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Premorbid adjustment and personality in people with schizophrenia†

Published online by Cambridge University Press:  03 January 2018

A. Malmberg ,
G. Lewis ,
A. David  and
P. Allebeck
A. Malmberg*
Affiliation:
University Department of Psychiatry, Warneford Hospital, Oxford
G. Lewis
Affiliation:
Department of Psychological Medicine, University of Wales College of Medicine, Cardiff
A. David
Affiliation:
Institute of Psychiatry, Denmark Hill, London
P. Allebeck
Affiliation:
Department of Social Medicine, University of Göteborg, Vasa Hospital. S-411 33 Göteborg, Sweden
*
Dr A. Malmberg, PO Box 650528, Benmore 2010, Johannesburg, Republic of South Africa
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Abstract

Background

Schizoid personality and poor social adjustment have been thought of as common antecedents of schizophrenia but the existing literature is inconclusive. We have carried out a large cohort study with improved methodology.

Method

The premorbid personality and adjustment of 50 054 Swedish men were assessed on entry into the army at the age of 18. Individuals who developed schizophrenia or another psychosis after 15-year follow-up were identified. Odds ratios for variables independently associated with the later development of schizophrenia were calculated, adjusting for potential confounders.

Results

Four variables reflecting early problems with interpersonal relationships were strongly associated with later schizophrenia and, to a lesser extent, non-schizophrenic psychoses, but also occurred commonly in the cohort as a whole. These associations with schizophrenia persisted after early-onset cases were excluded, though their predictive value was low (3.0%, 95% CI 1.5–4.5).

Conclusions

Some aspects of premorbid personality and adjustment may act as risk factors for schizophrenia. The results appear to be most consistent with a multi-factorial aetiology for schizophrenia and offer tentative support for a psychological disturbance mediating genetic and environmental effects on the causal pathway to the illness.

Type
Papers
Information
The British Journal of Psychiatry , Volume 172 , Issue 4 , April 1998 , pp. 308 - 313
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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Footnotes

†.

See editorial, pp. 289–290, and commentaries, pp. 314–315, this issue.

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