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Schizophr Res. 2013 Dec;151(1-3):252-8. doi: 10.1016/j.schres.2013.10.027. Epub 2013 Nov 17.

Three-factor model of premorbid adjustment in a sample with chronic schizophrenia and first-episode psychosis.

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Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain; Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Boi de Llobregat, Barcelona, Spain; Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Esplugues de Llobregat, Barcelona, Spain; Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Esplugues de Llobregat, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain. Electronic address:



The dimensionality of premorbid adjustment (PA) has been a debated issue, with attempts to determine whether PA is a unitary construct or composed of several independent domains characterized by a differential deterioration pattern and specific outcome correlates.


This study examines the factorial structure of PA, as well as, the course and correlates of its domains.


Retrospective study of 84 adult patients experiencing first-episode psychosis (FEP) (n=33) and individuals with schizophrenia (SCH) (n=51). All patients were evaluated with a comprehensive battery of instruments including clinical, functioning and neuropsychological variables. A principal component analysis accompanied by a varimax rotation method was used to examine the factor structure of the PAS-S scale. Paired t tests and Wilcoxon rank tests were used to assess the changes in PAS domains over time. Bivariate correlation analyses were performed to analyse the relationship between PAS factors and clinical, social and cognitive variables.


PA was better explained by three factors (71.65% of the variance): Academic PA, Social PA and Socio-sexual PA. The academic domain showed higher scores of PA from childhood. Social and clinical variables were more strongly related to Social PA and Socio-sexual PA domains, and the Academic PA domain was exclusively associated with cognitive variables.


This study supports previous evidence, emphasizing the validity of dividing PA into its sub-components. A differential deterioration pattern and specific correlates were observed in each PA domains, suggesting that impairments in each PA domain might predispose individuals to develop different expressions of psychotic dimensions.


Academic domain; Incipient psychosis; Premorbid functioning; Psychotic disorders; Social domain; Socio-sexual domain

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