1
|
Seguí-Grivé M, Jurado N, Navarrete A, Morelló C, Ortega E, Boluda M, Muntané G, Llaurador-Coll M, Vilella E, Gutiérrez-Zotes A. Influence of the typology and timing of childhood trauma in psychoticism. Arch Womens Ment Health 2024; 27:705-719. [PMID: 38656388 DOI: 10.1007/s00737-024-01459-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/14/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Child maltreatment (CM) is associated with psychosis; however little is known about the frequency, type, and timing of abuse in the personality pathology domain of psychoticism (PSY) in the DSM-5. The purpose of this study was to analyze childhood trauma typology and frequency according to gender and to identify sensitive periods of susceptibility to CM in women with high PSY. METHODS The Maltreatment and Abuse Chronology Exposure (MACE) scale was used to evaluate the frequency, severity and timing of each type of maltreatment. The full sample consisted of 83 participants with different psychiatric diagnoses. Psychoticism was assessed with the DSM-5 Personality Inventory (PID-5). To identify the differences in CM exposure between the PSY+ (high psychoticism) and PSY- (low psychoticism) groups, the Mann-Whitney U test, the chi square test and random forest (RF) test were used. RESULTS Comparing PSY + and PSY-, revealed gender differences in the impact of abuse, with highly frequent and severe types of abuse, in women. In women, PSY + and PSY-, were differentiated especially in non-verbal emotional abuse, peer physical bullying and parental verbal abuse. Several periods with a major peak at age seven followed by peaks at age 17 and 12 years old were identified. CONCLUSION Increased exposure to CM occurs in women with PSY+. A sensitivity to CM exposure during early childhood and late adolescence could be a risk factor for psychoticism in women.
Collapse
Affiliation(s)
- M Seguí-Grivé
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - N Jurado
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - A Navarrete
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - C Morelló
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - E Ortega
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - M Boluda
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
| | - G Muntané
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - M Llaurador-Coll
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
| | - E Vilella
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain
- Universitat Rovira i Virgili, Reus, Spain
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - A Gutiérrez-Zotes
- Hospital Universitari Institut Pere Mata, Ctra de l'Institut Pere Mata, s/n. 43206, Reus, Spain.
- Institut d'Investigació Sanitària Pere Virgili-CERCA, Reus, Spain.
- Universitat Rovira i Virgili, Reus, Spain.
- Centro de Investigación Biomédica en Red en Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain.
| |
Collapse
|
2
|
Ware K, Misiak B, Hamza EA, Nalla S, Moustafa AA. The Impact of Childhood Trauma on the Negative Symptoms of Schizophrenia. J Nerv Ment Dis 2024; 212:460-470. [PMID: 39120941 DOI: 10.1097/nmd.0000000000001788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
ABSTRACT Schizophrenia is a debilitating mental health disorder that imposes profound economic, societal, and personal burdens. The negative symptoms of schizophrenia ( i.e. , blunted affect, alogia, anhedonia, asociality, and avolition) are highly prevalent and pervasive in the psychotic disorder and pose significant resistance to available treatment options. Traumatic childhood experiences are strongly linked with the risk of developing schizophrenia. Most prior studies have primarily focused on positive symptoms of schizophrenia ( e.g. , hallucinations and delusions), whereas less attention has been given to negative symptoms. The current study investigated the relationship between childhood trauma ( i.e. , physical abuse, sexual abuse, and emotional abuse and neglect) and negative symptoms in a sample of schizophrenia outpatients and healthy controls ( n = 159 participants, including 99 patients with schizophrenia). The observations from the current study revealed that schizophrenia patients experienced a significantly greater degree of childhood trauma and negative symptoms than the control individuals. The results of the current study also indicated that more severe experiences of total childhood trauma ( i.e. , summation of all trauma types), physical abuse, and emotional neglect may increase the risk of schizophrenia patients reporting negative symptoms. However, childhood sexual and emotional abuse was found to have no impact on the degree of negative symptoms experienced by schizophrenia patients. Implications and limitations of the current study are discussed. In conclusion, we found that the severity of overall childhood trauma, physical abuse, and emotional neglect may play an important role in increasing the likelihood of schizophrenia patients reporting negative symptoms.
Collapse
Affiliation(s)
- Katelyn Ware
- School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, Queensland, Australia
| | - Blazej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Shahad Nalla
- Department of Human Anatomy and Physiology, the Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | | |
Collapse
|
3
|
Wold KF, Ottesen A, Flaaten CB, Kreis I, Lagerberg TV, Romm KL, Simonsen C, Widing L, Åsbø G, Melle I. Childhood trauma and treatment resistance in first-episode psychosis: Investigating the role of premorbid adjustment and duration of untreated psychosis. Schizophr Res 2024; 270:441-450. [PMID: 38991420 DOI: 10.1016/j.schres.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/02/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Early identification of treatment non-response in first-episode psychosis (FEP) is essential to outcome. Despite indications that exposure to childhood trauma (CT) can have adverse effects on illness severity, its impact on treatment non-response and the interplay with other pre-treatment characteristics is sparsely investigated. We use a lack of clinical recovery as an early indicator of treatment resistance to investigate the relationship between CT and treatment resistance status at one-year follow-up and the potential mediation of this effect by other pre-treatment characteristics. METHODS This prospective one-year follow-up study involved 141 participants recruited in their first year of treatment for a schizophrenia-spectrum disorder. We investigated clinical status, childhood trauma (CT), premorbid adjustment (PA), and duration of untreated psychosis (DUP) at baseline and clinical status at one-year follow-up. Ordinal regression analyses were conducted to investigate how PA and DUP affected the relationship between CT and one-year outcome in FEP. RESULTS 45 % of the FEP sample reported moderate to severe CT, with significantly higher levels of CT in the early treatment resistant group compared to participants with full or partial early recovery. Ordinal regression analysis showed that CT was a significant predictor of being in a more severe outcome group (OR = 4.59). There was a partial mediation effect of PA and a full mediation effect of DUP on the effect of CT on outcome group membership. DISCUSSION Our findings indicate that reducing treatment delays may mitigate the adverse effects of CT on clinical outcomes and support the inclusion of broad trauma assessment in FEP services.
Collapse
Affiliation(s)
- Kristin Fjelnseth Wold
- NORMENT, Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Akiah Ottesen
- NORMENT, Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Camilla Bärthel Flaaten
- NORMENT, Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Isabel Kreis
- NORMENT, Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristin Lie Romm
- NORMENT, Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for Southeast Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Carmen Simonsen
- NORMENT, Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Early Intervention in Psychosis Advisory Unit for Southeast Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Line Widing
- NORMENT, Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Gina Åsbø
- NORMENT, Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Centre of Excellence, Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
4
|
Peralta V, García de Jalón E, Moreno-Izco L, Peralta D, Janda L, Sánchez-Torres AM, Cuesta MJ. The association of adverse childhood experiences with long-term outcomes of psychosis: a 21-year prospective cohort study after a first episode of psychosis. Psychol Med 2024:1-10. [PMID: 38813601 DOI: 10.1017/s0033291724001223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND Evidence suggests a possible relationship between exposure to childhood adversity (CA) and functional impairment in psychosis. However, the impact of CA on long-term outcomes of psychotic disorders remains poorly understood. METHODS Two hundred and forty-three patients were assessed at their first episode of psychosis for CA and re-assessed after a mean of 21 years of follow-up for several outcome domains, including symptoms, functioning, quality of life, cognitive performance, neurological dysfunction, and comorbidity. The unique predictive ability of CA exposure for outcomes was examined using linear regression analysis controlling for relevant confounders, including socioeconomic status, family risk of schizophrenia, and obstetric complications. RESULTS There were 54% of the patients with a documented history of CA at mild or higher levels. CA experiences were more prevalent and severe in schizophrenia than in other psychotic disorders (p < 0.001). Large to very large effect sizes were observed for CA predicting most role functioning variables and negative symptoms (ΔR2 between 0.105 and 0.181). Moderate effect sizes were observed for positive symptoms, personal functioning, impaired social cognition, impaired immediate verbal learning, poor global cognition, internalized stigma, poor personal recovery, and drug abuse severity (ΔR2 between 0.040 and 0.066). A dose-response relationship was observed between levels of CA and severity of outcome domains. CONCLUSION Our results suggest a strong and widespread link between early adversity exposure and outcomes of psychotic disorders. Awareness of the serious long-term consequences of CA should encourage better identification of those at risk and the development of effective interventions.
Collapse
Affiliation(s)
- Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Elena García de Jalón
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Lucía Moreno-Izco
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - David Peralta
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Lucía Janda
- Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra (UPNA), Campus de Arrosadia, Pamplona, España
| | - Manuel J Cuesta
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
| |
Collapse
|
5
|
Szwajca M, Kazek G, Śmierciak N, Mizera J, Pomierny-Chamiolo L, Szwajca K, Biesaga B, Pilecki M. GDNF and miRNA-29a as biomarkers in the first episode of psychosis: uncovering associations with psychosocial factors. Front Psychiatry 2024; 15:1320650. [PMID: 38645418 PMCID: PMC11027163 DOI: 10.3389/fpsyt.2024.1320650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/14/2024] [Indexed: 04/23/2024] Open
Abstract
Aim Schizophrenia involves complex interactions between biological and environmental factors, including childhood trauma, cognitive impairments, and premorbid adjustment. Predicting its severity and progression remains challenging. Biomarkers like glial cell line-derived neurotrophic factor (GDNF) and miRNA-29a may bridge biological and environmental aspects. The goal was to explore the connections between miRNAs and neural proteins and cognitive functioning, childhood trauma, and premorbid adjustment in the first episode of psychosis (FEP). Method This study included 19 FEP patients who underwent clinical evaluation with: the Childhood Trauma Questionnaire (CTQ), the Premorbid Adjustment Scale (PAS), the Positive and Negative Syndrome Scale (PANSS), and the Montreal Cognitive Assessment Scale (MoCA). Multiplex assays for plasma proteins were conducted with Luminex xMAP technology. Additionally, miRNA levels were quantitatively determined through RNA extraction, cDNA synthesis, and RT-qPCR on a 7500 Fast Real-Time PCR System. Results Among miRNAs, only miR-29a-3p exhibited a significant correlation with PAS-C scores (r = -0.513, p = 0.025) and cognitive improvement (r = -0.505, p = 0.033). Among the analyzed proteins, only GDNF showed correlations with MoCA scores at the baseline and after 3 months (r = 0.533, p = 0.0189 and r = 0.598, p = 0.007), cognitive improvement (r = 0.511, p = 0.025), and CTQ subtests. MIF concentrations correlated with the PAS-C subscale (r = -0.5670, p = 0.011). Conclusion GDNF and miR-29a-3p are promising as biomarkers for understanding and addressing cognitive deficits in psychosis. This study links miRNA and MIF to premorbid adjustment and reveals GDNF's unique role in connection with childhood trauma.
