Part III. The Relationship of Demographic and Diagnostic Factors to Measures of Premorbid Adjustment in Schizophrenia*

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Abstract
The prognostic value of the various premorbid ad- justment scales has been established (Kokes, Strauss, and Klorman 1977), but the specific factors that account for their validity have not been identified. In this paper, we will assess the interaction between scores on these prog- nostic scales and various sociocultural and diagnostic variables, including (a) demographic factors such as marital status, sex, socioeconomic class, race, and specific type of cultural setting; and (b) diagnostic characteristics of patients. In particular, we will explore whether scores on scales of premorbid adjustment have different prognostic implications as a function of pa- tients' demographic and diagnostic characteristics. Ex- ploration of these relationships should prove useful, not only for delineating the validity of prognostic scales, but for increasing our understanding of premorbid adjust- ment as a separate dimension of clinically relevant be- havior. Marital Status and Heterosexual Adjustment Marital status and heterosexual adjustment are im- portant predictors of the occurrence of schizophrenia as well as its outcome. Regarding the occurrence of the disorder, several studies have shown that there is a considerably higher prevalence of hospitalization for schizophrenia in single than in married individ- uals. Norris (1956) conducted a comprehensive epi- demiological survey covering the 1947-1949 triennium in London. In this investigation, the age-corrected ratio of single to married hospitalizations for schizophrenia was 6.2 for males and 3.7 for females. Comparable fig- ures were obtained in 0degaard's (1946) comprehensive survey of all first admissions in Norway for the decade of 1926-1935. The relatively smaller differences in the hospitalization rates of female schizophrenics as a func-

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