Background. Premorbid adjustment (PA) abnormalities in psychotic disorders are associated with an earlier age at onset (AAO) and unfavorable clinical outcomes, including treatment resistance. Prior family studies suggest that familial liability, likely reflecting increased genetic risk, and socioeconomic status (SES) contribute to premorbid maladjustment. However, their joint effect possibly indicating gene–environment interaction has not been evaluated. Methods. We examined whether family history of psychosis (FHP) and parental SES may predict PA and AAO in unrelated cases with first-episode psychosis (n = 108) and schizophrenia (n = 104). Premorbid academic and social functioning domains during childhood and early adolescence were retrospectively assessed. Regression analyses were performed to investigate main effects of FHP and parental SES, as well as their interaction. The relationships between PA, AAO, and response to antipsychotic medication were also explored. Results. Positive FHP associated with academic PA difficulties and importantly interacted with parental SES to moderate social PA during childhood (interaction p = 0.024). Positive FHP and parental SES did not predict differences in AAO. Nevertheless, an earlier AAO was observed among cases with worse social PA in childhood (β = −0.20; p = 0.005) and early adolescence (β = −0.19; p = 0.007). Further, confirming evidence emerged for an association between deficient childhood social PA and poor treatment response (p = 0.04). Conclusions. Familial risk for psychosis may interact with parental socioeconomic position influencing social PA in childhood. In addition, this study supports the link between social PA deviations, early psychosis onset, and treatment resistance, which highlights premorbid social functioning as a promising clinical indicator.

中文翻译：

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家庭和社会经济对精神病病前功能的贡献：对发病年龄和治疗反应的影响

背景。精神病的病前调整 (PA) 异常与较早的发病年龄 (AAO) 和不利的临床结果有关，包括治疗抵抗。先前的家庭研究表明，可能反映遗传风险增加的家族责任和社会经济地位 (SES) 会导致病前适应不良。然而，它们可能表明基因-环境相互作用的联合效应尚未得到评估。方法。我们研究了精神病家族史 (FHP) 和父母 SES 是否可以预测首发精神病（n = 108）和精神分裂症（n = 104）无关病例的 PA 和 AAO。回顾性评估了儿童期和青春期早期的病前学业和社会功能领域。进行回归分析以研究 FHP 和父母 SES 的主要影响，以及他们的互动。还探讨了 PA、AAO 和抗精神病药物反应之间的关系。结果。积极的 FHP 与学业 PA 困难相关，重要的是与父母的 SES 相互作用，以减轻儿童时期的社会 PA（相互作用 p = 0.024）。FHP 阳性和父母 SES 不能预测 AAO 的差异。然而，在儿童期（β = -0.20；p = 0.005）和青春期早期（β = -0.19；p = 0.007）社会 PA 较差的病例中观察到了较早的 AAO。此外，证实了儿童社会 PA 不足与治疗反应差之间存在关联的证据 (p = 0.04)。结论。精神病的家族风险可能与父母的社会经济地位相互作用，影响儿童时期的社会 PA。此外，这项研究支持社会 PA 偏差之间的联系，