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Premorbid Social Underachievement in Schizophrenia

Results from the Camberwell Collaborative Psychosis Study

Published online by Cambridge University Press:  03 January 2018

P. B. Jones*
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry and King's College Hospital, De Crespigny Park, London SE5 8AF
P. Bebbington
Affiliation:
Institute of Psychiatry, De Crespigny Park, London SE5 8AF
A. Foerster
Affiliation:
National Institutes of Mental Health, Bethesda, Maryland, USA
S. W. Lewis
Affiliation:
Academic Department of Psychiatry, Charing Cross and Westminster Medical School, London W6 8RP
R. M. Murray
Affiliation:
Institute of Psychiatry and King's College Hospital, De Crespigny Park, London SE5 8AF
A. Russell
Affiliation:
Genetics Section, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
P. C. Sham
Affiliation:
Genetics Section, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
B. K. Toone
Affiliation:
King's College and Maudsley Hospitals, Denmark Hill, London SE5 9RS
S. Wilkins
Affiliation:
Genetics Section, Institute of Psychiatry, De Crespigny Park, London SE5 8AF
*
Correspondence

Abstract

In an investigation of the timing and precursors of social decline in schizophrenia and affective psychosis, 195 subjects from the Camberwell Collaborative Psychosis Study were currently of lower social class than were their fathers. A comparison between father's occupation and proband's best premorbid occupational level indicated underachievement confined to DSM–III schizophrenia, there being no such effect in affective psychosis. Decline in social status following onset of psychosis, analysed by comparing best premorbid occupation with current occupation, was marked in both schizophrenia and affective psychosis, indicating a non-specific effect. Schizophrenic patients who failed to achieve their fathers' social status had poorer educational qualifications than those who equalled or bettered their paternal social class, despite similar premorbid IQ (NART) scores and age at onset of psychosis. These results indicate that schizophrenia may be manifest before the onset of psychosis, and lend weight to the notion of a developmental origin to this disorder.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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