Social premorbid adjustment and linguistic abilities in first-episode schizophrenia
Schizophrenia is a psychotic disorder usually characterized by withdrawal from reality, which involves alterations in cognition and emotions, language and thought, perceptions and affect. It is characterized by positive symptoms, such as delusions, hallucinations, disorganized thinking and disorganized behavior, and by negative symptoms, such as abolition, anhedonia, alogia and affective flattening (American Psychiatric Association 2000). Precisely identifying the onset of psychotic symptoms in an individual’s life course is a challenging task. In fact, psychotic disorders are highly dynamic in nature, and they present with great levels of inter-subject variability. Research has clearly shown that, in the early stages of psychosis, spontaneous mechanisms governing social interactions are altered (see also Chapter 8), bringing characteristic and recognizable changes in social capacities. Sentiments of strangeness or familiarity appear, sometimes in alternation, producing great instability. In these moments, individuals experience a state of “great worry”, a perception that implies an estrangement of the subject from the rest of his or her social group and which brings along uncertainty and distrust. As a result, social isolation is often seen in the prodromal phase of a first psychotic episode (Grivois and Grosso 1998).