Premorbid adjustment (PA) is one of the main prognostic indicators of schizophrenia. Both social and cognitive deficits observed during the premorbid period hold a predictive value for the onset of schizophrenia.

To investigate how cognitive functions are related to aspects of PA.

To examine the relationship of each PA domain (academic and social) at each of the three developmental stages (childhood, early adolescence and late adolescence), as well as their course with the cognitive functions in schizophrenia patients.

PA, intellectual quotient (IQ), verbal learning, memory, processing speed, executive functions and verbal fluency were assessed using PAS, WAIS, RAVLT, TMT, WCST and COWAT measures respectively in a sample of 85 clinically stabilized male schizophrenia inpatients.

Negative correlations emerged between academic PA during adolescence and both verbal IQ and processing speed, while positive correlations were found with working memory. Negative correlations emerged between deterioration in academic PA during adolescence and both processing speed and immediate auditory verbal recall, while correlations with verbal learning were positive. There was no relationship between cognitive functions and either social PA or its deterioration.

Our findings revealed significant associations between both academic PA and its course with cognitive functions in schizophrenia patients. In summary, deficits in several fields of cognitive functions seem to follow a different path long before and after the onset of the disease, but further investigation is necessary.