ABSTRACT
Investigation of childhood precursors of adult psychotic illnesses aims to clarify our understanding of aetiologic mechanisms and may ultimately aid the development of stategies for early detection and treatment of the disorder. Reviews of the literature on premorbid characteristics of schizophrenic patients have shown that approximately a third have shown obvious premorbid behavioural abnormalities, including social withdrawal, extreme sensitivity, inability to make friends and poor academic competence.1-5
The premorbid functioning of patients who develop affective psychosis has been studied less frequently, perhaps reflecting different views about the aetiology of the condition. Studies comparing the premorbid adjustment of patients with affective psychosis and schizophrenia have found that adjustment is poorer in schizophrenia,6-9 but without a normal control group could not determine whether the affective psychotic patients were also impaired but to a lesser degree. Prospective and retrospective cohort studies10-12 have usually, though not inevitably,13 failed to find significant differences between preaffective psychotic children and normal controls. Poor premorbid functioning is an indicator of poor outcome in affective disorder,14 and is also a predictor of vulnerability to psychosis in major depressive disorder.15
