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Gautam N, Rahman MM, Khanam R. Adverse childhood experiences and externalizing, internalizing, and prosocial behaviors in children and adolescents: A longitudinal study. J Affect Disord 2024; 363:124-133. [PMID: 39043305 DOI: 10.1016/j.jad.2024.07.064] [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: 12/04/2023] [Revised: 06/27/2024] [Accepted: 07/14/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have a profound impact on individuals, shaping their long-term health and life opportunities. This study delves into the complex ties between ACEs and the socioemotional development of Australian children and youth by examining the relationships between adverse childhood experiences and externalizing, internalizing, and prosocial behaviors. METHODS This study utilized data from the Longitudinal Study of Australian Children and employed the generalized estimating equation method to investigate the relationships between adverse childhood experiences and externalizing, internalizing, and prosocial behaviors in Australian children and adolescents. RESULTS Adverse childhood experiences such as physical punishment, hostile parenting, parental conflicts, separation, financial strain, and parental mental health issues increased the risk of externalizing and internalizing behaviors while reducing prosocial behaviors. The risk increases with the number of ACEs, as evidenced by the incidence ratio (IR); for example, for externalizing behaviors, an ACEs score of one leads to IR = 1.69, while an ACEs score of 4 results in IR = 3.34. Similar trends were observed for internalizing and prosocial behaviors. LIMITATIONS The presence of imbalanced longitudinal data, arising from variations in the number of observations across different time points, challenges robust inferences. Furthermore, this study investigates the relationship between ACEs and behavioral problems, without establishing causality. Consequently, the results should be interpreted with caution. CONCLUSIONS The findings of this study highlight that adverse childhood experiences significantly influence behavioral outcomes in children and adolescents. These findings underscore the critical need for early detection and intervention to mitigate the consequences of traumatic childhood experiences.
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Affiliation(s)
- Nirmal Gautam
- School of Business, University of Southern Queensland, Toowoomba 4350, Queensland, Australia; The Centre for Health Research, University of Southern Queensland, Toowoomba 4350, Queensland, Australia.
| | - Mohammad Mafizur Rahman
- School of Business, University of Southern Queensland, Toowoomba 4350, Queensland, Australia; The Centre for Health Research, University of Southern Queensland, Toowoomba 4350, Queensland, Australia
| | - Rasheda Khanam
- School of Business, University of Southern Queensland, Toowoomba 4350, Queensland, Australia; The Centre for Health Research, University of Southern Queensland, Toowoomba 4350, Queensland, Australia
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2
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Stevenson A, Misra S, Girma E, Isvoranu AM, Akena D, Alemayehu M, Atwoli L, Gelaye B, Gichuru S, Kariuki SM, Kwobah EK, Kyebuzibwa J, Mwema RM, Newman CP, Newton CRJC, Ongeri L, Stroud RE, Teferra S, Koenen KC, Seedat S. Relationships between trauma types and psychotic symptoms: A network analysis of patients with psychotic disorders in a large, multi-country study in East Africa. Compr Psychiatry 2024; 133:152504. [PMID: 38876004 PMCID: PMC11253580 DOI: 10.1016/j.comppsych.2024.152504] [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: 12/11/2023] [Revised: 04/30/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND The link between trauma exposure and psychotic disorders is well-established. Further, specific types of trauma may be associated with specific psychotic symptoms. Network analysis is an approach that can advance our understanding of the associations across trauma types and psychotic symptoms. METHODS We conducted a network analysis with data from 16,628 adult participants (mean age [standard deviation] = 36.3 years [11.5]; 55.8% males) with psychotic disorders in East Africa recruited between 2018 and 2023. We used the Life Events Checklist and the Mini International Neuropsychiatric Interview to determine whether specific trauma types experienced over the life course and specific psychotic symptoms were connected. We used an Ising model to estimate the network connections and bridge centrality statistics to identify nodes that may influence trauma types and psychotic symptoms. RESULTS The trauma type "exposure to a war zone" had the highest bridge strength, betweenness, and closeness. The psychotic symptom "odd or unusual beliefs" had the second highest bridge strength. Exposure to a war zone was directly connected to visual hallucinations, odd or unusual beliefs, passivity phenomena, and disorganized speech. Odd or unusual beliefs were directly connected to transportation accidents, physical assault, war, and witnessing sudden accidental death. CONCLUSION Specific trauma types and psychotic symptoms may interact bidirectionally. Screening for psychotic symptoms in patients with war-related trauma and evaluating lifetime trauma in patients with odd or unusual beliefs in clinical care may be considered points of intervention to limit stimulating additional psychotic symptoms and trauma exposure. This work reaffirms the importance of trauma-informed care for patients with psychotic disorders.
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Affiliation(s)
- Anne Stevenson
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA; Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Supriya Misra
- Department of Public Health, San Francisco State University, San Francisco, CA, USA
| | - Engida Girma
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Dickens Akena
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Melkam Alemayehu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Lukoye Atwoli
- Department of Mental Health and Behavioural Sciences, School of Medicine, Moi University College of Health Sciences, Eldoret, Kenya; Brain and Mind Institute, The Aga Khan University, Nairobi, Kenya; Department of Medicine, Medical College East Africa, The Aga Khan University, Nairobi, Kenya
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA; Department of Psychiatry, Harvard Medical School and the Chester M. Pierce MD, Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Stella Gichuru
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Symon M Kariuki
- Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Research Programme-Coast, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Edith Kamaru Kwobah
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Joseph Kyebuzibwa
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rehema M Mwema
- Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Research Programme-Coast, Kilifi, Kenya
| | - Carter P Newman
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Charles R J C Newton
- Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Research Programme-Coast, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Linnet Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Rocky E Stroud
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA; Psychiatric & Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Soraya Seedat
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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3
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Hall LM, Moussa-Tooks AB, Sheffield JM. Associations between social engagement, internalizing symptoms, and delusional ideation in the general population. Soc Psychiatry Psychiatr Epidemiol 2024; 59:989-1002. [PMID: 37624462 DOI: 10.1007/s00127-023-02540-x] [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: 11/16/2022] [Accepted: 07/30/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Delusions are a hallmark feature of psychotic disorders and lead to significant clinical and functional impairment. Internalizing symptoms-such as symptoms of depression, anxiety, and trauma exposure-are commonly cited to be related to delusions and delusional ideation and are often associated with deficits in social functioning. While emerging studies are investigating the impact of low social engagement on psychotic-like experiences, little work has examined the relationship between social engagement, internalizing symptoms, and delusional ideation, specifically. METHODS Using general population data from the Nathan Kline Institute-Rockland (NKI-Rockland) database (N = 526), we examined the relationships between self-reported delusional ideation, internalizing symptoms, and social engagement and tested four indirect effect models to understand how these factors interrelate. RESULTS Delusional ideation was significantly associated with both increased internalizing symptoms (r = 0.41, p < 0.001) and lower social engagement (r = - 0.14, p = 0.001). Within aspects of social engagement, perceived emotional support showed the strongest relationship with delusional ideation (r = - 0.17, p < 0.001). Lower social engagement was also significantly associated with increased internalizing symptoms (r = - 0.29, p < 0.001). Cross-sectional models suggest that internalizing symptoms have a significant indirect effect on the association between delusional ideation and social engagement. CONCLUSIONS These findings reveal that elevated delusional ideation in the general population is associated with lower social engagement. Elevated internalizing symptoms appear to play a critical role in reducing engagement, possibly exacerbating delusional thinking. Future work should examine the causal and temporal relationships between these factors.