Collapse
Affiliation(s)
- Marta Szwajca
- Department of Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Grzegorz Kazek
- Department of Pharmacological Screening, Jagiellonian University Medical College, Krakow, Poland
| | - Natalia Śmierciak
- Department of Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Józef Mizera
- Department of Toxicology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Krzysztof Szwajca
- Department of Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Beata Biesaga
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Maciej Pilecki
- Department of Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| |
Collapse
|
6
|
Fares-Otero NE, Alameda L, Pfaltz MC, Martinez-Aran A, Schäfer I, Vieta E. Examining associations, moderators and mediators between childhood maltreatment, social functioning, and social cognition in psychotic disorders: a systematic review and meta-analysis. Psychol Med 2023; 53:5909-5932. [PMID: 37458216 PMCID: PMC10520610 DOI: 10.1017/s0033291723001678] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/11/2023] [Accepted: 05/23/2023] [Indexed: 07/24/2023]
Abstract
Childhood maltreatment (CM) has been related to social functioning and social cognition impairment in people with psychotic disorders (PD); however, evidence across different CM subtypes and social domains remains less clear. We conducted a systematic review and meta-analysis to quantify associations between CM, overall and its different subtypes (physical/emotional/sexual abuse, physical/emotional neglect), and domains of social functioning and social cognition in adults with PD. We also examined moderators and mediators of these associations. A PRISMA-compliant systematic search was performed on 24 November 2022 (PROSPERO CRD42020175244). Fifty-three studies (N = 13 635 individuals with PD) were included in qualitative synthesis, of which 51 studies (N = 13 260) with 125 effects sizes were pooled in meta-analyses. We found that CM was negatively associated with global social functioning and interpersonal relations, and positively associated with aggressive behaviour, but unrelated to independent living or occupational functioning. There was no meta-analytic evidence of associations between CM and social cognition. Meta-regression analyses did not identify any consistent moderation pattern. Narrative synthesis identified sex and timing of CM as potential moderators, and depressive symptoms and maladaptive personality traits as possible mediators between CM and social outcomes. Associations were of small magnitude and limited number of studies assessing CM subtypes and social cognition are available. Nevertheless, adults with PD are at risk of social functioning problems after CM exposure, an effect observed across multiple CM subtypes, social domains, diagnoses and illness stages. Maltreated adults with PD may thus benefit from trauma-related and psychosocial interventions targeting social relationships and functioning.
Collapse
Affiliation(s)
- Natalia E. Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Luis Alameda
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, University Hospital (CHUV), Lausanne, Switzerland
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Department of Psychiatry, CIBERSAM, Institute of Biomedicine of Sevilla (IBIS), University Hospital Virgen del Rocio, University of Seville, Seville, Spain
| | - Monique C. Pfaltz
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| |
Collapse
|
7
|
Ottesen A, T. V. Hegelstad W, Joa I, Opjordsmoen SE, Rund BR, Røssberg JI, Simonsen E, Johannessen JO, Larsen TK, Haahr UH, McGlashan TH, Friis S, Melle I. Childhood trauma, antipsychotic medication, and symptom remission in first-episode psychosis. Psychol Med 2023; 53:2399-2408. [PMID: 37144963 PMCID: PMC10123824 DOI: 10.1017/s003329172100427x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND To what extent psychotic symptoms in first-episode psychosis (FEP) with a history of childhood interpersonal trauma (CIT) are less responsive to antipsychotic medication is not known. In this longitudinal study, we compare symptom trajectories and remission over the first 2 years of treatment in FEP with and without CIT and examine if differences are linked to the use of antipsychotics. METHODS FEP (N = 191) were recruited from in- and outpatient services 1997-2000, and assessed at baseline, 3 months, 1 and 2 years. Inclusion criteria were 15-65 years, actively psychotic with a DSM-IV diagnosis of psychotic disorder and no previous adequate treatment for psychosis. Antipsychotic medication is reported as defined daily dosage (DDD). CIT (<18) was assessed with the Brief Betrayal Trauma Survey, and symptomatic remission based on scores from the Positive and Negative Syndrome Scale. RESULTS CIT (n = 63, 33%) was not associated with symptomatic remission at 2 years follow-up (71% in remission, 14% in relapse), or time to first remission (CIT 12/ no-CIT 9 weeks, p = 0.51). Those with CIT had significantly more severe positive, depressive, and excited symptoms. FEP with physical (N = 39, 20%) or emotional abuse (N = 22, 14, 7%) had higher DDD at 1 year (p < 0.05). Mean DDD did not excerpt a significant between-group effect on symptom trajectories of positive symptoms. CONCLUSION Results indicate that antipsychotic medication is equally beneficial in the achievement of symptomatic remission in FEP after 2 years independent of CIT. Still, FEP patients with CIT had more severe positive, depressive, and excited symptoms throughout.
Collapse
Affiliation(s)
- Akiah Ottesen
- NORMENT Centre, Division of Mental Health and Addiction Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - W. T. V. Hegelstad
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Inge Joa
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health, Network for Medical Sciences, University of Stavanger, 4036 Stavanger, Norway
| | - Stein E. Opjordsmoen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Bjørn Rishovd Rund
- Department of Psychology, University of Oslo, Oslo, Norway
- Vestre Viken Hospital Trust, Drammen, Norway
| | - Jan Ivar Røssberg
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erik Simonsen
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jan Olav Johannessen
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health, Network for Medical Sciences, University of Stavanger, 4036 Stavanger, Norway
| | - Tor K. Larsen
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Institute of Psychiatry, University of Bergen, Bergen, Norway
| | - Ulrik Helt Haahr
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark
| | | | - Svein Friis
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
8
|
Christy A, Cavero D, Navajeeva S, Murray-O’Shea R, Rodriguez V, Aas M, Trotta G, Moudiab S, Garrido N, Zamora B, Sideli L, Wrobel AL, Salazar de Pablo G, Alameda L. Association Between Childhood Adversity and Functional Outcomes in People With Psychosis: A Meta-analysis. Schizophr Bull 2023; 49:285-296. [PMID: 36107860 PMCID: PMC10016406 DOI: 10.1093/schbul/sbac105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Despite the accepted link between childhood adversity (CA) and psychotic disorders, evidence on the relationship between CA and poor functional outcome remains less consistent and has never been reviewed quantitatively. The aim of this meta-analysis was to systematically examine the association between CA and functional outcomes in people with psychotic disorders. STUDY DESIGN The study protocol was registered on the International Prospective Register of Systematic Reviews (CRD42021254201). A search was conducted across EMBASE, MEDLINE, PsycINFO, and Cochrane Libraries (CENTRAL) using search terms related to psychosis; CA (general, sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect); and functional outcomes (social, occupational, and general functioning [GF]). We conducted random-effects models, sensitivity and heterogeneity analyses, meta-regressions, and we assessed quality. STUDY RESULTS Our meta-analysis comprised 35 studies, including 10 568 cases with psychosis. General CA was negatively associated with GF (28 studies; r = -0.109, 95%CI = -0.161 to -0.05, P < .001), with greater effects in prospective data (10 studies; r = -0.151, 95% CI = -0.236 to -0.063, P = .001). General CA was also associated with social functioning (r = -0.062, 95% CI = -0.120 to -0.004, P = .018) but not occupational outcomes. All CA subtypes except sexual abuse were significantly associated with GF, with emotional and physical neglect showing the largest magnitudes of effect (ranging from r = -0.199 to r = -0.250). CONCLUSIONS This meta-analysis provides evidence for a negative association between general CA, specific subtypes, and general and social functional outcomes in people with psychosis.
Collapse
Affiliation(s)
- Angeline Christy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Daniela Cavero
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sujeena Navajeeva
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Rachel Murray-O’Shea
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
- NORMENT, Centre for Research on Mental Disorders, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - Socayna Moudiab
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Nathalia Garrido
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
| | - Blanca Zamora
- Universidad Internacional de la Rioja (UNIR), Logroño, Spain
| | - Lucia Sideli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Human Science, LUMSA University, Rome, Italy
| | - Anna L Wrobel
- IMPACT – The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - Gonzalo Salazar de Pablo
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s CollegeLondon, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| |
Collapse
|
9
|
Steenkamp LR, Parrish EM, Chalker SA, Badal VD, Pinkham AE, Harvey PD, Depp CA. Childhood trauma and real-world social experiences in psychosis. Schizophr Res 2023; 252:279-286. [PMID: 36701936 DOI: 10.1016/j.schres.2022.12.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/30/2022] [Accepted: 12/28/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Childhood trauma is associated with a variety of negative outcomes in psychosis, but it is unclear clear if childhood trauma affects day-to-day social experiences. We aimed to examine the association between childhood trauma and functional and structural characteristics of real-world social relationships in psychosis. METHODS Participants with psychotic disorders or affective disorders with psychosis completed ecological momentary assessments (EMAs) over ten days (N = 209). Childhood trauma was assessed retrospectively using the Childhood Trauma Questionnaire. Associations between childhood trauma and EMA-assessed social behavior and perceptions were examined using linear mixed models. Analyses were adjusted for sociodemographic characteristics and psychotic and depressive symptom severity. RESULTS Higher levels of childhood trauma were associated with more perceived threat (B = -0.19, 95 % CI [-0.33, -0.04]) and negative self-perception (B = -0.18, 95 % CI [-0.34, -0.01]) during recent social interactions, as well as reduced social motivation (B = -0.29, 95 % CI [-0.47, -0.10]), higher desire for social avoidance (B = 0.34, 95 % CI [0.14, 0.55]), and lower sense of belongingness (B = -0.24, 95 % CI [-0.42, -0.06]). These negative social perceptions were mainly linked with emotional abuse and emotional neglect. In addition, paranoia was more strongly associated with negative social perceptions in individuals with high versus low levels of trauma. Childhood trauma was not associated with frequency (i.e., time spent alone) or type of social interactions. CONCLUSION Childhood trauma - particularly emotional abuse and neglect - is associated with negative social perceptions but not frequency of real-world social interactions. Our findings suggest that childhood trauma may affect day-to-day social experiences beyond its association with psychosis.
