The role of premorbid adjustment in schizophrenia: Focus on cognitive remediation outcome

Mariachiara Buonocore, Francesca Bosinelli, Margherita Bechi, Marco Spangaro, Marco Piantanida, Federica Cocchi, Laura Bianchi, Carmelo Guglielmino, Antonella Rita Mastromatteo, Roberto Cavallaro, Marta Bosia

Research output: Contribution to journalArticlepeer-review


Premorbid adjustment has been associated with several outcomes in schizophrenia and has been proposed as an index of cognitive reserve. This study aims to comprehensively analyse the relation between premorbid adjustment and clinical, neurocognitive, socio-cognitive and functional assessments, as well as to investigate the effect of premorbid adjustment on cognitive improvements after a cognitive remediation therapy protocol. Seventy-nine clinically stabilised outpatients with schizophrenia underwent a combined intervention consisting of cognitive remediation therapy added to standard rehabilitation therapy. All patients were assessed at baseline for psychopathology, premorbid adjustment, intellectual level, cognition and functioning. Cognitive evaluations were also repeated after the intervention. At baseline, significant correlations were observed between premorbid adjustment and working memory. The global cognitive improvement after treatment was significantly predicted by age and premorbid adjustment. This study confirms the association between premorbid adjustment and cognitive impairment and is the first to highlight the possible role of premorbid adjustment on the capacity to recover from cognitive deficits through a cognitive remediation therapy protocol. The data suggest that cognitive remediation may be particularly effective for people in the early course and that the assessment of premorbid adjustment could be of value to design individualised interventions.

Original languageEnglish
Pages (from-to)1611-1624
Number of pages14
JournalNeuropsychological Rehabilitation
Issue number10
Publication statusPublished - Nov 26 2019


  • Cognition
  • Functioning
  • Neuropsychology
  • Psychosis

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Rehabilitation
  • Arts and Humanities (miscellaneous)
  • Applied Psychology


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