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Affiliation(s)
- Lauren M Hall
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA.
| | - Alexandra B Moussa-Tooks
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA
| | - Julia M Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA
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Quidé Y, Watkeys OJ, Tonini E, Grotegerd D, Dannlowski U, Nenadić I, Kircher T, Krug A, Hahn T, Meinert S, Goltermann J, Gruber M, Stein F, Brosch K, Wroblewski A, Thomas-Odenthal F, Usemann P, Straube B, Alexander N, Leehr EJ, Bauer J, Winter NR, Fisch L, Dohm K, Rössler W, Smigielski L, DeRosse P, Moyett A, Houenou J, Leboyer M, Gilleen J, Thomopoulos SI, Thompson PM, Aleman A, Modinos G, Green MJ. Childhood trauma moderates schizotypy-related brain morphology: analyses of 1182 healthy individuals from the ENIGMA schizotypy working group. Psychol Med 2024; 54:1215-1227. [PMID: 37859592 DOI: 10.1017/s0033291723003045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
BACKGROUND Schizotypy represents an index of psychosis-proneness in the general population, often associated with childhood trauma exposure. Both schizotypy and childhood trauma are linked to structural brain alterations, and it is possible that trauma exposure moderates the extent of brain morphological differences associated with schizotypy. METHODS We addressed this question using data from a total of 1182 healthy adults (age range: 18-65 years old, 647 females/535 males), pooled from nine sites worldwide, contributing to the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Schizotypy working group. All participants completed both the Schizotypal Personality Questionnaire Brief version (SPQ-B), and the Childhood Trauma Questionnaire (CTQ), and underwent a 3D T1-weighted brain MRI scan from which regional indices of subcortical gray matter volume and cortical thickness were determined. RESULTS A series of multiple linear regressions revealed that differences in cortical thickness in four regions-of-interest were significantly associated with interactions between schizotypy and trauma; subsequent moderation analyses indicated that increasing levels of schizotypy were associated with thicker left caudal anterior cingulate gyrus, right middle temporal gyrus and insula, and thinner left caudal middle frontal gyrus, in people exposed to higher (but not low or average) levels of childhood trauma. This was found in the context of morphological changes directly associated with increasing levels of schizotypy or increasing levels of childhood trauma exposure. CONCLUSIONS These results suggest that alterations in brain regions critical for higher cognitive and integrative processes that are associated with schizotypy may be enhanced in individuals exposed to high levels of trauma.
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Affiliation(s)
- Yann Quidé
- NeuroRecovery Research Hub, School of Psychology, UNSW Sydney, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Oliver J Watkeys
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
| | - Emiliana Tonini
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Axel Krug
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Institute for Translational Neuroscience, University of Münster, Münster, Germany
| | - Janik Goltermann
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Marius Gruber
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department for Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Florian Thomas-Odenthal
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Paula Usemann
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Nina Alexander
- Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany
| | - Elisabeth J Leehr
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Jochen Bauer
- Clinic for Radiology, University Hospital Münster, Münster, Germany
| | - Nils R Winter
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Lukas Fisch
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Katharina Dohm
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Lukasz Smigielski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Pamela DeRosse
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Ashley Moyett
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
| | - Josselin Houenou
- Université Paris Est Créteil, Mondor University Hospitals, DMU IMPACT, APHP, INSERM U955 Team "Translational NeuroPsychiatry", Créteil, France
- Fondation FondaMental, Créteil, France
- NeuroSpin neuroimaging platform, UNIACT Lab, PsyBrain team, CEA Saclay, Gif-Sur-Yvette, France
| | - Marion Leboyer
- Université Paris Est Créteil, Mondor University Hospitals, DMU IMPACT, APHP, INSERM U955 Team "Translational NeuroPsychiatry", Créteil, France
- Fondation FondaMental, Créteil, France
| | - James Gilleen
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- School of Psychology, University of Roehampton, London, UK
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - André Aleman
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Melissa J Green
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, UNSW Sydney, Sydney, NSW, Australia
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Oh HY, Jacob L, Smith L, Leaune E, Zhou S, Shin JI, Koyanagi A. Sexual Minority Status and Psychotic Experiences Among Young Adult College Students in the United States. JOURNAL OF HOMOSEXUALITY 2024; 71:916-933. [PMID: 36318731 DOI: 10.1080/00918369.2022.2132582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
2020-2021 Healthy Minds Study, and used multivariable logistic regression to examine the associations between sexual minority status and psychotic experiences, adjusting for age, gender, and race/ethnicity. We then tested whether psychosocial factors accounted for the association. Sexual minority status was associated with 1.87 times greater odds of having psychotic experiences over the past 12 months (aOR: 1.87; 95% CI: 1.77-1.99; N = 110,551). Several factors mediated the association between sexual orientation and psychotic experiences such as loneliness (26.93%), anxiety (30.90%), depression (33.18%), and marijuana use (13.95%); all factors together accounted for 59.01% of the association between sexual minority status and psychotic experiences. Food insecurity, recent abuse, and discrimination did not significantly mediate the association. Findings should raise clinical awareness that psychotic experiences are more common among sexual minorities than among heterosexuals, which is largely explained by mental health factors, calling for targeted outreach and intervention.
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Affiliation(s)
- Hans Y Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM ISCIII), Barcelona, Spain
- Center for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Lee Smith
- Center for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Edouard Leaune
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Sasha Zhou
- Department of Public Health, Wayne State University, Detroit, Michigan, USA
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica En Red de Salud Mental (CIBERSAM ISCIII), Barcelona, Spain
- Institución Catalana de Investigación y Estudios Avanzados (ICREA), Barcelona, Spain
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Kovess-Masfety V, Sabawoon A, Keyes K, Karam E. Prevalence, risk factors, and comorbidities of psychotic experiences in Afghanistan: a highly stressful environment. Soc Psychiatry Psychiatr Epidemiol 2024; 59:99-109. [PMID: 37558897 DOI: 10.1007/s00127-023-02539-4] [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: 11/04/2022] [Accepted: 07/30/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVES To estimate the prevalence and demographic, psychiatric, and trauma-focused correlates of psychotic experiences (PEs) in the Afghan general population. METHODS Data were drawn from a cross-sectional household survey implemented in eight regions of Afghanistan (N = 4445). The CIDI structured instrument was administered to adults to assess psychiatric disorders and psychotic experiences; life events and PTSD were assessed using validated instruments. Weighted multivariate models integrated socio-demographics, regions, traumas as determinants of PE. RESULTS PEs were frequently reported in the Afghan population: 27.50% of the population reported a lifetime PE. PEs were more common among specific ethnic groups, and were associated with lower income in adjusted regression models. PEs were associated with mental health problems including major depressive disorders (OR = 3.43), PTSD (OR = 5.08), generalized anxiety (OR = 4.2); lifetime suicidal attempts (OR 6.04), lifetime suicidal thoughts (OR = 3.42), addiction (OR = 2.18); and psychological distress and impairment due to mental health (OR = 2.95 and 2.46, respectively). CONCLUSION Psychotic experiences in the Afghan general population confirm general population findings in other countries, that psychotic experiences are common and associated with economic and social marginalization, and part of a continuum of mental health problems experienced in populations. Efforts to reduce and treat psychotic experiences within a broad array of psychiatric conditions are needed.
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Affiliation(s)
- V Kovess-Masfety
- LPPS, University of Paris Cité, Paris, France.
- Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - A Sabawoon
- Mailman School of Public Health, Columbia University, New York, NY, USA
- Governance Institute of Afghanistan (GI-A), Kabul, Afghanistan
| | - K Keyes
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - E Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
- Faculty of Medicine, Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center University of Balamand, Beirut, Lebanon
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Ng LC, Hook K, Hailemariam M, Selamu M, Fekadu A, Hanlon C. Experience of traumatic events in people with severe mental illness in a low-income country: a qualitative study. Int J Ment Health Syst 2023; 17:45. [PMID: 38053187 PMCID: PMC10699012 DOI: 10.1186/s13033-023-00616-4] [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] [Received: 07/14/2022] [Accepted: 11/22/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND This study describes the trauma experiences of people with severe mental illness (SMI) in Ethiopia and presents a model of how SMI and trauma exposure interact to reduce functioning and quality of life in this setting. METHODS A total of 53 participants living and working in a rural district in southern Ethiopia were interviewed: 18 people living with SMI, 21 caregivers, and 14 primary health care providers. RESULTS Many participants reported that exposure to traumatic and stressful events led to SMI, exacerbated SMI symptoms, and increased caregiver stress and distress. In addition, SMI symptoms and caregiver desperation, stress or stigma were also reported to increase the possibility of trauma exposure. CONCLUSIONS Results suggest it is incumbent upon health professionals and the broader health community to view trauma exposure (broadly defined) as a public health problem that affects all, particularly individuals with SMI.