Collapse
Affiliation(s)
- Lisa R Steenkamp
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Emma M Parrish
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Samantha A Chalker
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States; Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| | - Varsha D Badal
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States; Stein Institute for Research on Aging, University of California San Diego, San Diego, CA, United States
| | - Amy E Pinkham
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, United States; Research Service, Bruce W. Carter VA Medical Center, Miami, FL, United States
| | - Colin A Depp
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States; Veterans Affairs San Diego Healthcare System, San Diego, CA, United States; Stein Institute for Research on Aging, University of California San Diego, San Diego, CA, United States.
| |
Collapse
|
10
|
Butjosa A, Usall J, Vila-Badia R, Mezquida G, Cuesta MJ, Rodríguez-Toscano E, Amoretti S, Lobo A, González-Pinto A, Espliego A, Corripio I, Vieta E, Baeza I, Bergé D, Bernardo M, García-Rizo C, Mayoral M, Merchan J, Alonso-Solís A, Rabella M, López P, Zorrilla I, De-la-Cámara C, Barcones F, Sanjuan J, Dolores Moltó M, Morro L, Monserrat C, Verdolini N, Salagre E, la Serna ED, Castro-Fornieles J, Contreras Fernández F, Saiz Masvidal C, Paz Garcia-Portilla M, Bousoño M, Gutiérrez Fraile M, Zabala Rabadán A, Dompablo M, Rodriguez-Jimenez R, Rubio-Abadal E, Pardo M, Sarró S, Pomarol-Clotet E, Ibanez A, Sánchez-Torres AM, Selva-Vera G. Impact of traumatic life events on clinical variables of individuals with first-episode psychosis and healthy controls. Int J Soc Psychiatry 2023; 69:134-145. [PMID: 35068217 DOI: 10.1177/00207640211070398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Traumatic life events (TLEs) are one of the most robust environmental risk factors for the onset of first-episode psychosis (FEP). AIMS To explore TLEs in FEP patients and healthy controls (HC), to analyze gender differences and to examine whether TLEs were associated with sociodemographic, clinical and psychofunctional variables in all FEP sample and split by age. METHODS Descriptive and cross-sectional study. Three hundred and thirty-five FEP and 253 HC were recruited at 16 Spanish mental health research centers. The Traumatic Experiences in Psychiatric Outpatients Questionnaire was administered. RESULTS We found a higher number of TLEs in FEP than in HC, and the proportion of individuals with three or more TLEs was significantly higher in the FEP group. No differences were found in terms of gender and age. There was no relationship between total number of TLEs and psychotic symptomatology and functional outcomes. CONCLUSIONS The number and cumulative TLEs should be taken into account in the detection, epidemiology and process of recovery in FEP.
Collapse
Affiliation(s)
- Anna Butjosa
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain
| | - Judith Usall
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Regina Vila-Badia
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Gisela Mezquida
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, IDIBAPS, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Spain
| | - Elisa Rodríguez-Toscano
- Instituto de Psiquiatría y Salud Mental del Hospital Gregorio Marañón, Servicio de Psiquiatría del Niño y del Adolescente, Madrid, Spain.,Departamento de Psicología experimental, Procesos psicológicos y logopedia, Universidad Complutense de Madrid, Spain
| | - Silvia Amoretti
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, IDIBAPS, Spain
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Department of Medicine and Psychiatry, University of Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Department of Psychiatry, Hospital Universitario de Alava, BIOARABA, UPV/EHU, Vitoria, Spain
| | - Ana Espliego
- Departamento de Psicología experimental, Procesos psicológicos y logopedia, Universidad Complutense de Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Department of Psychiatry, Hospital de Sant Pau, Barcelona, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Catalonia, Spain
| | - Inmaculada Baeza
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Child and Adolescent Psychiatry and Psychology Department, SGR489, Hospital Clinic of Barcelona, Institute of Neurosciences, University of Barcelona, Spain
| | - Dani Bergé
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Miguel Bernardo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Spain.,Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, IDIBAPS, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Setién-Suero E, Ayesa-Arriola R, Peña J, Crespo-Facorro B, Ojeda N. Trauma and psychosis: The mediating role of premorbid adjustment and recent stressful events in a 3-year longitudinal study. J Psychiatr Res 2022; 155:279-285. [PMID: 36166937 DOI: 10.1016/j.jpsychires.2022.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/30/2022] [Accepted: 09/16/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Some of the most-studied environmental factors that can contribute to the development of psychosis are the adversities experienced at an early age. Among these, childhood interpersonal trauma (CIT) has been considered especially influential in the onset of the disease. The aim of the study was to explore the relationship between CIT and the first episode of psychosis (FEP), as well as the relationship between CIT and clinical and functional outcomes 3 years after illness onset. METHODS A total of 278 patients with a FEP and 52 healthy controls were studied. Logistic regression analysis was carried out to examine the explained variation by CIT at the beginning of psychosis. Recent stressful events and premorbid adjustment related to CIT, were introduced in path analyses to determine their mediating effects between CIT and the disease and its clinical and functional results. RESULTS Mediation analyses showed that CIT was indirectly associated with belonging to the FEP group through recent stressful events (Effect = 0.981; SE = 0.323; CI = 0.485 to 1.761). Premorbid academic adjustment in late adolescence mediated the relationship between CIT and clinical and functional outcomes, specifically in the measurements of the Scales for Assessment of Positive and Negative Symptoms, in the Brief Psychiatric Rating Scale, and in the Disability Assessment Scale. CONCLUSIONS These findings suggest that early traumatic experiences play an important role in the FEP. Early intervention that promotes good academic adjustment during adolescence and/or avoids retraumatisation could positively impact both the onset and the course of psychotic illness.
Collapse
Affiliation(s)
- Esther Setién-Suero
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Rosa Ayesa-Arriola
- University Hospital Marqués de Valdecilla. Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; IDIVAL, Valdecilla Biomedical Research Institute, Santander, Spain.
| | - Javier Peña
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria de Sevilla, IBiS, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - Natalia Ojeda
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| |
Collapse
|
12
|
Vila-Badia R, Del Cacho N, Butjosa A, Serra Arumí C, Esteban Santjusto M, Abella M, Cuevas-Esteban J, Morelló G, Pardo M, Muñoz-Samons D, Usall J. Prevalence and types of childhood trauma in first episode psychosis patients. Relation with clinical onset variables. J Psychiatr Res 2022; 146:102-108. [PMID: 34959161 DOI: 10.1016/j.jpsychires.2021.12.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/01/2021] [Accepted: 12/11/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To study the prevalence and the type of childhood trauma (CT) in a first-episode psychosis (FEP) cohort and in a healthy control (HC) sample. To study which clinical and sociodemographic variables in the onset of the FEP are related to having suffered some traumatic experience in childhood. METHOD 100 FEP patients and 94 HC participated in the study. The Childhood Traumatic Questionnaire (CTQ) was used to evaluate CT. The Positive and Negative Syndrome Scale (PANSS), the Personal and Social Performance (PSP), the Suicide Risk Scale of Plutchik (SRSP), and the Perceived Stress Scale (PSS) were also administered. RESULTS 61% of FEP patients and 17% of HC reported having experienced some kind of CT. FEP showed more CT than controls in all subscales, except in sexual abuse. The most frequent CT was emotional abuse. For the FEP group, younger age, more years of education, have a first-degree family history, more positive and negative symptoms, more perceived stress and more personal and social functioning were the variables more influenced by having suffered some kind of CT. CONCLUSIONS There is a high prevalence of CT in FEP patients. Having a first-degree family history of mental illness, more positive symptoms, and more perception of stress at the time of hospital admission were related to having suffered CT. More research is needed to find out the best way to detect CT and its role in psychosis to be able to implement interventions to improve the evolution of these patients.
Collapse
Affiliation(s)
- R Vila-Badia
- Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Facultat de Medicina i Ciències de La Salut Barcelona, Barcelona, Spain.
| | - N Del Cacho
- Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain
| | - A Butjosa
- Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Hospital Infanto-juvenil Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, CIBERSAM, Esplugues de Llobregat, Spain
| | - C Serra Arumí
- Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Facultat de Medicina i Ciències de La Salut Barcelona, Barcelona, Spain
| | - M Esteban Santjusto
- Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain
| | - M Abella
- Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - J Cuevas-Esteban
- Hospital Universitari Germans Trias i Pujol, CIBERSAM, Badalona, Spain; Universitat Autònoma de Barcelona, Cerdanyola Del Vallès, Spain
| | - G Morelló
- Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain
| | - M Pardo
- Hospital Infanto-juvenil Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, CIBERSAM, Esplugues de Llobregat, Spain
| | - D Muñoz-Samons
- Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Hospital Infanto-juvenil Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, CIBERSAM, Esplugues de Llobregat, Spain
| | -
- Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain
| | - Judith Usall
- Etiopatogènia i Tractament Dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain
| |
Collapse
|
13
|
Li S, Wang R, Thomas E, Jiang Z, Jin Z, Li R, Qian Y, Song X, Sun Y, Zhang S, Chen R, Wan Y. Patterns of adverse childhood experiences and depressive symptom trajectories in young adults: A longitudinal study of college students in China. Front Psychiatry 2022; 13:918092. [PMID: 35958653 PMCID: PMC9358020 DOI: 10.3389/fpsyt.2022.918092] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs) tend to cluster together in daily life, and most studies focus on the level of depression at certain points, but the dynamic process of depression is often neglected. Thus, research is urgently needed to explore the relationship between ACEs pattern and trajectory of depressive symptom levels at multiple time points in order to provides early targeted interventions to those who are most at risk. OBJECTIVE We aimed to explore patterns of ACEs, including types and timing, associated with depression trajectories in college students. METHODS A school-based health survey was used to collect data as part of a longitudinal study in two medical college in Anhui province, China. Questionnaires were issued to 3,662 participants aged 17-22 and recorded details of ACEs (types and timing) and depression. Latent class analysis (LCA) was used to identify "patterns" of ACEs type and timing. Depressive symptom trajectories employed latent class growth analysis (LCGA). Multiple logistic regressions were employed to evaluate the relationships between ACEs patterns and depressive symptom trajectories. RESULTS We identified five ACEs patterns: "High neglect/emotional abuse/community violence," "High neglect/emotional abuse," "High neglect/family dysfunction," "High neglect," "Low ACEs." We traced three depression trajectories: "High depressive symptom" "Moderate depressive symptom," "Low depressive symptom." "High neglect/emotional abuse/community violence," "High neglect/emotional abuse" and "High neglect/family dysfunction" demonstrated a high risk for "High depressive symptom" and "Moderate depressive symptom." "High neglect" showed a high risk for "Moderate depressive symptom" but not for "High depressive symptom" (P < 0.05). CONCLUSIONS The findings address the need for a comprehensive consideration of exposure to childhood adversity associated with the risk of depression in young adults through identifying more problematic ACEs patterns amongst exposed children.
Collapse
Affiliation(s)
- Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Rui Wang
- Teaching Affairs Office, Anqing Medical College, Anhui, China
| | - Erica Thomas
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Zhicheng Jiang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Zhengge Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Ruoyu Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Yan Qian
- Teaching Affairs Office, Anqing Medical College, Anhui, China
| | - Xianbing Song
- Department of Human Anatomy, Histology and Embryology, Anhui Medical College, Anhui, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Shichen Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui, China
| |
Collapse
|
14
|
Hegelstad WTV, Berg AO, Bjornestad J, Gismervik K, Johannessen JO, Melle I, Stain HJ, Joa I. Childhood interpersonal trauma and premorbid social adjustment as predictors of symptom remission in first episode psychosis. Schizophr Res 2021; 232:87-94. [PMID: 34029946 DOI: 10.1016/j.schres.2021.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/11/2021] [Accepted: 05/12/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Childhood interpersonal trauma (CIT) and premorbid adjustment are both associated with poor outcome in psychosis. In this study we investigate the relative impact of CIT and premorbid adjustment on symptom remission in first episode psychosis (FEP) over two years. METHOD A total of 232 participants with FEP were recruited through the early detection program of the The early detection and Intervention in Psychosis (TIPS)-2 study and followed up after two years. Symptom remission was according to consensus criteria. CIT was assessed with the semi-structured interview Freyd Goldberg Brief Betrayal Trauma Survey, and premorbid adjustment with the Premorbid Adjustment Scale. Generalized estimating equations and multivariate models were used to analyze the associations between remission, symptom levels over time, CIT and premorbid adjustment; and a path analysis of mediation effects of CIT through premorbid adjustment on remission. RESULTS In this sample with 57% males and a mean age of 26.6 years (SD 10.2), a third of participants had experienced CIT. The participants with CIT had poorer premorbid adjustment compared to those without. Statistical analyses found independent effects of CIT and an interaction effect of CIT with premorbid adjustment on remission after two years, suggesting that CIT moderates the effect of premorbid adjustment. However contrary to expectations, premorbid adjustment did not mediate the effect of CIT. CONCLUSION Our findings indicate a complex interplay between effects of interpersonal trauma and premorbid social adjustment on remission in psychosis. CIT appeared to moderate the effect of premorbid adjustment such that individuals with CIT and who had poor social functioning in childhood are at greater risk of non-remission. Findings indicate that better premorbid social relations could provide a buffer for the effects of trauma on symptom course.
