Premorbid adjustment amongst outpatients with schizophrenia in a Nigerian psychiatric facility

BACKGROUND: Studies from developed countries have shown that poor premorbid adjustment in patients with schizophrenia is associated with poor outcome. However, similar studies in developing countries like Nigeria are few despite the stability of schizophrenia prevalence across cultures. AIM: The aim of this study was to assess the prevalence and correlates of poor premorbid adjustment amongst outpatients with schizophrenia. SETTING: The Neuropsychiatric Hospital, Abeokuta in Ogun State, Nigeria. METHODS: The premorbid adjustment of 300 outpatients with schizophrenia was assessed using the premorbid adjustment scale. Pattern and severity of psychosis, overall illness severity, global assessment of functioning and socio-demographic factors were investigated as correlates of premorbid functioning. RESULTS: About half (53.3%) of the respondents had poor premorbid adjustment and most of them were males (56.9%). Poor premorbid adjustment was associated with male gender (χ(2) = 7.81, p = 0.005) whilst good premorbid adjustment was associated with no or borderline illness severity (χ(2) = 8.26, p = 0.016) as well as no or mild impairment in functioning (χ(2) = 7.01, p = 0.029) amongst the respondents. Positive, negative and general symptomatology were predicted by premorbid adjustment at different developmental stages. CONCLUSION: Consistent with existing literature, poor premorbid adjustment was prevalent amongst patients with schizophrenia in this study and was associated with male gender, poorer clinical outcomes and greater illness severity. Mental health promotion and other preventative approaches are recommended as possible early intervention strategies in dealing with schizophrenia.