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Affiliation(s)
- Lauren C Ng
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA.
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA.
- Department of Psychiatry, Boston University, School of Medicine, Boston, MA, USA.
| | - Kimberly Hook
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychiatry, Boston University, School of Medicine, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maji Hailemariam
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
- Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Medhin Selamu
- Center for Innovative Drug Development, Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, School of Medicine, College of Health Sciences, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- Center for Innovative Drug Development, Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, School of Medicine, College of Health Sciences, Addis Ababa, Ethiopia
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Center for Innovative Drug Development, Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, School of Medicine, College of Health Sciences, Addis Ababa, Ethiopia
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Health Service and Population Research Department, Centre for Global Mental Health, King's College London, WHO Collaborating Centre for Mental Health Research and Training, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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8
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van Sambeek N, Franssen G, van Geelen S, Scheepers F. Making meaning of trauma in psychosis. Front Psychiatry 2023; 14:1272683. [PMID: 38025479 PMCID: PMC10656619 DOI: 10.3389/fpsyt.2023.1272683] [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] [Received: 08/04/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background Finding new meaning and identity in the aftermath of trauma has been identified as a key process of mental health recovery. However, research indicates that this meaning-making process is compromised in people with psychosis. Considering the high prevalence, yet under-treatment of trauma in people with psychosis, it is urgent to gain insight into how their meaning-making process can be supported. Aim To gain insight into how people with psychosis make meaning of trauma and identify barriers and facilitators in their meaning-making process. Methods Qualitative inquiry of N = 21 interviews transcripts from the Dutch Psychiatry Storybank. We included interviews of people who (a) lived through multiple psychotic episodes, and (b) spontaneously addressed traumatic experiences in a low-structured interview. Storyline analysis was performed to gain insight into the meaning-making of trauma within their self-stories. Psychosocial conceptualizations of narrative identity were used to inform the analysis. A data-validation session with four experts-by-experience was organized to check and improve the quality of our analysis. Results We identified four different story types: (1) Psychiatry as the wrong setting to find meaning; (2) The ongoing struggle to get trauma-therapy; (3) Exposure to trauma as a threat to a stable life, and (4) Disclosure as the key to resolving alienation. Each story type comprises a different plot, meaning of trauma withing the self-story, (lack of) integration and barriers and facilitators in the meaning-making process. Overall, barriers in the meaning-making process were mostly situated within mental healthcare and stigma-related. People felt particularly hindered by pessimistic ideas on their capacity to develop self-insight and cope with distress, resulting in limited treatment options. Their process of adaptive meaning-making often started with supportive, non-judgmental relationships with individuals or communities that offered them the safety to disclose trauma and motivated them to engage in a process of self-inquiry and growth. Conclusion The outcomes illuminate the social context of the meaning-making challenges that people with psychosis face and illustrate the devastating influence of stigma. Our outcomes offer guidance to remove barriers to adaptive meaning-making in people with psychosis, and can help clinicians to attune to differences in the meaning-making of trauma.
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Affiliation(s)
- Nienke van Sambeek
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Gaston Franssen
- Faculty of Humanities, University of Amsterdam, Amsterdam, Netherlands
| | | | - Floortje Scheepers
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
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9
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Smyth E, Steel C, Ellett L. The prevalence of non-affective psychosis in refugee populations: A systematic review. Schizophr Res 2023; 260:99-112. [PMID: 37634388 DOI: 10.1016/j.schres.2023.08.011] [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: 07/13/2021] [Revised: 06/27/2023] [Accepted: 08/13/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND As we face the largest refugee crisis since World War Two, research is increasingly examining the impact of forced displacement. The risk of non-affective psychosis in refugees is evidenced to be significantly greater than non-refugees, and the role of pre-, peri- and post-migratory trauma and dissociation is increasingly implicated. AIMS To determine the prevalence of non-affective psychosis in refugee populations. METHOD PRISMA guidelines were followed. Three key databases (PubMed, PsychINFO and Web of Science), Google scholar and study references were searched. The full-text of 62 studies were screened and 23 studies were eligible for inclusion. A narrative synthesis was undertaken and the Quality Assessment Tool for Quantitative Studies was used to assess methodological quality. (PROSPERO registration CRD42019152170). RESULTS The results were widely heterogeneous. The combined weighted average prevalence of non-affective psychosis in refugee populations was 0.9 %. Psychosis prevalence for individual psychotic symptoms was 28.4 %; 0.5 % for schizophrenia; 1.0 % for psychosis; 0.6 % for mixed psychotic disorders and 2.9 % for psychotic episodes. CONCLUSIONS Variations in examined populations, diagnostic and prevalence classifications, and study designs and methodologies likely contributed to heterogeneity across the data. The findings highlight a greater need to provide more specialist mental health services and trauma-focused interventions, as well as transculturally sensitive assessment and treatment to address refugee vulnerability to psychosis. Future research should examine psychosis prevalence longitudinally and in refugees-only, address methodological bias and further examine the role of trauma and dissociation in refugee psychosis prevalence.
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Affiliation(s)
- Emily Smyth
- Psychology Department, Royal Holloway, University of London, Egham Hill, Egham TW20 0EX, UK.
| | - Craig Steel
- The Oxford Institute of Clinical Psychology Training and Research, The Oxford Centre for Psychological Health, University of Oxford, Isis Education Centre, Warneford Hospital, Oxford OX3 7JX, UK.
| | - Lyn Ellett
- School of Psychology, University of Southampton, UK.
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10
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Rossi R, Jannini TB, Ciocca G, Cipriani C, Socci V, Pacitti F, Di Lorenzo G. Attachment and resilience as mediators or moderators in the relationship between trauma and psychotic-like experiences. Schizophr Res 2023; 258:36-44. [PMID: 37473666 DOI: 10.1016/j.schres.2023.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/14/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND A large body of evidence has established a tight relation between traumatic experiences (TEs) and psychotic-like experiences (PLEs). Nevertheless, more comprehensive models involving multiple interactions of serial or parallel mediations and moderations still need to be elucidated. Among the many potential mediators or moderators, insecure attachment and resilience play a key role in the association of stress with PLEs. Hence, we aim to explore the complex pathways that lead from different types of TEs to PLEs, involving attachment and resilience modeled as mediators or moderators. METHODS One thousand ten high school students completed the International Trauma Exposure Measure (ITEM), the 11-item Resilience Scale for Adults (RSA-11), the 16-item Prodromal Questionnaire (iPQ-16), and the Relationship Questionnaire (RQ). A path analysis was conducted to assess mediation and moderation. RESULTS The final model showed that the impact of childhood TEs on PLEs was mediated by a pathway through anxious-insecure attachment styles (i.e., fearful and preoccupied, respectively, 8.75 % and 8.53 % of the total effect) and personal resilience resources. Conversely, the avoidant-insecure attachment was associated with lower interpersonal resilience (b = 0.14 [0.08, 0.20]), which in turn moderated the impact of recent TEs on PLEs (interaction term b = 0.34 [0.21, 0.47]). CONCLUSIONS Our model examines a complex model that includes factors buffering the effect of traumatic experiences on PLEs. Our results highlight the importance of insecure-anxious attachment to personal resilience resources and of insecure-avoidant attachment to interpersonal resilience as potential targets for clinical practice.
