Impairment of social functioning before the onset of psychosis (Review) [La compromissione del funzionamento sociale precedente l'esordio psicotico]

Introduction: Treatment of schizophrenia is frequently associated with poor social outcomes, even when it improves positive symptoms. This observation suggests that the social deficits might be an independent psychopathological area that was present before the onset of psychosis. We conducted a short review of the literature to analyze published data on the premorbid social functioning of patients with psychosis. Materials and methods: We conducted a short review of published reports (English only) of case-control trials that examined premorbid social functioning in patients with psychosis. The literature search was conducted electronically and involved the PubMed, EmBase, and PsychINFO databases (1988-2009). Search terms included [social adjustment] or [premorbid social adjustment] or [social development] and [schizophrenia] or [early psychosis], alone or in combination. The references cited in each single article were manually searched to complete the review. Results: The literature search identified 23 studies that documented impairments in the premorbid social functioning of patients with psychosis. These deficits involved different areas of social performance, but they did not appear to be distinctive of schizophrenia. In fact, some studies with controls suffering from other psychiatric diseases failed to find significant differences between the premorbid social functioning of these patients and those with schizophrenia. Conclusions: Further research should analyze premorbid social functioning in patients with schizophrenia to provide a more detailed description of its characteristic aspects