schizophrenia Bulletin, 13, 485495.10.1093/schbul/13.3.485CrossRefGoogle ScholarPubMed
Nyman, A. K. (1978) Non-regressive schizophrenia: clinical course and outcome. Acta Psychiatrica Scandinavica (suppl. 272).CrossRefGoogle Scholar
Office of Population, Censuses and Surveys (1987) OPCS Monitor. London: HMSO.Google Scholar
Offord, D. R. & Cross, L. A. (1969) Behavioural antecedents of adult schizophrenia. Archives of General Psychiatry, 21, 267283.10.1001/archpsyc.1969.01740210011003CrossRefGoogle ScholarPubMed
Sartorius, N., Jablensky, A., Korten, A., et al (1986) Early manifestations and first-contact incidence of schizophrenia in different cultures. Psychological Medicine, 16, 909928.10.1017/S0033291700011910CrossRefGoogle ScholarPubMed
Strauss, J. G., Kokes, R. F., Klorman, R., et al (1977) Premorbid adjustment in schizophrenia: concepts, measures and implications. Schizophrenia Bulletin, 3, 182185.10.1093/schbul/3.2.182CrossRefGoogle ScholarPubMed
Wahl, O. F. & Hunter, J. (1992) Are gender effects being neglected in schizophrenia research? Schizophrenia Bulletin, 18, 313317.10.1093/schbul/18.2.313CrossRefGoogle ScholarPubMed
Watt, N. F. (1972) Longitudinal changes in the social behaviour of children hospitalised for schizophrenia as adults. Journal of Nervous and Mental Disease, 155, 4254.10.1097/00005053-197207000-00006CrossRefGoogle ScholarPubMed
Weinberger, D. R., Cannon-Spoor, E., Potkin, S. G., et al (1980) Poor premorbid adjustment and CT scan abnormalities in chronic schizophrenia. American Journal of Psychiatry, 137, 14101413.Google ScholarPubMed
Williams, A. O., Reveley, M. A., Kolakowska, T., et al (1985) Schizophrenia with good and poor outcome 11: cerebral ventricular size and its clinical significance. British Journal of Psychiatry, 146, 239246.10.1192/bjp.146.3.239CrossRefGoogle Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
Zigler, E. & Levine, J. (1973) Premorbid adjustment and paranoid-nonparanoid status in schizophrenia: A further investigation. Journal of Abnormal Psychology, 82, 189199.10.1037/h0035152CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.