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Affiliation(s)
- Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Tommaso B Jannini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Giacomo Ciocca
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Chiara Cipriani
- Department of Neuroscience and Mental Health, Sapienza University, Rome, Italy
| | - Valentina Socci
- Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, L'Aquila, Italy
| | - Francesca Pacitti
- Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, L'Aquila, Italy
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; IRCSS Fondazione Santa Lucia, Rome, Italy
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11
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Hillow MA, Atwoli L, Kwobah EK. "Association between Traumatic Life Events and Psychosis: A case-control study in western Kenya". Heliyon 2023; 9:e18144. [PMID: 37483688 PMCID: PMC10362348 DOI: 10.1016/j.heliyon.2023.e18144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/16/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023] Open
Abstract
Globally close to 70% of the general population has experienced at least one traumatic life event (TLE). Although child and adulthood exposure to TLEs is considered a risk factor for the subsequent development of psychosis, few studies have examined the association between trauma and psychosis in the African population. We sought to explore the association between TLEs and psychosis in patients with psychotic disorders (N = 254) and individuals without (N = 254). The participants were matched by age and sex. The study was conducted at a national referral hospital, the Life Events Checklist for DSM-5 (LEC-5) was used to obtain data on TLEs, and ethical approval was obtained from the ethics committee. The proportion of those who experienced TLEs was equal among the cases and controls at about 80%. However, more cases reported that the TLEs happened to them (cases 60.3, p = 0.004). After multivariate analysis, the following specific TLEs remained statistically significant.: Physical assault (aOR = 3.66, 95% CI 2.28-5.48), assaults with a weapon (aOR = 5.26, 95% CI 2.15-10.48), sexual assault (aOR = 4.55, 95% CI 1.08-10.48). The sudden death of a loved one (aOR = 2.33, 95% CI 1.15-4.70) and serious injury/harm to others (aOR = 10.53, 95% CI 1.47-89.37).
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Affiliation(s)
| | - Lukoye Atwoli
- Department of Internal Medicine, Medical College East Africa, Brain and Mind Institute Aga Khan University, Aga Khan University, Karachi, Pakistan
| | - Edith Kamaru Kwobah
- Mental Health Department, MOI TEACHING AND REFERRAL HOSPITAL, Eldoret, Kenya
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12
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Monshouwer K, Ten Have M, Tuithof M, van Dorsselaer S, Bak M, Gunter N, Delespaul P, van Os J, de Graaf R. Prevalence, incidence, and persistence of psychotic experiences in the general population: results of a 9-year follow-up study. Psychol Med 2023; 53:3750-3761. [PMID: 36117284 DOI: 10.1017/s0033291722002690] [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] [Indexed: 11/05/2022]
Abstract
BACKGROUND Psychotic experiences (PEs) frequently occur and are associated with a range of negative health outcomes. Prospective studies on PEs are scarce, and to date no study investigated PE prevalence, incidence, persistence, their risk indicators, and psychiatric comorbidity, in one dataset. Furthermore, most studies are based on self-report, and it is unclear how this compares to clinical interviews. METHODS Data are used from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a psychiatric cohort study among a representative sample of adults (baseline characteristics: N = 6646; 49.6% female; 18-64 years). Results are presented for self-reported and clinically validated PEs. Associations are assessed for mental disorders, socio-demographic, vulnerability, physical health, and substance use factors. RESULTS Based on self-report, at baseline 16.5% of respondents had at least one PE in their lifetime, of those, 30.1% also reported a PE at 3-year follow-up. 4.8% had a first PE at 3-year follow up. The 3-year prevalence of PE was associated with almost all studied risk indicators. Generally, the strongest associations were found for mental health disorders. Prevalence and incidence rates were two to three times higher in self-report than in clinical interview but results on associated factors were similar. CONCLUSIONS Validated prevalence and incidence estimates of PE are substantially lower than self-reported figures but results on associated factors were similar. Therefore, future studies on associations of PEs can rely on relatively inexpensive self-reports of PEs. The associations between PE and mental disorders underline the importance of assessment of PE in general practice.
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Affiliation(s)
- Karin Monshouwer
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Margreet Ten Have
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marlous Tuithof
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Saskia van Dorsselaer
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
- FACT, Mondriaan, Heerlen/Maastricht, The Netherlands
| | - Nicole Gunter
- School of Psychology, Open University, Heerlen, The Netherlands
| | - Philippe Delespaul
- School for Mental Health & Neurosciences, Maastricht University, Maastricht, The Netherlands
- Mondriaan, Heerlen, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
- Department Psychiatry, UMC Utrecht Brain Center, Utrecht, The Netherlands
- King's Health Partners Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Ron de Graaf
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
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13
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Airey ND, Taylor CDJ, Vikram A, Berry K. Trauma measures for use with psychosis populations: A systematic review of psychometric properties using COSMIN. Psychiatry Res 2023; 323:115163. [PMID: 36948019 DOI: 10.1016/j.psychres.2023.115163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/04/2023] [Accepted: 03/07/2023] [Indexed: 03/24/2023]
Abstract
Traumatic events play a key role in the development and course of psychosis. Psychotic symptoms themselves and coercive treatment practices can be inherently traumatic. Hence, reliable and valid methods of assessing trauma and its impact (i.e., Post-Traumatic Stress Disorder (PTSD) symptomology) are essential for use with people with psychosis. Many measures are available to select from, but this is the first review to appraise the psychometric properties of trauma measures to guide decision making regarding instrument use. The review was prospectively registered on Prospero (CRD42022306100). Evaluation of methodological and psychometric quality followed Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidance. Twenty-four articles were eligible, with sixteen trauma measures evaluated. Childhood Trauma Questionnaire- Short Form demonstrated the most robust evidence for assessing experience of trauma. The Trauma and Life Experience (TALE) checklist was the only measure to include specific psychosis and iatrogenic harm items. For PTSD measures, the Symptoms of Trauma Scale and PTSD Symptom Scale- Self Report had the highest quality evidence. Psychometric strengths and weaknesses of various trauma measures are comprehensively evaluated, highlighting future research directions to strengthen the evidence base with emphasis on further evaluation of the TALE, which integrates trauma specific to psychosis.
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Affiliation(s)
- Nicola D Airey
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, 2(nd) Floor Zochonis Building, Brunswick Street, Manchester M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Bury New Road, Prestwich, Manchester M25 3BL, UK.
| | - Christopher D J Taylor
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, 2(nd) Floor Zochonis Building, Brunswick Street, Manchester M13 9PL, UK; Community Mental Health Team, Pennine Care NHS Foundation Trust, Humphrey House, Angouleme Way, Bury BL9 0EQ, UK
| | - Anvita Vikram
- Community Mental Health Team, Pennine Care NHS Foundation Trust, Humphrey House, Angouleme Way, Bury BL9 0EQ, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, 2(nd) Floor Zochonis Building, Brunswick Street, Manchester M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Bury New Road, Prestwich, Manchester M25 3BL, UK
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14
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Astill Wright L, McElroy E, Barawi K, Roberts NP, Simon N, Zammit S, Bisson JI. Associations among psychosis, mood, anxiety, and posttraumatic stress symptoms: A network analysis. J Trauma Stress 2023; 36:385-396. [PMID: 36862599 DOI: 10.1002/jts.22916] [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] [Received: 09/05/2022] [Revised: 11/30/2022] [Accepted: 12/21/2022] [Indexed: 03/03/2023]
Abstract
The associations among psychotic experiences (i.e., hallucinations and delusions), trauma exposure, and posttraumatic stress symptoms are complex and multidirectional. Using network analysis to understand how psychotic experiences and symptoms of posttraumatic stress disorder (PTSD) relate to one another may identify new interventional targets to treat comorbidity and its underlying pathological processes. This study aimed to use network analysis to examine the associations among psychotic experiences; negative symptoms of psychosis; and symptoms of PTSD, anxiety, and depression. In this population-based cohort study, 4,472 participants (36.7% male) were assessed for psychotic experiences, negative symptoms of psychosis, PTSD, anxiety, and depression at age 23 (M = 23.86 years, SD = 0.520) or 24 years (M = 24.03, SD = 0.848). Associations among symptoms were assessed via network analysis. Exploratory graph analysis identified three clusters of densely connected symptoms within the overall network: psychotic experiences; PTSD symptoms; and depressive and anxiety symptoms and negative symptoms of psychosis. Psychotic experiences had the strongest associations with other symptoms in the network, and symptoms of anxiety played a key role in bridging psychotic experiences, symptoms of PTSD, and depressive symptoms. Consistent with the stress reactivity and affective models for psychotic experiences, the results suggest that symptoms of anxiety and emotional distress (e.g., hyperarousal, panic) may have a key role in the development and maintenance of psychotic experiences and symptoms of PTSD. Targeting these symptoms may ameliorate symptom burden transdiagnostically.