Collapse
Affiliation(s)
- Wenche Ten Velden Hegelstad
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway; Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
| | - Akiah Ottesen Berg
- NORMENT Centre, Division of Mental Health and Addiction Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jone Bjornestad
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway; Department of Social Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Kristina Gismervik
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
| | - Jan Olav Johannessen
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway; Network for Medical Sciences, Faculty of Health, University of Stavanger, 4036 Stavanger, Norway
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Helen J Stain
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway; School of Arts and Humanities, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Inge Joa
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway; Network for Medical Sciences, Faculty of Health, University of Stavanger, 4036 Stavanger, Norway
| |
Collapse
|
15
|
Tang W, Xu D, Yang Y, Xu J. Psychotic-like experiences in Chinese children and adolescents: The effect of earthquake exposure, maltreatment and negative life events. Early Interv Psychiatry 2021; 15:536-546. [PMID: 32500658 DOI: 10.1111/eip.12976] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/02/2020] [Accepted: 04/28/2020] [Indexed: 02/05/2023]
Abstract
AIM Psychotic-like experiences (PLEs) are common in adolescents who have experienced or are experiencing trauma. However, the potential relationships between exposure to a major earthquake, negative life events or maltreatment and PLEs in Chinese adolescents are poorly understood. Therefore, this study explored the prevalence of PLEs and the psychosocial correlates in adolescent earthquake survivors. METHODS A total of 6132 adolescents from 11 primary and high schools in the areas most severely affected by the Ya'an earthquake completed questionnaires on earthquake exposure, maltreatment, negative life events and PLEs, which included paranoid ideation and psychoticism. RESULTS It was found that earthquake exposure significantly contributed to the PLEs, child maltreatment explained a significant amount of the PLE variances, emotional abuse had the most important PLE role and negative life events also explained a large amount of the PLE variances, of which interpersonal difficulties and academic pressure had the greatest effects. CONCLUSIONS Interventions should seek to reduce parental emotional abuse, reduce academic performance pressure, improve interpersonal skills and resolve interpersonal difficulties, and specific interventions should target children and adolescents exposed to the earthquake to prevent PLEs, schizophrenia or other mental illnesses arising from multiple traumas.
Collapse
Affiliation(s)
- Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China.,Institute of Emergency Management and Post-Disaster Reconstruction, Sichuan University, Chengdu, China
| | - Dun Xu
- Institute of Emergency Management and Post-Disaster Reconstruction, Sichuan University, Chengdu, China
| | - Yanchun Yang
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-Disaster Reconstruction, Sichuan University, Chengdu, China
| |
Collapse
|
16
|
Pruessner M, King S, Veru F, Schalinski I, Vracotas N, Abadi S, Jordan G, Lepage M, Iyer S, Malla AK, Shah J, Joober R. Impact of childhood trauma on positive and negative symptom remission in first episode psychosis. Schizophr Res 2021; 231:82-89. [PMID: 33812301 DOI: 10.1016/j.schres.2021.02.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/10/2020] [Accepted: 02/08/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Early life adversity is suspected to play an important role for onset and course of psychosis, but its relationship with longer-term clinical outcome is not entirely clear. In this longitudinal study, we investigated the impact of childhood trauma (CT) on positive and negative symptom remission in first episode psychosis (FEP) patients over two years. METHODS A total of 210 FEP patients were assessed with the Childhood Trauma Questionnaire. Patients reporting moderate to severe trauma (CT; N = 114; 54.3%) were compared to those without trauma (N-CT; N = 96; 45.7%). Positive (PSR) and negative symptom remission (NSR) were determined monthly over 24 months following established criteria using the Scale for Assessment of Positive Symptoms and the Scale for Assessment of Negative Symptoms. Global Functioning was evaluated at baseline and 24 months of follow-up. RESULTS Compared to N-CT patients, CT patients had achieved significantly lower rates of PSR at 12 months and significantly lower rates of NSR at 24 months. A dose-response relationship was observed between the number of trauma categories fulfilled and the number of patients not achieving PSR and NSR at these time points. Higher trauma scores were significantly associated with poor functioning and higher positive and negative symptom severity at 24 months, but not at baseline and 12 months of follow-up. CONCLUSION Differential effects of CT on clinical outcome may not be apparent at psychosis onset, but only become evident through poor symptomatic remission and general functioning over time. Targeted diagnostic and therapeutic efforts after illness onset might limit these detrimental consequences.
Collapse
Affiliation(s)
- Marita Pruessner
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Québec, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada; University of Konstanz, Department of Psychology, Konstanz, Germany.
| | - Suzanne King
- McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Franz Veru
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Québec, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Inga Schalinski
- University of Konstanz, Department of Psychology, Konstanz, Germany
| | - Nadia Vracotas
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Québec, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Sherezad Abadi
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Québec, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Gerald Jordan
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Québec, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Martin Lepage
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Québec, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Srividya Iyer
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Québec, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Ashok K Malla
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Québec, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Jai Shah
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Québec, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Québec, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| |
Collapse
|
17
|
Rodriguez V, Aas M, Vorontsova N, Trotta G, Gadelrab R, Rooprai NK, Alameda L. Exploring the Interplay Between Adversity, Neurocognition, Social Cognition, and Functional Outcome in People With Psychosis: A Narrative Review. Front Psychiatry 2021; 12:596949. [PMID: 33762975 PMCID: PMC7982734 DOI: 10.3389/fpsyt.2021.596949] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/10/2021] [Indexed: 12/14/2022] Open
Abstract
History of adversity is associated with subsequent psychosis, and with a spectrum of cognitive alterations in individuals with psychosis. These cognitive features go from neurocognitive aspects as working memory and attention, to complex social cognitive processes as theory of mind and emotional perception. Difficulties in these domains impact patients' social and occupational functioning, which has been shown to be more impaired in those previously exposed to childhood trauma. However, the interplay between adversity, neurocognition, and functioning is yet poorly understood. This narrative review aims to explore the evidence on whether deficits in neurocognitive and social cognitive domains may act as possible putative mechanism linking adversity with functioning in people with psychosis. We show available evidence supporting the link between adversity and poorer functioning in psychosis, especially in chronic stages; and replicated evidence suggesting associations of social cognition and, to a lesser extent, neurocognition with impairment in functioning in patients; although there is still an important gap in the literature testing particularly deficits in social cognition as mediator of the link between adversity and functional decline in psychosis. Targeting interventions focusing on neurocognition and social cognition in individuals with adversity and psychosis seems important, given the severe deterioration of these patients in these domains, although more research is needed to test whether such treatments can specifically improve functioning in individuals with psychosis and adversity. Literature aiming to understand the determinants of functional outcome should consider the pervasive impact of childhood adversity, and its related effects on cognition.
Collapse
Affiliation(s)
- Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- NORMENT Centre for Psychosis Research, Oslo University Hospital, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Department of Mental Health Research and Development, Vestre Viken Hospital Trust, Drammen, Norway
| | - Natasha Vorontsova
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Romayne Gadelrab
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Navneet Kaur Rooprai
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Departamento de Psiquiatría, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
| |
Collapse
|
18
|
Vila-Badia R, Butjosa A, Del Cacho N, Serra-Arumí C, Esteban-Sanjusto M, Ochoa S, Usall J. Types, prevalence and gender differences of childhood trauma in first-episode psychosis. What is the evidence that childhood trauma is related to symptoms and functional outcomes in first episode psychosis? A systematic review. Schizophr Res 2021; 228:159-179. [PMID: 33434728 DOI: 10.1016/j.schres.2020.11.047] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/28/2020] [Accepted: 11/28/2020] [Indexed: 11/24/2022]
Abstract
This paper reviews and discusses the literature on childhood trauma (CT) in people with first-episode psychosis (FEP). The aim is to update the knowledge on the prevalence and the types of CT suffered by FEP people, to compare them with other samples, to study the impact of gender, and to examine the relationship between CT and symptoms and functional outcomes. We conducted a literature search (1995-2019), to identify reported data on any topic related to CT in FEP samples. The following terms were used in the search: CT or sexual abuse or physical abuse or neglect, and first-episode psychosis. We found 493 studies, of which 68 were included in the review. FEP presented a higher prevalence of CT than controls. Women suffer more sexual abuse. The effect of CT on the severity, the prognosis and the evolution of FEP is unclear. FEP have a high prevalence of CT. Its relationship with symptoms and functional outcomes indicates its importance within treatment. This suggests the importance of creating and implementing specific interventions and personalized therapies addressed to work through their past traumatic experiences to improve their quality of live and their prognosis.
Collapse
Affiliation(s)
- Regina Vila-Badia
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Barcelona, Spain.
| | - Anna Butjosa
- Hospital Infanto-juvenil Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, CIBERSAM, Barcelona, Spain
| | - Núria Del Cacho
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Barcelona, Spain
| | - Clara Serra-Arumí
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Barcelona, Spain
| | - Marina Esteban-Sanjusto
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Spain
| |
Collapse
|
19
|
Childhood maltreatment, personality vulnerability profiles, and borderline personality disorder symptoms in adolescents. Dev Psychopathol 2021; 34:1163-1176. [PMID: 33494855 DOI: 10.1017/s0954579420002151] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Adverse childhood experiences are significant risk factors in the development of adolescent borderline personality disorder symptoms (BPDs). Theorists have posited that two personality vulnerabilities factors, self-criticism and dependency, may inform our understanding of this relationship. However, no research has examined the associations between early negative experiences, personality vulnerabilities, and adolescent BPDs. The current study aimed to identify profiles of dependency and self-criticism to examine the associations of these profiles with cumulative forms of childhood maltreatment (CM) and BPDs as well as to explore the mediating and moderating role of vulnerable personality profiles in the relationship between cumulative CM and BPDs. Two hundred and forty-one nonclinical and clinical adolescents participated in the study (Mage = 16.37, SD = 1.84). The findings indicated three different profiles: average dependent profile, dependent and self-critical profile, and self-critical profile. Individuals in the average dependent profile presented lower levels of CM and BPDs. Mediation analyses showed that relative to the average dependent profile, a higher cumulative CM history predicted a higher probability of belonging in the dependent and self-critical profile or the self-critical profile and, in turn, this was associated with higher levels of BPDs. No moderating effects of profiles of dependency and self-criticism were found.
