Abstract
BackgroundStudies from developed countries have shown that poor premorbid adjustment in patients with schizophrenia is associated with poor outcome. However, similar studies in developing countries like Nigeria are few despite the stability of schizophrenia prevalence across cultures.AimThe aim of this study was to assess the prevalence and correlates of poor premorbid adjustment amongst outpatients with schizophrenia.SettingThe Neuropsychiatric Hospital, Abeokuta in Ogun State, Nigeria.MethodsThe premorbid adjustment of 300 outpatients with schizophrenia was assessed using the premorbid adjustment scale. Pattern and severity of psychosis, overall illness severity, global assessment of functioning and socio-demographic factors were investigated as correlates of premorbid functioning.ResultsAbout half (53.3%) of the respondents had poor premorbid adjustment and most of them were males (56.9%). Poor premorbid adjustment was associated with male gender (χ2 = 7.81, p = 0.005) whilst good premorbid adjustment was associated with no or borderline illness severity (χ2 = 8.26, p = 0.016) as well as no or mild impairment in functioning (χ2 = 7.01, p = 0.029) amongst the respondents. Positive, negative and general symptomatology were predicted by premorbid adjustment at different developmental stages.ConclusionConsistent with existing literature, poor premorbid adjustment was prevalent amongst patients with schizophrenia in this study and was associated with male gender, poorer clinical outcomes and greater illness severity. Mental health promotion and other preventative approaches are recommended as possible early intervention strategies in dealing with schizophrenia.
Highlights
Premorbid adjustment in relation to mental disorder has been defined by various authors
It has been shown that most patients with schizophrenia had poor premorbid adjustment,[4,5] and this has been associated with brain atrophy,[6] ventricular enlargement,[7] attention deficits,[8] verbal reasoning difficulties,[9] negative symptoms,[10] poor treatment response,[11] prolonged hospital stay[12] and poor functioning[13]
Poor premorbid adjustment was significantly associated with the male gender, whilst good premorbid adjustment was associated with no to borderline illness as well as no to mild impairment (Table 3)
Summary
Premorbid adjustment in relation to mental disorder has been defined by various authors. Scholars have reiterated the prognostic importance of premorbid adjustment in schizophrenia.[2,3]. It is important to note that the above findings were observed amongst people of European descent and there appears to be only one relevant study on the subject amongst Nigerian patients with schizophrenia.[14] It was a comparative study on the premorbid social adjustment of 38 patients with schizophrenia and 20 with mania. The authors found that the patients with schizophrenia consistently tended to have poorer premorbid adjustment compared with patients with mania, and this was significant with the domain of ‘highest level of functioning’. Studies from developed countries have shown that poor premorbid adjustment in patients with schizophrenia is associated with poor outcome. Similar studies in developing countries like Nigeria are few despite the stability of schizophrenia prevalence across cultures
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Schedule a callMore From: The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa
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