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Affiliation(s)
- Laurence Astill Wright
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Eoin McElroy
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, United Kingdom
| | - Kali Barawi
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Neil P Roberts
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
- Directorate of Psychology and Psychological Therapies, Cardiff & Vale University Health Board, Cardiff, United Kingdom
| | - Natalie Simon
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Stanley Zammit
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom
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15
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Moffa G, Kuipers J, Carrà G, Crocamo C, Kuipers E, Angermeyer M, Brugha T, Toumi M, Bebbington P. Longitudinal symptomatic interactions in long-standing schizophrenia: a novel five-point analysis based on directed acyclic graphs. Psychol Med 2023; 53:1371-1378. [PMID: 34348816 PMCID: PMC10009394 DOI: 10.1017/s0033291721002920] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 04/29/2021] [Accepted: 07/01/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Recent network models propose that mutual interaction between symptoms has an important bearing on the onset of schizophrenic disorder. In particular, cross-sectional studies suggest that affective symptoms may influence the emergence of psychotic symptoms. However, longitudinal analysis offers a more compelling test for causation: the European Schizophrenia Cohort (EuroSC) provides data suitable for this purpose. We predicted that the persistence of psychotic symptoms would be driven by the continuing presence of affective disturbance. METHODS EuroSC included 1208 patients randomly sampled from outpatient services in France, Germany and the UK. Initial measures of psychotic and affective symptoms were repeated four times at 6-month intervals, thereby furnishing five time-points. To examine interactions between symptoms both within and between time-slices, we adopted a novel technique for modelling longitudinal data in psychiatry. This was a form of Bayesian network analysis that involved learning dynamic directed acyclic graphs (DAGs). RESULTS Our DAG analysis suggests that the main drivers of symptoms in this long-term sample were delusions and paranoid thinking. These led to affective disturbance, not vice versa as we initially predicted. The enduring relationship between symptoms was unaffected by whether patients were receiving first- or second-generation antipsychotic medication. CONCLUSIONS In this cohort of people with chronic schizophrenia treated with medication, symptoms were essentially stable over long periods. However, affective symptoms appeared driven by the persistence of delusions and persecutory thinking, a finding not previously reported. Although our findings as ever remain hostage to unmeasured confounders, these enduring psychotic symptoms might nevertheless be appropriate candidates for directly targeted psychological interventions.
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Affiliation(s)
- Giusi Moffa
- Department of Mathematics and Computer Science, University of Basel, Basel, Switzerland
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, UK
| | | | - Giuseppe Carrà
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, UK
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, Monza 20900, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, Monza 20900, Italy
| | - Elizabeth Kuipers
- Department of Psychology, IoPPN, King's College London, London SE5 8AF, UK
| | - Matthias Angermeyer
- Department of Psychiatry, University of Leipzig, Johannisallee 20, 04137 Leipzig, Germany
| | - Traolach Brugha
- Department of Health Sciences, College of Life Sciences, University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, UK
| | - Mondher Toumi
- Laboratoire de Santé Publique, Université de la Méditerranée, Marseille, France
| | - Paul Bebbington
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, UK
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16
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Allardyce J, Hollander AC, Rahman S, Dalman C, Zammit S. Association of trauma, post-traumatic stress disorder and non-affective psychosis across the life course: a nationwide prospective cohort study. Psychol Med 2023; 53:1620-1628. [PMID: 34412716 PMCID: PMC10009379 DOI: 10.1017/s0033291721003287] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 03/30/2021] [Accepted: 07/21/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND We aimed to examine the temporal relationships between traumatic events (TE), post-traumatic stress disorder (PTSD) and non-affective psychotic disorders (NAPD). METHODS A prospective cohort study of 1 965 214 individuals born in Sweden between 1971 and 1990 examining the independent effects of interpersonal and non-interpersonal TE on incidence of PTSD and NAPD using data from linked register data (Psychiatry-Sweden). Mediation analyses tested the hypothesis that PTSD lies on a causal pathway between interpersonal trauma and NAPD. RESULTS Increasing doses of interpersonal and non-interpersonal TE were independently associated with increased risk of NAPD [linear-trend incidence rate ratios (IRR)adjusted = 2.17 [95% confidence interval (CI) 2.02-2.33] and IRRadjusted = 1.27 (95% CI 1.23-1.31), respectively]. These attenuated to a relatively small degree in 5-year time-lagged models. A similar pattern of results was observed for PTSD [linear-trend IRRadjusted = 3.43 (95% CI 3.21-3.66) and IRRadjusted = 1.45 (95% CI 1.39-1.50)]. PTSD was associated with increased risk of NAPD [IRRadjusted = 8.06 (95% CI 7.23-8.99)], which was substantially attenuated in 5-year time-lagged analyses [IRRadjusted = 4.62 (95% CI 3.65-5.87)]. There was little evidence that PTSD diagnosis mediated the relationship between interpersonal TE and NAPD [IRRadjusted = 0.92 (percentile CI 0.80-1.07)]. CONCLUSION Despite the limitations to causal inference inherent in observational designs, the large effect-sizes observed between trauma, PTSD and NAPD in this study, consistent across sensitivity analyses, suggest that trauma may be a component cause of psychotic disorders. However, PTSD diagnosis might not be a good proxy for the likely complex psychological mechanisms mediating this association.
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Affiliation(s)
- Judith Allardyce
- Division of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales
- Centre for Clinical Brain Sciences (Division of Psychiatry), University of Edinburgh, Edinburgh, Scotland
| | | | - Syed Rahman
- Dept of Global Public Health, Karolinksa Institutet, Solna, Sweden
| | - Christina Dalman
- Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Psykisk Hälsa, Centrum för epidemiologi och samhällsmedicin, Stockholm, Sweden
| | - Stan Zammit
- Division of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales
- Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, England
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17
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Zhu W, Li Y, Ma X, Yang H, Wang Z, Shi R, Shi W, Cong B. Bibliometric analysis of post-traumatic stress disorder in forensic medicine: Research trends, hot spots, and prospects. Front Psychol 2023; 13:1074999. [PMID: 36726521 PMCID: PMC9884826 DOI: 10.3389/fpsyg.2022.1074999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/22/2022] [Indexed: 01/17/2023] Open
Abstract
Background Post-traumatic stress disorder (PTSD) has various risk factors, complex pathogenesis, and diverse symptoms, and is often comorbid with other injuries and diseases, making forensic diagnosis difficult. Methods To explore the current research status and trends of PTSD, we used the Web of Science Core Collection databases to screen PTSD-related literature published between 2010 and 2021 and CiteSpace to perform bibliometric analysis. Results In recent years, PTSD-related research has grown steadily. The countries and institutions with the most research results were the United States and England, and King's College London and Boston University, respectively. Publications were identified from 2,821 different journals, including 13 forensic-related journals, but the journal distribution was relatively scattered and there was a lack of professional core journals. Keyword co-occurrence and clustering identified many hot topics; "rat model," "mental health," and "satisfaction" were the topics most likely to have a clear effect on future research. Analysis extracted nine turning points from the literature that suggested that neural network centers, the hypothalamic-pituitary-adrenal axis, and biomarkers were new research directions. It was found that COVID-19 can cause severe psychological stress and induce PTSD, but the relationship needs further study. The literature on stress response areas and biomarkers has gradually increased over time, but specific systemic neural brain circuits and biomarkers remain to be determined. Conclusion There is a need to expand the collection of different types of biological tissue samples from patients with different backgrounds, screen PTSD biomarkers and molecular targets using multi-omics and molecular biology techniques, and establish PTSD-related molecular networks. This may promote a systematic understanding of the abnormal activation of neural circuits in patients with PTSD and help to establish a personalized, accurate, and objective forensic diagnostic standard.