Collapse
|
20
|
Weitkämper A, Kellner M, Iffland JR, Driessen M, Kley H, Neuner F, Iffland B. Childhood Maltreatment in Individuals With Schizophrenia Spectrum Disorders: The Impact of Cut-Off Scores on Prevalence Rates. Front Psychiatry 2021; 12:692492. [PMID: 34295277 PMCID: PMC8291124 DOI: 10.3389/fpsyt.2021.692492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
Childhood maltreatment is a common phenomenon in various psychiatric disorders. Accordingly, patients with disorders from the schizophrenia spectrum (SSD) appear to have high prevalence rates of childhood maltreatment. However, the interpretation and comparability of prevalence rates is impeded by methodological weaknesses and differences such as measures and thresholds used in previous studies. Therefore, we aimed to provide and compare systematically captured data on prevalence rates of all common types of childhood maltreatment in patients with SSD using a standardized and well-established questionnaire and the most frequently used thresholds. The sample consisted of 48 patients with a primary diagnosis of SSD. 58.3-77.1% of the sample experienced at least one type of childhood maltreatment. Prevalence rates for physical abuse, physical neglect, and emotional abuse were dependent on the thresholds used, while equal rates were found for emotional neglect and sexual abuse. Physical neglect (46-67%), and emotional abuse (44-48%) were most commonly reported, followed by emotional neglect (38%), physical abuse (25-38%), and sexual abuse (25%). Additionally, high levels of peer victimization were reported by SSD patients. It appears that childhood maltreatment is a common phenomenon in SSD, even though methodological details, especially cut-off scores, have a substantial impact on the prevalence rates that are determined. Therefore, the methodology of studies should be closely examined when drawing conclusions from presented prevalence rates.
Collapse
Affiliation(s)
- Angelina Weitkämper
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Michael Kellner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital Herford, Herford, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | - Martin Driessen
- Clinic of Psychiatry and Psychotherapy Bethel, Bielefeld, Germany
| | - Hanna Kley
- Department of Clinical Psychology and Psychotherapy, Outpatient Clinic, Bielefeld University, Bielefeld, Germany
| | - Frank Neuner
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Benjamin Iffland
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| |
Collapse
|
21
|
Stone LMD, Millman ZB, Öngür D, Shinn AK. The Intersection Between Childhood Trauma, the COVID-19 Pandemic, and Trauma-related and Psychotic Symptoms in People With Psychotic Disorders. SCHIZOPHRENIA BULLETIN OPEN 2021; 2:sgab050. [PMID: 34881362 PMCID: PMC8643711 DOI: 10.1093/schizbullopen/sgab050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION People with psychotic disorders may be disproportionately affected by the traumatic effects of the COVID-19 pandemic. Childhood trauma, which also increases vulnerability to subsequent stressors, is common in individuals with psychosis. In this study, we investigated the intersection of the pandemic, childhood trauma, and psychotic and trauma-related symptoms in individuals with psychotic disorders. METHODS We administered a cross-sectional survey to 151 participants [47 schizophrenia (SZ), 53 psychotic bipolar disorder (BP)], 51 healthy control (HC)] during the COVID-19 pandemic. Participants were asked about exposure to the pandemic's impacts, childhood trauma, and post-traumatic stress, dissociative, and psychotic symptoms. RESULTS BP reported greater negative impacts to emotional health than SZ and HC and to non-COVID physical health than HC. SZ reported less impact on work and employment during the pandemic. There were no other group differences in pandemic-related adversities. We also found that cumulative exposure to the pandemic's negative impacts was significantly associated with PTSD symptoms but not psychotic or dissociative symptoms. Moreover, the number of adversities an individual experienced during the pandemic was strongly associated with the cumulative number of traumatic experiences they had in childhood. DISCUSSION Our results suggest that having a psychotic disorder does not, in and of itself, increase susceptibility to the pandemic's negative impacts. Instead, we provide evidence of a graded relationship between cumulative exposure to the pandemic's negative impacts and PTSD symptom severity, as well as a graded relationship between cumulative childhood traumatic experiences and the number pandemic adversities, across diagnoses.
Collapse
Affiliation(s)
- Lena M D Stone
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
| | - Zachary B Millman
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Dost Öngür
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Ann K Shinn
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
22
|
Vallejos M, Cesoni OM. Child abuse, gender differences and their clinical and criminological implications in incarcerated individuals. ACTA ACUST UNITED AC 2020; 49:271-278. [PMID: 33328020 DOI: 10.1016/j.rcp.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/15/2018] [Accepted: 01/15/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Several studies show high rates of childhood traumatic events in subjects incarcerated in prison institutions. OBJECTIVE To assess the prevalence and gender differences of different types of childhood adverse experiences and their correlation with psychopathological and criminological variables in incarcerated individuals. MATERIAL AND METHODS An epidemiological, descriptive-observational study was conducted in two psychiatric prisons located in Argentina and 84 subjects of both sexes participated. A socio-demographic questionnaire was used, the SCID I and II scales and the Adverse Childhood Experiences questionnaire. RESULTS 91.7% of the participants had suffered some adverse experience in childhood. A high rate of physical (63%) and emotional abuse (61%) was detected. We found gender differences in the type of child abuse and the crimes committed. Significant relationships were found between some childhood adverse events and psychiatric disorders, crimes committed and recidivism. CONCLUSIONS In accordance with other studies, there was a high prevalence of adverse childhood experiences in incarcerated individuals and significant gender differences in the type of child abuse, in psychiatric disorders, in the crimes committed and recidivism.
Collapse
Affiliation(s)
- Miguel Vallejos
- Hospital Interdisciplinario Psicoasistencial José T. Borda, Buenos Aires, Argentina.
| | | |
Collapse
|
23
|
Murray RM, Mondelli V, Stilo SA, Trotta A, Sideli L, Ajnakina O, Ferraro L, Vassos E, Iyegbe C, Schoeler T, Bhattacharyya S, Marques TR, Dazzan P, Lopez-Morinigo J, Colizzi M, O'Connor J, Falcone MA, Quattrone D, Rodriguez V, Tripoli G, La Barbera D, La Cascia C, Alameda L, Trotta G, Morgan C, Gaughran F, David A, Di Forti M. The influence of risk factors on the onset and outcome of psychosis: What we learned from the GAP study. Schizophr Res 2020; 225:63-68. [PMID: 32037203 DOI: 10.1016/j.schres.2020.01.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/06/2020] [Accepted: 01/09/2020] [Indexed: 01/05/2023]
Abstract
The GAP multidisciplinary study carried out in South London, recruited 410 first episode of psychosis patients and 370 controls; the aim was to elucidate the multiple genetic and environmental factors influencing the onset and outcome of psychosis. The study demonstrated the risk increasing effect of adversity in childhood (especially parental loss, abuse, and bullying) on onset of psychosis especially positive symptoms. Adverse life events more proximal to onset, being from an ethnic minority, and cannabis use also played important roles; indeed, one quarter of new cases of psychosis could be attributed to use of high potency cannabis. The "jumping to conclusions" bias appeared to mediate the effect of lower IQ on vulnerability to psychosis. We confirmed that environmental factors operate on the background of polygenic risk, and that genetic and environment act together to push individuals over the threshold for manifesting the clinical disorder. The study demonstrated how biological pathways involved in the stress response (HPA axis and immune system) provide important mechanisms linking social risk factors to the development of psychotic symptoms. Further evidence implicating an immune/inflammatory component to psychosis came from our finding of complement dysregulation in FEP. Patients also showed an upregulation of the antimicrobial alpha-defensins, as well as differences in expression patterns of genes involved in NF-κB signaling and Cytokine Production. Being of African origin not only increased risk of onset but also of a more difficult course of illness. The malign effect of childhood adversity predicted a poorer outcome as did continued use of high potency cannabis.
Collapse
Affiliation(s)
- R M Murray
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK; Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.
| | - V Mondelli
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - S A Stilo
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK; Division of Psychology and Language Sciences, University College London, London, UK
| | - A Trotta
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - L Sideli
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK; Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - O Ajnakina
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - L Ferraro
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - E Vassos
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - C Iyegbe
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - T Schoeler
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK; Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - S Bhattacharyya
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - T R Marques
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - P Dazzan
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - J Lopez-Morinigo
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK; Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
| | - M Colizzi
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - J O'Connor
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK; Department of Neuropsychology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK
| | - M A Falcone
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - D Quattrone
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - V Rodriguez
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - G Tripoli
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK; Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - D La Barbera
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - C La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - L Alameda
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - G Trotta
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK; Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - C Morgan
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - F Gaughran
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK
| | - A David
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK; Institute of Mental Health, University College London, London, UK
| | - M Di Forti
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, King's College London, London, UK; Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| |
Collapse
|
24
|
Prokopez CR, Vallejos M, Farinola R, Alberio G, Caporusso GB, Cozzarin LG, Chiapella LC, Fuentes P, Daray FM. The history of multiple adverse childhood experiences in patients with schizophrenia is associated with more severe symptomatology and suicidal behavior with gender-specific characteristics. Psychiatry Res 2020; 293:113411. [PMID: 32890864 DOI: 10.1016/j.psychres.2020.113411] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/05/2020] [Accepted: 08/17/2020] [Indexed: 12/19/2022]
Abstract
The current study aims to compare the prevalence of adverse childhood experiences (ACEs) between patients with schizophrenia and non-psychiatric control group, and to analyze the association of having suffered multiple ACEs with clinical symptoms of schizophrenia and suicidal behavior. A multicenter, cross-sectional study was conducted across three facilities in Buenos Aires, Argentina. One-hundred patients with schizophrenia and 50 healthy subjects were assessed with the Adverse Childhood Experiences questionnaire (ACE-Q), the Positive and Negative Syndrome Scale (PANSS), and the Columbia-Suicide Severity Rating Scale (C-SSRS). We observed that the prevalence of at least one ACE in schizophrenic patients was almost double in comparison with the non-psychiatric control group. Multiple ACEs were associated with persistent auditory hallucinations and lower negative symptoms in both sexes. Higher frequency of death ideation and a higher number of suicide attempts were reported among women. The strength of this study is the possibility of comparing the presence of ACEs between schizophrenic patients and non-psychiatric control using the same questionnaire in an under-reported sample of low socio-economic patients assisted in public hospitals. A limitation is that the history of ACEs relied on the retrospective assessment of childhood experiences, and adults could over-report ACEs because of recall bias.
