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Elaboration on premorbid intellectual performance in schizophrenia: premorbid intellectual decline and risk for schizophrenia.
Arch Gen Psychiatry. 2005 Dec; 62(12):1297-304.AG

Abstract

CONTEXT

Consistent evidence indicates that some, but not most, patients with schizophrenia have below-average intelligence years before they manifest psychosis. However, it is not clear whether this below-average premorbid intelligence is stable or progressive.

OBJECTIVE

To examine whether increased risk for schizophrenia is associated with declining intellectual performance from childhood through adolescence.

DESIGN

Historical cohort study of an entire population using record linkage for psychiatric hospitalization during an 8- to 17-year follow-up period.

SETTING

Mandatory assessment by the draft board of Israeli conscripts.

PARTICIPANTS

Population-based cohort of 555 326 adolescents born in Israel. Data were available on 4 intelligence subtests as well as on reading and spelling abilities and on behavioral and psychosocial variables. A regression-based approach was used to assess the discrepancy between actual IQ at age 17 years and estimated IQ during childhood based on reading and spelling abilities.

MAIN OUTCOME MEASURES

Hospitalization for schizophrenia (as per the International Statistical Classification of Diseases, 10th Revision criteria).

RESULTS

Lower-than-expected IQ at age 17 years was associated with increased risk for later hospitalization for schizophrenia. Results were held after controlling for potential confounders. For 75% of patients with schizophrenia with low actual IQ (<85) at age 17 years and for 23% of patients with actual IQ within the normal range (> or =85), actual IQ was 10 or more points lower than expected. Lower-than-expected IQ was not associated with bipolar disorder or with depression or anxiety disorder.

CONCLUSIONS

Indirect evidence suggests that intellectual deterioration from childhood through adolescence is associated with increased risk for schizophrenia. Despite within-normal-range premorbid IQ scores, apparently healthy adolescents who will later manifest schizophrenia nevertheless have intellectual decline.

Authors+Show Affiliations

Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA. avi.reichenberg@mssm.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16330717

Citation

Reichenberg, Abraham, et al. "Elaboration On Premorbid Intellectual Performance in Schizophrenia: Premorbid Intellectual Decline and Risk for Schizophrenia." Archives of General Psychiatry, vol. 62, no. 12, 2005, pp. 1297-304.
Reichenberg A, Weiser M, Rapp MA, et al. Elaboration on premorbid intellectual performance in schizophrenia: premorbid intellectual decline and risk for schizophrenia. Arch Gen Psychiatry. 2005;62(12):1297-304.
Reichenberg, A., Weiser, M., Rapp, M. A., Rabinowitz, J., Caspi, A., Schmeidler, J., Knobler, H. Y., Lubin, G., Nahon, D., Harvey, P. D., & Davidson, M. (2005). Elaboration on premorbid intellectual performance in schizophrenia: premorbid intellectual decline and risk for schizophrenia. Archives of General Psychiatry, 62(12), 1297-304.
Reichenberg A, et al. Elaboration On Premorbid Intellectual Performance in Schizophrenia: Premorbid Intellectual Decline and Risk for Schizophrenia. Arch Gen Psychiatry. 2005;62(12):1297-304. PubMed PMID: 16330717.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Elaboration on premorbid intellectual performance in schizophrenia: premorbid intellectual decline and risk for schizophrenia. AU - Reichenberg,Abraham, AU - Weiser,Mark, AU - Rapp,Michael A, AU - Rabinowitz,Jonathan, AU - Caspi,Asaf, AU - Schmeidler,James, AU - Knobler,Haim Y, AU - Lubin,Gad, AU - Nahon,Daniela, AU - Harvey,Philip D, AU - Davidson,Michael, PY - 2005/12/7/pubmed PY - 2005/12/28/medline PY - 2005/12/7/entrez SP - 1297 EP - 304 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 62 IS - 12 N2 - CONTEXT: Consistent evidence indicates that some, but not most, patients with schizophrenia have below-average intelligence years before they manifest psychosis. However, it is not clear whether this below-average premorbid intelligence is stable or progressive. OBJECTIVE: To examine whether increased risk for schizophrenia is associated with declining intellectual performance from childhood through adolescence. DESIGN: Historical cohort study of an entire population using record linkage for psychiatric hospitalization during an 8- to 17-year follow-up period. SETTING: Mandatory assessment by the draft board of Israeli conscripts. PARTICIPANTS: Population-based cohort of 555 326 adolescents born in Israel. Data were available on 4 intelligence subtests as well as on reading and spelling abilities and on behavioral and psychosocial variables. A regression-based approach was used to assess the discrepancy between actual IQ at age 17 years and estimated IQ during childhood based on reading and spelling abilities. MAIN OUTCOME MEASURES: Hospitalization for schizophrenia (as per the International Statistical Classification of Diseases, 10th Revision criteria). RESULTS: Lower-than-expected IQ at age 17 years was associated with increased risk for later hospitalization for schizophrenia. Results were held after controlling for potential confounders. For 75% of patients with schizophrenia with low actual IQ (<85) at age 17 years and for 23% of patients with actual IQ within the normal range (> or =85), actual IQ was 10 or more points lower than expected. Lower-than-expected IQ was not associated with bipolar disorder or with depression or anxiety disorder. CONCLUSIONS: Indirect evidence suggests that intellectual deterioration from childhood through adolescence is associated with increased risk for schizophrenia. Despite within-normal-range premorbid IQ scores, apparently healthy adolescents who will later manifest schizophrenia nevertheless have intellectual decline. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/16330717/Elaboration_on_premorbid_intellectual_performance_in_schizophrenia:_premorbid_intellectual_decline_and_risk_for_schizophrenia_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archpsyc.62.12.1297 DB - PRIME DP - Unbound Medicine ER -