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18
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Domínguez-Martínez T, Sheinbaum T, Fresán A, Nieto L, López SR, Robles R, Lara MDC, de la Fuente-Sandoval C, Barrantes-Vidal N, Saracco R, Franco-Paredes K, Díaz-Reséndiz F, Rosel M. Psychosocial factors associated with the risk of developing psychosis in a Mexican general population sample. Front Psychiatry 2023; 14:1095222. [PMID: 36873227 PMCID: PMC9979221 DOI: 10.3389/fpsyt.2023.1095222] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Epidemiological evidence has linked an array of sociodemographic and psychosocial factors with an increased risk of developing psychosis. However, research in samples from low- and middle-income countries is still scarce. This study used a Mexican sample to explore (i) sociodemographic and psychosocial differences between individuals with and without a positive screen for Clinical High-Risk for psychosis (CHR), and (ii) sociodemographic and psychosocial factors associated with screening positive for CHR. The sample consisted of 822 individuals from the general population who completed an online survey. Of the participants, 17.3% (n = 142) met the CHR screening criteria. Comparisons between those who screened positive (CHR-positive group) and those who did not (Non-CHR group) showed that participants in the CHR-positive group were younger, had a lower educational level, and reported more mental health problems than the Non-CHR group. Furthermore, relative to the Non-CHR group, the CHR-positive group had a greater prevalence of medium/high risk associated with cannabis use, a higher prevalence of adverse experiences (bullying, intimate partner violence, and experiencing a violent or unexpected death of a relative or friend), as well as higher levels of childhood maltreatment, poorer family functioning, and more distress associated with the COVID-19 pandemic. Groups did not differ in sex, marital/relationship status, occupation, and socio-economic status. Finally, when examined in multivariate analyses, the variables associated with screening positive for CHR were: having an unhealthy family functioning (OR = 2.75, 95%CI 1.69-4.46), a higher risk associated with cannabis use (OR = 2.75, 95%CI 1.63-4.64), a lower level of education (OR = 1.55, 95%CI 1.003-2.54), having experienced a major natural disaster (OR = 1.94, 95%CI 1.18-3.16), having experienced a violent or unexpected death of a relative or friend (OR = 1.85, 95%CI 1.22-2.81), higher levels of childhood emotional abuse (OR = 1.88, 95%CI 1.09-3.25), physical neglect (OR = 1.68, 95%CI 1.08-2.61), and physical abuse (OR = 1.66, 95%CI 1.05-2.61), and higher COVID-related distress (OR = 1.10, 95%CI 1.01-1.20). An older age was a protective factor for screening positive for CHR (OR = 0.96, 95%CI 0.92-0.99). Overall, the findings highlight the importance of examining potential psychosocial contributors to psychosis vulnerability across different sociocultural contexts to delineate risk and protective processes relevant to specific populations and better target preventive intervention efforts.
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Affiliation(s)
- Tecelli Domínguez-Martínez
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz"-UNAM, Mexico City, Mexico
| | - Tamara Sheinbaum
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Lourdes Nieto
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz"-UNAM, Mexico City, Mexico
| | - Steven R López
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Rebeca Robles
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz"-UNAM, Mexico City, Mexico
| | - Ma Del Carmen Lara
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | | | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.,Sant Pere Claver - Fundació Sanitària, Barcelona, Spain.,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Ricardo Saracco
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | | | | | - Mauricio Rosel
- Clínica de Esquizofrenia, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
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19
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Wastler HM, Núñez D. Psychotic experiences, emotion regulation, and suicidal ideation among Chilean adolescents in the general population. Front Psychiatry 2022; 13:983250. [PMID: 36465305 PMCID: PMC9710630 DOI: 10.3389/fpsyt.2022.983250] [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] [Received: 06/30/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022] Open
Abstract
Psychotic experiences are associated with increased risk for suicide. Despite this well-established finding, very little is known about factors that contribute to this relationship. The current study investigated the relationship between psychotic experiences, emotion regulation, and suicidal ideation among 1,590 Chilean adolescents in the general population. Participants completed self-report measures of psychotic experiences (Community Assessment of Psychic Experiences), emotion regulation (Emotion Regulation Questionnaire), depression (Patient Health Questionnaire-9), and suicidal ideation (Columbia Suicide Severity Rating Scale). Statistical analyses included Mann-Whitney U tests, point-biserial correlations, logistic regression, and moderation analyses. Results suggest that paranoid ideation, bizarre experiences, and perceptual abnormalities were moderately associated with suicidal ideation. Additionally, greater expressive suppression and cognitive reappraisal were associated with suicidal ideation. Results from the logistic regression indicate that paranoid ideation, perceptual abnormalities, and expressive suppression have the strongest relationship with suicidal ideation, even when controlling for depression and relevant demographic variables. Additionally, paranoid ideation interacted with expressive suppression to predict suicidal ideation, with expressive suppression having the strongest relationship with suicidal ideation when paranoid ideation was low to moderate. Taken together, these findings support the broader literature suggesting that emotion regulation might be a transdiagnostic risk factor for suicidal ideation. Additional longitudinal research is needed to examine whether expressive suppression and other maladaptive emotion regulation strategies serve as a mechanism for suicidal ideation both in the general population and among individuals with psychotic experiences.
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Affiliation(s)
- Heather M. Wastler
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, United States
| | - Daniel Núñez
- Faculty of Psychology, Universidad de Talca, Talca, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
- Programa de Investigación Asociativa, Faculty of Psychology, Centro de Investigación en Ciencias Cognitivas, Universidad de Talca, Talca, Chile
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20
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Girma E, Ametaj A, Alemayehu M, Milkias B, Yared M, Misra S, Stevenson A, Koenen KC, Gelaye B, Teferra S. Measuring traumatic experiences in a sample of Ethiopian adults: Psychometric properties of the life events checklist-5. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022; 6. [DOI: 10.1016/j.ejtd.2022.100298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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21
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Degenhardt L, Bharat C, Glantz MD, Bromet EJ, Alonso J, Bruffaerts R, Bunting B, de Girolamo G, de Jonge P, Florescu S, Gureje O, Haro JM, Harris MG, Hinkov H, Karam EG, Karam G, Kovess-Masfety V, Lee S, Makanjuola V, Medina-Mora ME, Navarro-Mateu F, Piazza M, Posada-Villa J, Scott KM, Stein DJ, Tachimori H, Tintle N, Torres Y, Viana MC, Kessler RC, Al-Hamzawi A, Al-Kaisy MS, Alonso J, Altwaijri Y, Helena Andrade L, Atwoli L, Benjet C, Borges G, Bromet EJ, Bruffaerts R, Bunting B, Caldas-de-Almeida JM, Cardoso G, Chatterji S, Cia AH, Degenhardt L, Demyttenaere K, Florescu S, Girolamo GD, Gureje O, Haro JM, Harris MG, Hinkov H, Hu CY, de Jonge P, Karam AN, Karam EG, Kawakami N, Kessler RC, Kiejna A, Kovess-Masfety V, Lee S, Lepine JP, McGrath J, Medina-Mora ME, Mneimneh Z, Moskalewicz J, Navarro-Mateu F, Piazza M, Posada-Villa J, Scott KM, Slade T, Stagnaro JC, Stein DJ, ten Have M, Torres Y, Viana MC, Vigo DV, Whiteford H, Williams DR, Wojtyniak B. The associations between traumatic experiences and subsequent onset of a substance use disorder: Findings from the World Health Organization World Mental Health surveys. Drug Alcohol Depend 2022; 240:109574. [PMID: 36150948 DOI: 10.1016/j.drugalcdep.2022.109574] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 01/06/2023]
Abstract
AIM Exposure to traumatic events (TEs) is associated with substance use disorders (SUDs). However, most studies focus on a single TE, and are limited to single countries, rather than across countries with variation in economic, social and cultural characteristics. We used cross-national data to examine associations of diverse TEs with SUD onset, and variation in associations over time. METHODS Data come from World Mental Health surveys across 22 countries. Adults (n = 65,165) retrospectively reported exposure to 29 TEs in six categories: "exposure to organised violence"; "participation in organised violence"; "interpersonal violence"; "sexual-relationship violence"; "other life-threatening events"; and those involving loved ones ("network traumas"). Discrete-time survival analyses were used to examine associations with subsequent first SUD onset. RESULTS Most (71.0%) reported experiencing at least one TE, with network traumas (38.8%) most common and exposure to organised violence (9.5%) least. One in five (20.3%) had been exposed to sexual-relationship violence and 26.6% to interpersonal violence. Among the TE exposed, lifetime SUD prevalence was 14.5% compared to 5.1% with no trauma exposure. Most TE categories (except organised violence) were associated with increased odds of SUD. Increased odds of SUD were also found following interpersonal violence exposure across all age ranges (ORs from 1.56 to 1.78), and sexual-relationship violence exposure during adulthood (ORs from 1.33 to 1.44), with associations persisting even after >11 years. CONCLUSION Sexual and interpersonal violence have the most consistent associations with progression to SUD; increased risk remains for many years post-exposure. These need to be considered when working with people exposed to such traumas.
