Does premorbid IQ have a pathoplastic effect on symptom presentation in schizophrenic and bipolar disorders?

Education and employment levels among Jamaican patients newly diagnosed with schizophrenia and bipolar disorder

BACKGROUND

Comparisons between persons with bipolar disorder and those with schizophrenia are not well researched in the Caribbean.

AIMS

To compare the educational and occupational attainments in Jamaicans diagnosed with these two disorders.

METHODS

Data on diagnosis, educational level, type of employment and other basic socio-demographic variables were collected from Jamaican hospital patients who were newly diagnosed with schizophrenia or bipolar disorder. Fisher's exact and χ2 tests, as well as binary logistic regression, were used to explore how these characteristics varied according to diagnosis. Statistical significance was taken at p < .05.

RESULTS

Schizophrenia was associated with significantly lower educational attainment than bipolar disorder (p = .022 for educational level attained; p = .026 for completion of secondary school). The majority (87.1%) of the 93 patients included in the analysis had no specific marketable job skills. However, the proportion of persons with bipolar disorder who had such skills was three times the corresponding proportion of persons with schizophrenia.

CONCLUSIONS

The low educational achievement among persons with schizophrenia makes education a potentially important area for interventions targeted at this group. Because gross deficiencies in job skills were common to both patient groups, improvement in job skill levels is an important goal for persons with either of these disorders.

Premorbid intelligence of inpatients with different psychiatric diagnoses does not differ

The diagnostic specificity of poor premorbid intelligence is controversial. We explored premorbid intelligence level in psychiatric patients with personality disorders, depressive disorders, bipolar disorders and schizophrenic disorders. 273 consecutively admitted patients and 81 controls were included in the study and tested with the 'Test di Intelligenza Breve', an Italian adaptation of the National Adult Reading Test. Significant differences between the clinical samples and the control subjects were found but not among the 4 clinical groups. The observation of premorbid IQ deficits in subjects with diagnoses other than schizophrenia suggests a common vulnerability diathesis, which is most likely to have a neurodevelopmental basis.