Collapse
Affiliation(s)
- Cintia R Prokopez
- Braulio A. Moyano Neuropsychiatric Hospital, City of Buenos Aires, Argentina; University of Buenos Aires, School of Medicine, Institute of Pharmacology, Argentina
| | - Miguel Vallejos
- José Tiburcio Borda Hospital, City of Buenos Aires, Argentina
| | - Romina Farinola
- José Tiburcio Borda Hospital, City of Buenos Aires, Argentina
| | - Germán Alberio
- Braulio A. Moyano Neuropsychiatric Hospital, City of Buenos Aires, Argentina
| | | | | | - Luciana C Chiapella
- National Scientific and Technical Research Council (CONICET). Ciudad Autónoma de Buenos Aires, Argentina; Pharmacology Area, Faculty of Biochemical and Pharmaceutical Sciences, National University of Rosario, Argentina
| | - Pamela Fuentes
- Braulio A. Moyano Neuropsychiatric Hospital, City of Buenos Aires, Argentina
| | - Federico M Daray
- University of Buenos Aires, School of Medicine, Institute of Pharmacology, Argentina; National Scientific and Technical Research Council (CONICET). Ciudad Autónoma de Buenos Aires, Argentina.
| |
Collapse
|
25
|
Wang L, Cheng H, Qu Y, Zhang Y, Cui Q, Zou H. The prevalence of child maltreatment among Chinese primary and middle school students: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1105-1119. [PMID: 32632599 DOI: 10.1007/s00127-020-01916-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 06/30/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of this study was to provide an estimate of the prevalence of child maltreatment among Chinese primary and middle school students. An attempt was also made to explore the causes of heterogeneity by analyzing stratified variables and other potentially related factors included in the study. METHODS Literature retrieval has been carried out in the databases, including Pubmed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang database and China Biology Medicine disc (CBMdisc), for relevant published studies up to October 2019. The Cochran's chi-squared test (Cochran's Q), I2 test and subgroup analysis were performed to evaluate the heterogeneity. Funnel plots were used to detect publication bias. Trim-and-fill method was performed to identify possible asymmetry and assess the robustness of the conclusions. RESULTS A total of 1433 studies were obtained after retrieval. Finally, 19 eligible studies were included in meta-analysis after detailed exclusion. The pooled prevalence of child physical abuse (CPA), child emotional abuse (CEA), child sexual abuse (CSA), child physical neglect (CPN) and child emotional neglect (CEN) were 0.20 (95% CI 0.13, 0.27), 0.30 (95% CI 0.20, 0.39), 0.12 (95% CI 0.09, 0.15), 0.47 (95% CI 0.35, 0.58) and 0.44 (95% CI 0.28, 0.59), respectively. In subgroup analyses, a higher prevalence of CEN was reported in rural areas. Meanwhile, the prevalence of CPN and CEN in non-only child group was higher than that observed in only child group. Compared with children without mental symptoms, children with mental symptoms have a higher incidence of all categories of child maltreatment. In terms of assessment tools, studies using Childhood Trauma Questionnaire as an assessment tool reported lower prevalence of CPA, CEA. Childhood Trauma Questionnaire In addition, the prevalence of CPN, CEN in studies conducted in northern China was significantly higher than that estimated in southern and central China. For CSA, eight additional studies required trimming according to the trim-and-fill analysis, and the pooled estimate was 0.042 after filling. For CPA, CEA, CPN and CEN, there were no indications of publication with the trim and fill method (data unchanged). CONCLUSION Our findings indicated that primary and middle school students had a relatively high prevalence of maltreatment. Because of the visible heterogeneity of the studies included, more large samples, high-quality and prospective studies are needed in the future to acquire the accurate prevalence of child maltreatment in China. Certainly, future research needs to focus not only on the estimate of prevalence of child maltreatment, but also on risk factors and intervention strategies for child maltreatment.
Collapse
Affiliation(s)
- Lu Wang
- School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing, 100144, China
| | - Huan Cheng
- School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing, 100144, China
| | - Yanhua Qu
- School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing, 100144, China
| | - Yu Zhang
- School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing, 100144, China
| | - Qian Cui
- School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing, 100144, China
| | - Haiou Zou
- School of Nursing, Peking Union Medical College, 33 Badachu Road, Beijing, 100144, China.
| |
Collapse
|
26
|
The association between childhood trauma and treatment outcomes in schizophrenia spectrum disorders. Psychiatry Res 2020; 289:113004. [PMID: 32387789 DOI: 10.1016/j.psychres.2020.113004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 04/11/2020] [Accepted: 04/11/2020] [Indexed: 11/22/2022]
Abstract
Childhood trauma exposure has been associated with poorer treatment outcomes in schizophrenia. Most studies to date have been conducted in naturalistic settings in which the outcome may have been mediated by factors such as poor adherence and substance abuse. We compared the effects of high vs low childhood trauma exposure on the treatment response over 24 months in 78 patients with first-episode schizophrenia spectrum disorders who received standardised treatment with a long acting injectable antipsychotic. Compared to the low childhood trauma group (n = 37), the high childhood trauma group (n = 41) received higher doses of antipsychotic medication and were less likely to achieve remission. When age, sex and cannabis use were controlled for, patients with high levels of childhood trauma had a slower treatment response for positive and disorganized symptom domains, although differences did not differ significantly at 24 months. While there were no differences in functional outcomes, self-rated quality of life was the domain that most clearly differentiated the high and low childhood trauma groups. High childhood trauma exposure was associated with lower quality of life scores at baseline, a lesser degree of improvement with treatment, and lower quality of life scores at 24 months.
Collapse
|
27
|
Age at the time of onset of psychosis: A marker of specific needs rather than a determinant of outcome? Eur Psychiatry 2020; 45:20-26. [DOI: 10.1016/j.eurpsy.2017.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 05/11/2017] [Accepted: 06/07/2017] [Indexed: 12/17/2022] Open
Abstract
AbstractBackground:While there is suggestion that early onset of psychosis is a determinant of outcome; knowledge regarding correlates of later onset age is more limited. This study explores the characteristics of patients developing psychosis after age 26, towards the end of the usual age range of early intervention programs, in order to identify potential specific needs of such patients.Methods:Two hundred and fifty-six early psychosis patients aged 18–35 were followed-up prospectively over 36 months. Patients with onset after 26 (“later onset”, LO) were compared to the rest of the sample.Results:LO patients (32% of the sample) had shorter DUP, were less likely to be male, had better premorbid functioning and were more likely to have been exposed to trauma. They had greater insight at presentation and less negative symptoms overall. The trajectories for positive and depressive symptoms were similar in both groups. Evolution of functional level was similar in both groups, but while LO patients recovered faster, they were significantly less likely to return to premorbid functional level.Conclusions:Later psychosis onset correlates with better premorbid functioning and higher rate of trauma exposure; the latter should therefore be a treatment focus in such patients. LO patients were less likely to return to premorbid functional level, which suggests that current treatment strategies may not be efficient to help patients maintain employment. The possibility of distinct illness mechanisms according to onset age and the more central role for trauma in patients with onset after age 26 needs to be further explored.
Collapse
|
28
|
Ragazzi TCC, Shuhama R, Sinval J, Marôco J, Corsi-Zuelli F, Roza DLD, van Os J, Menezes PR, Del-Ben CM. Validation of the Portuguese version of the Community Assessment of Psychic Experiences and characterization of psychotic experiences in a Brazilian sample. ACTA ACUST UNITED AC 2020; 42:389-397. [PMID: 32130403 PMCID: PMC7430378 DOI: 10.1590/1516-4446-2019-0611] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/05/2019] [Indexed: 11/24/2022]
Abstract
Objective: We investigated: i) the reliability and validity of a Brazilian version of the Community Assessment of Psychic Experiences (CAPE), developed to detect and characterize psychotic experiences in the general population; and ii) the association between psychotic experiences, childhood adversity, and cannabis use in a population-based sample. Methods: We performed factorial analyses and generalized linear models with CAPE scores as the dependent variable in a sample composed of 217 first-episode psychosis patients, 104 unaffected biological siblings, and 319 non-psychotic population-based participants. Results: After removing seven items from its positive dimension and two items from its negative dimension, a 33-item Brazilian version of the CAPE showed acceptable adjustment indices (confirmatory fit index = 0.895; goodness of fit index = 0.822; parsimony goodness of fit index = 0.761; root mean square error of approximation [RMSEA] = 0.055, p [RMSEA ≤ 0.05] = 0.04) and internal consistency in all its dimensions (> 0.70). Childhood adversity was associated with higher scores in all three dimensions, as well as with total score. Lifetime cannabis use was associated with higher scores only in the positive dimension. Conclusion: The proposed Brazilian version of the CAPE corroborates the tridimensional approach for assessing psychosis-proneness, and the frequency and severity of psychotic manifestations are distributed as a spectrum in the general population.
Collapse
Affiliation(s)
- Taciana C C Ragazzi
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Rosana Shuhama
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Jorge Sinval
- Business Research Unit (BRU-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - João Marôco
- William James Center for Research, ISPA, Instituto Universitário, Lisbon, Portugal
| | - Fabiana Corsi-Zuelli
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Daiane L da Roza
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Jim van Os
- Department of Psychiatry, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Paulo R Menezes
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Cristina M Del-Ben
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| |
Collapse
|
29
|
Stanton KJ, Denietolis B, Goodwin BJ, Dvir Y. Childhood Trauma and Psychosis: An Updated Review. Child Adolesc Psychiatr Clin N Am 2020; 29:115-129. [PMID: 31708041 DOI: 10.1016/j.chc.2019.08.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There is growing evidence to support the link between childhood trauma and psychosis. Childhood trauma increases the risk for psychosis and affects severity and type of psychotic symptoms, and frequency of comorbid conditions, including depression and substance use. Childhood trauma is linked to more severe functional impairment in individuals with psychosis. There is evidence to support gender differences in the influence of childhood trauma on the course of psychotic illnesses, appearing to be more profound in girls and women. Other biological markers that may explain the link between childhood trauma and psychosis include brain-derived neurotrophic factor and other inflammatory markers.
Collapse
Affiliation(s)
- Kate J Stanton
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Brian Denietolis
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Brien J Goodwin
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, 135 Hicks Way/Tobin Hall, Amherst, MA 01003, USA
| | - Yael Dvir
- Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
| |
Collapse
|
30
|
Nischk D, Kügler F, Rockstroh B, Schalinski I. Einfluss belastender Kindheitserfahrungen bei akuten Psychosen und ihr Zusammenhang mit Schwere und kurzfristigem Verlauf. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2019. [DOI: 10.1026/1616-3443/a000560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Misshandlung, Missbrauch und Vernachlässigung (MMV) in der Kindheit stehen mit einem erhöhten Risiko für schizophrene Spektrumsstörungen sowie einem schlechten Verlauf in Zusammenhang. Fragestellung: 1.) Wie verteilen sich die Schweregrade von MMV bei Patient_innen im Vergleich zu Gesunden? 2.) Ist MMV mit höherer Erkrankungsschwere zu Behandlungsbeginn sowie 3.) einem schlechteren Verlauf einer akuten Psychose assoziiert? Methode: MMV wurde bei Patient_innen mit schizophrenen Spektrumsstörungen ( n = 101) und Gesunden ( n = 50) erhoben. Die Patient_innen wurden bei der stationären Aufnahme (t1), Entlassung (t2) und sechs Monate später (t3) untersucht. Ergebnisse: 1.) Gegenüber Kontrollpersonen zeigte sich ein ansteigender Anteil von Patient_innen mit mittleren und hohen MMV-Schweregraden. MMV-Erfahrungen waren zudem 2.) mit häufigerer psychiatrischer Komorbidität sowie 3.) mit höherer Depressivität, störungsunspezifischer Symptomatik und geringerer Lebenszufriedenheit im Verlauf assoziiert. Schlussfolgerungen: MMV-Erfahrungen sind für Erkrankungschwere und akuten Verlauf von schizophrenen Spektrumsstörungen bedeutsam.