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Affiliation(s)
- Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
| | - Chrianna Bharat
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Meyer D Glantz
- Department of Epidemiology, Services, and Prevention Research (DESPR), National Institute on Drug Abuse (NIDA), National Institute of Health (NIH), Bethesda, MD, USA
| | - Evelyn J Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain; Pompeu Fabra University (UPF), Barcelona, Spain
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - Brendan Bunting
- School of Psychology, Ulster University, Londonderry, United Kingdom
| | | | - Peter de Jonge
- Department of Developmental Psychology, University of Groningen, Groningen, the Netherlands; Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, the Netherlands
| | - Silvia Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Meredith G Harris
- School of Public Health, The University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
| | - Hristo Hinkov
- National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Elie G Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Balamand University, Faculty of Medicine, Beirut, Lebanon
| | - Georges Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Balamand University, Faculty of Medicine, Beirut, Lebanon
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - Victor Makanjuola
- Department of Psychiatry, College of Medicine, University of Ibadan; University College Hospital, Ibadan, Nigeria
| | | | - Fernando Navarro-Mateu
- Unidad de Docencia, Investigacion y Formación en Salud Mental, Servicio Murciano de Salud, Murcia, Spain; Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, Spain; Centro de Investigación Biomédica en ERed en Epidemíologia y Salud Pública, Murcia, Spain
| | - Marina Piazza
- Instituto Nacional de Salud, Universidad Cayetano Heredia, Lima, Peru
| | - José Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia
| | - Kate M Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Dan J Stein
- Dept of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
| | - Hisateru Tachimori
- National Institute of Mental Health, National Center for Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Nathan Tintle
- Department of Mathematics, Statistics and Computer Science, Dordt College, Sioux Center, IA, USA
| | - Yolanda Torres
- Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia
| | - Maria Carmen Viana
- Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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22
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Hogg B, Gardoki-Souto I, Valiente-Gómez A, Rosa AR, Fortea L, Radua J, Amann BL, Moreno-Alcázar A. Psychological trauma as a transdiagnostic risk factor for mental disorder: an umbrella meta-analysis. Eur Arch Psychiatry Clin Neurosci 2022; 273:397-410. [PMID: 36208317 DOI: 10.1007/s00406-022-01495-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/27/2022] [Indexed: 01/08/2023]
Abstract
This umbrella review is the first to systematically examine psychological trauma as a transdiagnostic risk factor across psychiatric conditions. We searched Pubmed, Scopus, and PsycNET databases from inception until 01/05/2021 for systematic reviews/meta-analyses evaluating the association between psychological trauma and at least one diagnosed mental disorder. We re-calculated the odds ratio (OR), then classified the association as convincing, highly suggestive, suggestive, or weak, based on the number of cases and controls with and without psychological trauma, random-effects p value, the 95% confidence interval of the largest study, heterogeneity between studies, 95% prediction interval, small-study effect, and excess significance bias. Additional outcomes were the association between specific trauma types and specific mental disorders, and a sensitivity analysis for childhood trauma. Transdiagnosticity was assessed using TRANSD criteria. The review was pre-registered in Prospero CRD42020157308 and followed PRISMA/MOOSE guidelines. Fourteen reviews met inclusion criteria, comprising 16,277 cases and 77,586 controls. Psychological trauma met TRANSD criteria as a transdiagnostic factor across different diagnostic criteria and spectra. There was highly suggestive evidence of an association between psychological trauma at any time-point and any mental disorder (OR = 2.92) and between childhood trauma and any mental disorder (OR = 2.90). Regarding specific trauma types, convincing evidence linked physical abuse (OR = 2.36) and highly suggestive evidence linked sexual abuse (OR = 3.47) with a range of mental disorders, and convincing evidence linked emotional abuse to anxiety disorders (OR = 3.05); there were no data for emotional abuse with other disorders. These findings highlight the importance of preventing early traumatic events and providing trauma-informed care in early intervention and psychiatric services.
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Affiliation(s)
- Bridget Hogg
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,PhD Programme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Itxaso Gardoki-Souto
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,PhD Programme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alicia Valiente-Gómez
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Adriane Ribeiro Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Department of Pharmacology, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil.,Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Lydia Fortea
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Joaquim Radua
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, King's College London, Psychology & Neuroscience, London, UK.,Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Benedikt L Amann
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019, Barcelona, Spain. .,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain. .,Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain. .,Department of Psychiatry and Psychotherapy, Klinikum Der Universität München, Munich, Germany.
| | - Ana Moreno-Alcázar
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, C/Llull 410, 08019, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
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23
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Lin BD, Pries LK, Sarac HS, van Os J, Rutten BPF, Luykx J, Guloksuz S. Nongenetic Factors Associated With Psychotic Experiences Among UK Biobank Participants: Exposome-Wide Analysis and Mendelian Randomization Analysis. JAMA Psychiatry 2022; 79:857-868. [PMID: 35857297 PMCID: PMC9301596 DOI: 10.1001/jamapsychiatry.2022.1655] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Although hypothesis-driven research has identified several factors associated with psychosis, this one-exposure-to-one-outcome approach fails to embrace the multiplicity of exposures. Systematic approaches, similar to agnostic genome-wide analyses, are needed to identify genuine signals. Objective To systematically investigate nongenetic correlates of psychotic experiences through data-driven agnostic analyses and genetically informed approaches to evaluate associations. Design, Setting, Participants This cohort study analyzed data from the UK Biobank Mental Health Survey from January 1 to June 1, 2021. An exposome-wide association study was performed in 2 equal-sized split discovery and replication data sets. Variables associated with psychotic experiences in the exposome-wide analysis were tested in a multivariable model. For the variables associated with psychotic experiences in the final multivariable model, the single-nucleotide variant-based heritability and genetic overlap with psychotic experiences using linkage disequilibrium score regression were estimated, and mendelian randomization (MR) approaches were applied to test potential causality. The significant associations observed in 1-sample MR analyses were further tested in multiple sensitivity tests, including collider-correction MR, 2-sample MR, and multivariable MR analyses. Exposures After quality control based on a priori criteria, 247 environmental, lifestyle, behavioral, and economic variables. Main Outcomes and Measures Psychotic experiences. Results The study included 155 247 participants (87 896 [57%] female; mean [SD] age, 55.94 [7.74] years). In the discovery data set, 162 variables (66%) were associated with psychotic experiences. Of these, 148 (91%) were replicated. The multivariable analysis identified 36 variables that were associated with psychotic experiences. Of these, 28 had significant genetic overlap with psychotic experiences. One-sample MR analyses revealed forward associations with 3 variables and reverse associations with 3. Forward associations with ever having experienced sexual assault and pleiotropy of risk-taking behavior and reverse associations without pleiotropy of experiencing a physically violent crime as well as cannabis use and the reverse association with pleiotropy of worrying too long after embarrassment were confirmed in sensitivity tests. Thus, associations with psychotic experiences were found with both well-studied and unexplored multiple correlated variables. For several variables, the direction of the association was reversed in the final multivariable and MR analyses. Conclusions and Relevance The findings of this study underscore the need for systematic approaches and triangulation of evidence to build a knowledge base from ever-growing observational data to guide population-level prevention strategies for psychosis.
