Previous research has shown that people with psychotic disorders have impaired functioning prior to the onset of the illness. The main goal of the proposed study was to deepen understanding of the characteristics of pre-morbid impairment in persons later diagnosed with psychotic disorders.

We examined unique pre-morbid data from IDF archives, including narrative summaries of pre-induction interviews of 17-year old adolescents (168 male adolescents who were later hospitalized for psychotic disorders, and 168 matched control subjects). The data were analyzed using mixed-method analysis, combining qualitative and quantitative research methods.

Between group comparisons revealed more adaptation difficulties, family problems and dealing with medical conditions in the group of future psychotic disorder patients, while suicidal thoughts and loss of a close person showed trends towards significance. Two factors characterized classification of outcome: adaptation difficulties and family problems. A “high-functioning” factor was significantly higher within the control group, while a “strange” factor was higher among the future psychosis patients. A “high-functioning” factor was identified as a protective factor.

This study used narrative analysis of interview summaries of adolescents who underwent pre-induction assessments. The current study replicated previously published findings that were obtained as a result of retrospective investigations and comparing numeric scores, using unique pre-morbid data and in-depth qualitative analyses, combined with a quantitative one. The main strengths of the current study are the fact that the subjects were interviewed before the onset of psychosis, as well as the fact that the analyses of the data were performed blinded to outcome.

The authors have not supplied their declaration of competing interest.