Collapse
Affiliation(s)
- Daniel Nischk
- Zentrum für Psychiatrie Reichenau
- Fachbereich Psychologie, Universität Konstanz
| | | | | | - Inga Schalinski
- Fachbereich Psychologie, Universität Konstanz
- Charité-Universitätsmedizin Berlin
| |
Collapse
|
31
|
Thomas S, Höfler M, Schäfer I, Trautmann S. Childhood maltreatment and treatment outcome in psychotic disorders: a systematic review and meta-analysis. Acta Psychiatr Scand 2019; 140:295-312. [PMID: 31357235 DOI: 10.1111/acps.13077] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Childhood maltreatment (CM) plays an important role in the aetiology and course of psychotic disorders and is associated with characteristics that could be relevant for treatment. We aimed to conduct a systematic review and meta-analysis on the association between CM and treatment outcome in psychotic disorders. METHODS Treatment outcome was defined as change in psychotic symptoms or in social or occupational functioning between first and last reported measurement in the course of a pharmacological and/or psychological treatment. RESULTS Twelve treatment results from seven studies (636 patients, average treatment duration: 59.2 weeks) were included. CM was related to poorer treatment outcomes in psychotic disorders (OR = 1.51, 95% CI = [1.08, 2.10]). There is evidence that this association might increase with illness duration and increasing age and might be stronger in schizophrenia samples. CONCLUSIONS Childhood maltreatment is highly understudied with regard to treatment outcome in psychotic disorders. The need for more studies is emphasized by the fact that this meta-analysis reveals evidence for a poorer treatment response in patients with CM. If this association is confirmed, the identification of patients with CM and the consideration of associated clinical and biological conditions could contribute to improve treatment outcome in psychotic disorders.
Collapse
Affiliation(s)
- S Thomas
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - I Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychology, Medical School Hamburg, Hamburg, Germany
| |
Collapse
|
32
|
Popovic D, Schmitt A, Kaurani L, Senner F, Papiol S, Malchow B, Fischer A, Schulze TG, Koutsouleris N, Falkai P. Childhood Trauma in Schizophrenia: Current Findings and Research Perspectives. Front Neurosci 2019; 13:274. [PMID: 30983960 PMCID: PMC6448042 DOI: 10.3389/fnins.2019.00274] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 03/07/2019] [Indexed: 01/09/2023] Open
Abstract
Schizophrenia is a severe neuropsychiatric disorder with persistence of symptoms throughout adult life in most of the affected patients. This unfavorable course is associated with multiple episodes and residual symptoms, mainly negative symptoms and cognitive deficits. The neural diathesis-stress model proposes that psychosocial stress acts on a pre-existing vulnerability and thus triggers the symptoms of schizophrenia. Childhood trauma is a severe form of stress that renders individuals more vulnerable to developing schizophrenia; neurobiological effects of such trauma on the endocrine system and epigenetic mechanisms are discussed. Childhood trauma is associated with impaired working memory, executive function, verbal learning, and attention in schizophrenia patients, including those at ultra-high risk to develop psychosis. In these patients, higher levels of childhood trauma were correlated with higher levels of attenuated positive symptoms, general symptoms, and depressive symptoms; lower levels of global functioning; and poorer cognitive performance in visual episodic memory end executive functions. In this review, we discuss effects of specific gene variants that interact with childhood trauma in patients with schizophrenia and describe new findings on the brain structural and functional level. Additive effects between childhood trauma and brain-derived neurotrophic factor methionine carriers on volume loss of the hippocampal subregions cornu ammonis (CA)4/dentate gyrus and CA2/3 have been reported in schizophrenia patients. A functional magnetic resonance imaging study showed that childhood trauma exposure resulted in aberrant function of parietal areas involved in working memory and of visual cortical areas involved in attention. In a theory of mind task reflecting social cognition, childhood trauma was associated with activation of the posterior cingulate gyrus, precuneus, and dorsomedial prefrontal cortex in patients with schizophrenia. In addition, decreased connectivity was shown between the posterior cingulate/precuneus region and the amygdala in patients with high levels of physical neglect and sexual abuse during childhood, suggesting that disturbances in specific brain networks underlie cognitive abilities. Finally, we discuss some of the questionnaires that are commonly used to assess childhood trauma and outline possibilities to use recent biostatistical methods, such as machine learning, to analyze the resulting datasets.
Collapse
Affiliation(s)
- David Popovic
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Lalit Kaurani
- German Center of Neurodegenerative Diseases, University of Göttingen, Göttingen, Germany
| | - Fanny Senner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Sergi Papiol
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Hospital of Jena, Jena, Germany
| | - Andre Fischer
- German Center of Neurodegenerative Diseases, University of Göttingen, Göttingen, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| |
Collapse
|
33
|
Alcalá HE, Balkrishnan R. Mental Health Services in Childhood: The Role of Family Adversity. Public Health Rep 2019; 134:180-188. [PMID: 30844343 DOI: 10.1177/0033354919826555] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Much of the research on the effects of childhood adversity on mental health has focused on adults. The objective of our study was to examine the individual and cumulative effect of childhood adversity on mental health service use among children. METHODS We used data from the 2011-2012 National Survey of Children's Health (n = 79 834) to determine the use of mental health services in the past 12 months among children aged 2-17. The independent variables of interest were experiencing any 1 of 9 adverse family experiences (AFEs). We used logistic regression models to determine if each AFE was associated with mental health service use. We also examined AFEs as a continuous measure, representing the number of AFEs (ranging from 0 to 9) that summed them individually, and we examined age-by-AFE and age-by-need interaction terms. We adjusted all models for confounders. RESULTS Compared with not experiencing an AFE, experiencing all AFEs was associated with higher odds of mental health service use. Neighborhood violence was associated with the greatest increase in odds of mental health service use (adjusted odds ratio [aOR] = 2.35; 95% confidence interval [CI], 2.00-2.77). When measured as a continuous scale, each additional AFE was associated with higher odds of mental health service use (aOR = 1.33; 95% CI, 1.28-1.37). The effect of AFEs on mental health service use decreased with age. CONCLUSIONS The observed association between AFEs and use of mental health services may be attributable to more severe or poorly managed mental illness among these children. Efforts are needed to increase access to and quality of mental health care among children affected by AFEs.
Collapse
Affiliation(s)
- Héctor E Alcalá
- 1 Program in Public Health, University of Virginia, Charlottesville, VA, USA.,2 Department of Family, Program in Public Health, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Rajesh Balkrishnan
- 1 Program in Public Health, University of Virginia, Charlottesville, VA, USA
| |
Collapse
|
34
|
Pruessner M, King S, Vracotas N, Abadi S, Iyer S, Malla AK, Shah J, Joober R. Gender differences in childhood trauma in first episode psychosis: Association with symptom severity over two years. Schizophr Res 2019; 205:30-37. [PMID: 29935881 DOI: 10.1016/j.schres.2018.06.043] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/11/2018] [Accepted: 06/14/2018] [Indexed: 01/12/2023]
Abstract
Early life adversity is associated with increased risk for psychosis onset and poor clinical outcome. Male compared to female patients often show a more severe course of psychotic illness. The aim of the present study was to investigate gender differences in childhood trauma (CT) and their impact on symptomatic and functional outcome following psychosis onset. The study included 210 patients (144 men, 66 women) diagnosed with a first-episode of psychosis (FEP). Early adversity was assessed with the Childhood Trauma Questionnaire. Psychotic symptoms and general functioning were rated with the Brief Psychiatric Rating Scale and Global Assessment of Functioning scale at baseline, 12 and 24 months of follow-up in an established early intervention service. Male patients reported higher rates of physical or emotional neglect, whereas female patients indicated significantly higher rates of emotional abuse. More severe CT was related to higher levels of depression in women and to negative symptoms in men. Distinct CT effects were observed on positive and negative symptom severity and global functioning in male patients at 24 months. Emotional abuse was the strongest predictor of depression in both genders. In male patients only, emotional abuse predicted positive symptom severity and impaired global functioning, whereas emotional neglect predicted more severe negative symptoms. Our results suggest differences in CT experiences in male and female FEP patients, with a more pronounced impact on longer-term outcome in male patients. The findings support the notion that sex differences in stress vulnerability account for the relatively poor illness course in male psychosis patients.
Collapse
Affiliation(s)
- Marita Pruessner
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada; University of Konstanz, Department of Clinical Psychology, Konstanz, Germany.
| | - Suzanne King
- McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Nadia Vracotas
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Sherezad Abadi
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Canada
| | - Srividya Iyer
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Ashok K Malla
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Jai Shah
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Douglas Mental Health University Institute, Verdun, Canada; McGill University, Department of Psychiatry, Montréal, Québec, Canada
| |
Collapse
|
35
|
Kaufman J, Torbey S. Child maltreatment and psychosis. Neurobiol Dis 2019; 131:104378. [PMID: 30685353 DOI: 10.1016/j.nbd.2019.01.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 01/16/2019] [Accepted: 01/23/2019] [Indexed: 12/27/2022] Open
Abstract
This paper reviews the literature on the association between experiences of child abuse and neglect and the development of psychoses. It then explores the premise that psychotic patients with a history of maltreatment may comprise a clinically and biological distinct subgroup. The review demonstrates that there is a growing consensus in the field that experiences of child maltreatment contribute to the onset of psychotic symptoms and psychotic disorders. There is also strong support for the premise that patients with psychotic disorders and histories of child maltreatment have distinct clinical characteristics and unique treatment needs, and emerging preliminary data to suggest psychotic patients with a history of maltreatment may comprise a distinct neurobiological subgroup. The mechanisms by which experiences of child maltreatment confers risk for psychotic disorders remains unknown, and the review highlights the value of incorporating translational research perspectives to advance knowledge in this area.
Collapse
Affiliation(s)
- Joan Kaufman
- Kennedy Krieger Institute, Center for Child and Family Traumatic Stress, 1741 Ashland Avenue, Baltimore, MD 21205, United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States.
| | - Souraya Torbey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| |
Collapse
|
36
|
Ajnakina O, Trotta A, Forti MD, Stilo SA, Kolliakou A, Gardner-Sood P, Lopez-Morinigo J, Gaughran F, David AS, Dazzan P, Pariante C, Mondelli V, Murray RM, Fisher HL. Different types of childhood adversity and 5-year outcomes in a longitudinal cohort of first-episode psychosis patients. Psychiatry Res 2018; 269:199-206. [PMID: 30153597 DOI: 10.1016/j.psychres.2018.08.054] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 01/01/2023]
Abstract
Little is known about the impact of different forms of childhood adversity on outcomes in first-episode psychosis (FEP) patients beyond the first year of treatment. We investigated associations between different types of childhood adversity and outcomes of FEP patients over the 5 years following their first contact with mental health services for psychosis. 237 FEP cases aged 18-65 years were followed on average for 5 years after first presentation to psychiatric services in South London, UK. Childhood adversity prior to 17 years of age was assessed at baseline using the Childhood Experience of Care and Abuse Questionnaire (CECA.Q). The results showed that exposure to at least one type of childhood adversity was significantly associated with a lower likelihood of achieving symptomatic remission, longer inpatient stays, and compulsory admission over the 5-year follow-up. There was no evidence though of a dose-response effect. Some specificity was evident. Childhood parental separation was associated with significantly greater likelihood of non-compliance with antipsychotic medications, compulsory admission, and substance dependence. Institutional care was significantly associated with longer total length of inpatient stays; and parental death was significantly associated with compulsory admissions. Clinicians should screen FEP patients for childhood adversity and tailor interventions accordingly to improve outcomes.
