NEGATIVE LABELING OF INDIVIDUALS WITH FIRST EPISODE SCHIZOPHRENIA - THE EFFECT OF PREMORBID FUNCTIONING

This study examines the hypothesis that negative labelling of individu als with a first episode of schizophrenia is related to the length and intensity of behavioural disturbance prior to first hospitalization. Forty-five individuals with first episode schizophrenia were assessed at admission to hospital for the presence and severity of symptoms, du ration of untreated illness and premorbid social and occupational func tioning. Negative labelling was assessed from ratings obtained from in dividuals designated as a significant other by the individuals with sc hizophrenia. Identical measures of labelling were obtained from indivi duals designated as a significant other by a comparison group (n=70) w ho had no history of psychiatric disorder. The results indicated that the individuals with schizophrenia received more negative labels than the asymptomatic individuals. The negative attributions were associate d with older age at onset of psychosis, a long period of deterioration before the onset of psychosis, and poor occupational functioning in t he 9 months prior to hospitalization. These findings are consistent wi th results from studies that have examined expressed emotion (EE) in f irst episode schizophrenia and suggest that the reported association o f high EE with relapse in first episode schizophrenia may be confounde d with premorbid functioning that is typically associated with poor ou tcome.