Premorbidity Explained

Premorbidity refers to the state of functionality prior to the onset of a disease or illness. It is most often used in relation to psychological function (e.g. premorbid personality or premorbid intelligence), but can also be used in relation to other medical conditions (e.g. premorbid lung function or premorbid heart rate).

Psychology

In psychology, premorbidity is most often used in relation to changes in personality, intelligence or cognitive function.Changes in personality are common in cases of traumatic brain injury involving the frontal lobes,^[1] the most famous example of this is the case of Phineas Gage who survived having a tamping iron shot through his head in a railway construction accident.Declines from premorbid levels of intelligence and other cognitive functions are observed in stroke,^[2] traumatic brain injury,^[3] and dementia^[4] as well as in mental illnesses such as depression^[5] and schizophrenia.^[6]

Other usage in psychology include premorbid adjustment which has important implications for the prognosis of mental illness such as schizophrenia.^[7] Efforts are also being made to identify premorbid personality profiles for certain illness, such as schizophrenia to determine at risk populations.^[8]

Clinical and diagnostic usage

In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), paranoid, schizoid, and schizotypal personality disorders may be diagnosed as conditions premorbid to the onset of schizophrenia.^[9]

See also

• Prodrome

Notes and References

1. Rush, B. K., Malec, J. F., Brown, A. W. & Moessner, A. M.. Personality and functional outcome following traumatic brain injury. Rehabilitation Psychology. 2006. 51. 3. 257–264. 10.1037/0090-5550.51.3.257.
2. Hoffman, M., Schmitt, F., & Bromley E.. Vascular cognitive syndromes: relation to stroke etiology and topography. Acta Neurologica Scandinavica. 2009. 120. 3. 161–169. 10.1111/j.1600-0404.2008.01145.x. 19486324. free.
3. Truelle, J., Koskinen, S., Hawthorne, G., Sarajuuri, J., Formisano, R., Von Wild, K., Neugebauer, E.. Quality of life after traumatic brain injury: The clinical use of the QOLIBRI, a novel disease-specific instrument. Brain Injury. 2010. 24. 11. 1272–1291. 10.3109/02699052.2010.506865. 20722501. 27074290. etal.
4. American Psychological Association. Guidelines for the evaluation of dementia and age-related cognitive change. American Psychologist. 2011. 1–9. 10.1037/a0024643. 67. 1. 21842971.
5. McDermott, L. M. . Ebmeier, K. P.. A meta-analysis of depression severity and cognitive function. Journal of Affective Disorders. 2009. 119. 1–3. 1–8. 10.1016/j.jad.2009.04.022. 19428120.
6. Kurtz, M. M., Donato, J., & Rose, J.. Crystallized verbal skills in schizophrenia: Relationship to neurocognition, symptoms, and functional status. Neuropsychology. 2011. 25. 6. 784–791. 10.1037/a0025534. 21928906.
7. Book: Bernstein, D. A., Penner, L. A., Clarke-Stewart, A. & Roy, E. J.. Psychology. 2006. Houghton Mifflin Company. Boston. 0-618-52718-4. 7th.
8. Bolinskey, P. K. . Gottesman, I. I.. Premorbid personality indicators of schizophrenia-related psychosis in a hypothetically psychosis-prone college sample. Scandinavian Journal of Psychology. 2010. 51. 1. 68–74. 10.1111/j.1467-9450.2009.00730.x. 19497029.
9. American Psychiatric Association, 2000. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, D.C.: American Psychiatric Press, Inc.