Collapse
Affiliation(s)
- Olesya Ajnakina
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Antonella Trotta
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Marta Di Forti
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London, Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Simona A Stilo
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Anna Kolliakou
- King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Poonam Gardner-Sood
- Imaging Trials Unit, University College London and University College London Hospitals NIHR Biomedical Research Centre, London UK; Centre for Medical Imaging, University College London, Charles Bell House, London, UK
| | - Javier Lopez-Morinigo
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Fiona Gaughran
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London, Maudsley NHS Foundation Trust, King's College London, London, UK; National Psychosis Unit, South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, London, UK
| | - Anthony S David
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London, Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Paola Dazzan
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London, Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Carmine Pariante
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London, Maudsley NHS Foundation Trust, King's College London, London, UK; King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Valeria Mondelli
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London, Maudsley NHS Foundation Trust, King's College London, London, UK; King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Robin M Murray
- King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London, Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Helen L Fisher
- King's College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
| |
Collapse
|
37
|
Vallejos M, Cesoni OM, Farinola R, Bertone MS, Prokopez CR. Adverse Childhood Experiences among Men with Schizophrenia. Psychiatr Q 2017; 88:665-673. [PMID: 27957657 DOI: 10.1007/s11126-016-9487-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Individuals who suffered traumatic events or adverse experiences during their childhood have an increased risk of developing during adulthood physical problems, aggressive behavior, and psychiatric disorders, such as schizophrenia. Patients diagnosed with schizophrenia have higher rates of traumatic experiences during childhood than the general population, and those who suffered multiple traumatic events have an increased risk of disease relapse. The current study aims to determine the prevalence of different types of adverse experiences during childhood among a male patient sample with schizophrenia. An Observational descriptive cross-sectional study was conducted at Jose T. Borda Hospital, in Buenos Aires, Argentina. Participants included 51 male patients between the ages of 18 and 63 years with a diagnosis of schizophrenia. Semi-structured interviews were conducted, applying a socio-demographic questionnaire, SCID I and II scales to assess psychiatric diagnosis, and the Adverse Childhood Experiences (ACE) Questionnaire to evaluate the presence of adverse childhood experiences. Statistical analyses were conducted using SPSS 22 software. We observed that 94% of participants had experienced at least one adverse childhood experience. Most (63%) suffered from 4 or more disruptive child events. A high prevalence of family history of mental illness was found, also emotional abuse and neglect. Most traumatic events occurred within the family group. It was found a moderately significant relationship between patients who suffered adverse events and the presence of auditory hallucinations.
Collapse
Affiliation(s)
- Miguel Vallejos
- José T. Borda Hospital, Dr. Ramón Carrillo 375, C1275AHG, Buenos Aires, Argentina
| | - Oscar M Cesoni
- José T. Borda Hospital, Dr. Ramón Carrillo 375, C1275AHG, Buenos Aires, Argentina
| | - Romina Farinola
- José T. Borda Hospital, Dr. Ramón Carrillo 375, C1275AHG, Buenos Aires, Argentina
| | - Matías S Bertone
- Belgrano University, Zabala 1837, C1426DQG, Buenos Aires, Argentina
| | - Cintia R Prokopez
- Braulio A. Moyano Hospital, Brandsen 2570, C1287ABJ, Buenos Aires, Argentina.
| |
Collapse
|
38
|
Stein MD, Conti MT, Kenney S, Anderson BJ, Flori JN, Risi MM, Bailey GL. Adverse childhood experience effects on opioid use initiation, injection drug use, and overdose among persons with opioid use disorder. Drug Alcohol Depend 2017; 179:325-329. [PMID: 28841495 PMCID: PMC5599365 DOI: 10.1016/j.drugalcdep.2017.07.007] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Adverse childhood experiences are associated with the development of substance use disorders. With opioid use disorder, a growing concern in the United States, we were interested in examining the relationship between adverse experiences and three landmarks of opioid use: age of opioid initiation, injection drug use, and lifetime overdose. METHODS Between May and December 2015, we interviewed consecutive persons seeking inpatient opioid detoxification. Participants were asked about age of opioid initiation, last month injection drug use, and lifetime history of overdose, and completed the ten-item Adverse Childhood Experience (ACE) questionnaire. RESULTS Participants (n=457) averaged 32.2 (±8.64) years of age, 71.3% were male, and 82.5% were non-Hispanic White. The mean score on the ACE scale was 3.64 (±2.75). Mean age at time of initiating opioid use was 21.7 (±7.1) years, 68.7% had injected drugs within the past month, and 39.0% had overdosed. After adjusting for age, gender, and ethnicity, the ACE score was inversely associated with age of initiating opioid use (b=-0.50, 95% CI -0.70; -0.29, p<.001), and positively associated with recent injection drug use (OR=1.11, 95% CI 1.02; 1.20, p=0.014) and the likelihood of experiencing an overdose (OR=1.10, 95% CI 1.02; 1.20, p=0.015) in a graded dose response manner. CONCLUSION Greater adverse childhood experiences are associated with three landmarks of opioid use risk. ACE screening may be useful in identifying high-risk subsets of opioid-using populations.
Collapse
Affiliation(s)
- Michael D. Stein
- Behavioral Medicine, Butler Hospital, Providence, RI, 02906,Boston University School of Public Health, Boston, MA 02118
| | - Micah T. Conti
- Behavioral Medicine, Butler Hospital, Providence, RI, 02906,Stanley Street Treatment and Resources, Inc., Fall River, Massachusetts 02720
| | - Shannon Kenney
- Behavioral Medicine, Butler Hospital, Providence, RI, 02906, USA; Warren Alpert Medical School of Brown University, Providence, RI, 02912, USA.
| | | | - Jessica N. Flori
- Behavioral Medicine, Butler Hospital, Providence, RI, 02906,Stanley Street Treatment and Resources, Inc., Fall River, Massachusetts 02720
| | - Megan M. Risi
- Behavioral Medicine, Butler Hospital, Providence, RI, 02906,Stanley Street Treatment and Resources, Inc., Fall River, Massachusetts 02720
| | - Genie L. Bailey
- Stanley Street Treatment and Resources, Inc., Fall River, Massachusetts 02720,Warren Alpert Medical School of Brown University, Providence, RI, 02912
| |
Collapse
|
39
|
Alameda L, Golay P, Baumann PS, Progin P, Mebdouhi N, Elowe J, Ferrari C, Do KQ, Conus P. Mild Depressive Symptoms Mediate the Impact of Childhood Trauma on Long-Term Functional Outcome in Early Psychosis Patients. Schizophr Bull 2017; 43:1027-1035. [PMID: 27884931 PMCID: PMC5581905 DOI: 10.1093/schbul/sbw163] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The mechanism linking childhood trauma (CT) to the functional deficits observed in early psychosis (EP) patients is as yet unknown. We aim to examine the potential mediating effect of depressive symptoms in this well-established association. METHODS Two hundred nine EP subjects aged 18-35 were assessed for functioning and psychopathology after 2, 6, 12, 18, 24, 30, and 36 months of treatment. Patients were classified into early trauma if they had faced at least one experience of abuse (physical, sexual, or emotional) or neglect (physical or emotional) before age 12, and late trauma if the exposure had occurred between ages 12 and 16. Diagnosis was based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Psychopathology was assessed with the Positive and Negative Syndrome Scale and the Montgomery-Asberg Depression Rating Scale. Functioning was measured with the Global Assessment of Functioning (GAF) and the Social and Occupational Functioning Assessment Scale (SOFAS). Mediation analyses were performed in order to study whether the relationship between CT and functioning was mediated by depressive symptoms. RESULTS When compared with nonexposed patients, early but not late trauma patients showed lower levels of GAF and SOFAS scores over all the time points, excepting after the first assessment. After 30 and 36 months, the effect of early trauma on functioning was completely mediated by depressive symptoms. No mediating effect of positive or negative symptoms was highlighted at those time points. CONCLUSION Mild depressive symptoms mediated the impact of early trauma on long-term functional outcome. Intensifying pharmacologic and/or psychotherapeutic treatment, focused on the depressive dimension, may help traumatized EP patients to improve their functioning.
Collapse
Affiliation(s)
- Luis Alameda
- Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland;,Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland;,Psychiatric Liaison Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland;,These authors contributed equally to this work.,To whom correspondence should be addressed; tel: 41-795025957, fax: 41-213141098, e-mail:
| | - Philippe Golay
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland;,These authors contributed equally to this work
| | - Philipp S Baumann
- Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland;,Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Pierre Progin
- Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland;,Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Nadir Mebdouhi
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Julien Elowe
- Mobile Psychiatry Unit, Department of Psychiatry, Prangins Psychiatric Hospital (CHUV), Prangins, Switzerland
| | - Carina Ferrari
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Kim Q Do
- Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland;,Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| |
Collapse
|
40
|
Interplay between Schizophrenia Polygenic Risk Score and Childhood Adversity in First-Presentation Psychotic Disorder: A Pilot Study. PLoS One 2016; 11:e0163319. [PMID: 27648571 PMCID: PMC5029892 DOI: 10.1371/journal.pone.0163319] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 09/07/2016] [Indexed: 11/19/2022] Open
Abstract
A history of childhood adversity is associated with psychotic disorder, with an increase in risk according to number or severity of exposures. However, it is not known why only some exposed individuals go on to develop psychosis. One possibility is pre-existing genetic vulnerability. Research on gene-environment interaction in psychosis has primarily focused on candidate genes, although the genetic effects are now known to be polygenic. This pilot study investigated whether the effect of childhood adversity on psychosis is moderated by the polygenic risk score for schizophrenia (PRS). Data were utilised from the Genes and Psychosis (GAP) study set in South London, UK. The GAP sample comprises 285 first-presentation psychosis cases and 256 unaffected controls with information on childhood adversity. We studied only white subjects (80 cases and 110 controls) with PRS data, as the PRS has limited predictive ability in patients of African ancestry. The occurrence of childhood adversity was assessed with the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) and the PRS was based on genome-wide meta-analysis results for schizophrenia from the Psychiatric Genomics Consortium. Higher schizophrenia PRS and childhood adversities each predicted psychosis status. Nevertheless, no evidence was found for interaction as departure from additivity, indicating that the effect of polygenic risk scores on psychosis was not increased in the presence of a history of childhood adversity. These findings are compatible with a multifactorial threshold model in which both genetic liability and exposure to environmental risk contribute independently to the etiology of psychosis.
Collapse
|