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Affiliation(s)
- Bochao Danae Lin
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.,Brainclinics foundation, Nijmegen, the Netherlands.,Department of Preventive Medicine, Institute of Biomedical Informatics, Bioinformatics Center, School of Basic Medical Sciences, Henan University, Kaifeng, China
| | - Lotta-Katrin Pries
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Halil Suat Sarac
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jurjen Luykx
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.,Brainclinics foundation, Nijmegen, the Netherlands.,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,GGNet Mental Health, Apeldoorn, the Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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24
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Oh H, Koyanagi A, Leaune E, Zhou S, Kelleher I, DeVylder JE. Psychotic experiences, sexual minority status, and suicidal behavior among young adult college students in the United States. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1925-1929. [PMID: 35429284 DOI: 10.1007/s00127-022-02285-z] [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] [Received: 11/07/2021] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
Abstract
Psychotic experiences significantly predict suicidal behaviors; however, it is unknown whether these associations are conditional on sexual minority status. We analyzed cross-sectional data from the Healthy Minds Study (N = 109,975), which was collected between September 2020 and June 2021 from young adult (aged 18-34) students from across 140 colleges across the United States. Having psychotic experiences and sexual minority status were associated with significantly greater odds of reporting suicidal ideation, suicide plan, and suicide attempt, adjusting for sociodemographic characteristics. We found significant interactions between psychotic experiences and sexual minority status, such that the relations between psychotic experiences and suicidal behaviors were stronger among heterosexual students than among sexual minority students. However, the interactions disappeared for suicidal ideation and plans after adjusting for socio-behavioral risk factors. Future research can explore whether psychotic experiences predict suicide attempts among sexual minority status behavior socio-behavioral risk factors.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, 1149 Hill St Suite 1422, Los Angeles, CA, 90015, USA.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830, Barcelona, Spain.,ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
| | - Edouard Leaune
- Center for Suicide Prevention, Centre Hospitalier le Vinatier, Bron, France
| | - Sasha Zhou
- Department of Public Health, Wayne State University, Detroit, MI, USA
| | - Ian Kelleher
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jordan E DeVylder
- Graduate School of Social Service, Fordham University, Bronx, NY, USA
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25
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Psychotic-like experiences of young adults in the general population predict mental disorders. Psychiatry Res 2022; 312:114543. [PMID: 35417824 DOI: 10.1016/j.psychres.2022.114543] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 12/15/2022]
Abstract
Psychotic-like experiences (PLEs) have been identified as risk markers for psychotic disorders and may indicate an individual's susceptibility to mental disorders in general. We examined whether 23 PLEs (assessed with M-CIDI questionnaire) reported in young adulthood (n = 1313) predict subsequent psychotic or any mental disorders in the general population. We also investigated whether these possible associations are explained by general psychological distress assessed with the General Health Questionnaire-12 (GHQ-12). The register follow-up period spanned 10-12 years. In Cox regression models, PLEs predicted subsequent psychotic disorders (n = 12) when the effects of age, sex, education, and marital status were adjusted for, but not when general psychological distress was added to the model. Having any mental disorders during follow-up (n = 91) was predicted by PLEs reported at a younger age, when controlling for age, sex, education, marital status, and general psychological distress. In line with earlier results in other age groups, PLEs can be seen as a sign of vulnerability to not just psychotic but all mental disorders during the following years also among young adults in the general population. PLEs were a predictive marker of general psychopathology independently from general psychological distress.
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Vargas T, Damme KS, Osborne KJ, Mittal VA. Differentiating kinds of systemic stressors with relation to psychotic-like experiences in late childhood and early adolescence: the stimulation, discrepancy, and deprivation model of psychosis. Clin Psychol Sci 2022; 10:291-309. [PMID: 35402089 PMCID: PMC8993139 DOI: 10.1177/21677026211016415] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Conceptualizations that distinguish systems-level stress exposures are lacking; the Stimulation (lack of safety and high attentional demands), Discrepancy (social exclusion and lack of belonging), and Deprivation (lack of environmental enrichment) (SDD) theory of psychosis and stressors occurring at the systems-level has not been directly tested. METHODS Exploratory factor analysis was conducted on 3,207 youth, and associations with psychotic-like experiences (PLEs) were explored. RESULTS Though model fit was suboptimal, five factors were defined, and four were consistent with the SDD theory, and related to PLEs. Objective and subjective/self-report exposures for deprivation showed significantly stronger PLE associations compared to discrepancy and objective stimulation factors. Objective and subjective/self-report measures converged overall, though self-report stimulation exhibited a significantly stronger association with PLEs compared to objective stimulation. DISCUSSION Considering distinct system-level exposures could help clarify putative mechanisms and psychosis vulnerability. The preliminary approach potentially informs health policy efforts aimed at psychopathology prevention and intervention.
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Affiliation(s)
| | | | | | - Vijay A. Mittal
- Northwestern University Department of Psychology, Northwestern University Department of Psychiatry, Northwestern University Department of Medical Social Sciences, Northwestern University Institute for Innovations in Developmental Sciences, Northwestern University Institute for Policy Research
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Schizotypy, childhood trauma and brain morphometry. Schizophr Res 2021; 238:73-81. [PMID: 34624682 DOI: 10.1016/j.schres.2021.09.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/15/2021] [Accepted: 09/26/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Childhood trauma confers risk for psychosis and is associated with increased 'schizotypy' (a multi-dimensional construct reflecting risk for psychosis in the general population). Structural brain alterations are associated with both childhood trauma and schizotypy, but the potential role of trauma exposure in moderating associations between schizotypy and brain morphology has yet to be determined. METHODS Participants were 160 healthy individuals (mean age: 40.08 years, SD = 13.64, range 18-64; 52.5% female). Childhood trauma exposure was assessed using the Childhood Adversity Questionnaire, and schizotypy was assessed using the Schizotypal Personality Questionnaire. Univariate voxel-based morphometry and multivariate analyses of grey matter volume covariation (GMC; derived from independent component analysis) were performed to determine the main effects of schizotypy, trauma exposure and their interaction on these indices of grey matter volume. Moderation analyses were performed following significant interaction. RESULTS Levels of schizotypy, in particular the Cognitive-Perceptual and Interpersonal dimensions, were negatively associated with GMC in the striatum, the hippocampus/parahippocampal gyrus, thalamus and insulae. Trauma exposure was negatively associated with GMC of the middle frontal gyrus and parietal lobule, while negatively associated with GMC in the cerebellum. Levels of schizotypy (total scores, and the cognitive-perceptual dimension) were negatively associated with striatal GMC in individuals not exposed to trauma, but not in those exposed to trauma. CONCLUSIONS Schizotypy and childhood trauma were independently associated with changes of grey matter in brain regions critical for cognition and social cognition. In individuals not exposed to trauma, increased schizotypy was associated with decreased striatal and limbic grey matter.
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Tonini E, Quidé Y, Whitford TJ, Green MJ. Cumulative sociodemographic disadvantage partially mediates associations between childhood trauma and schizotypy. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:444-464. [PMID: 34820861 DOI: 10.1111/bjc.12349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/31/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Risk for psychosis in the general population is characterized by a set of multidimensional traits that are referred to as schizotypy. Higher levels of schizotypy are associated with socioeconomic disadvantage and childhood trauma, just as these risk factors are associated with schizophrenia and bipolar disorder. Here, we set out to investigate whether cumulative sociodemographic disadvantage mediates associations between childhood trauma and schizotypy in adulthood. METHODS A sociodemographic cumulative risk (SDCR) score was derived from six risk indices spanning employment, education, income, socioeconomic status, marital, and living circumstances for 197 participants that included both healthy (n = 57) and clinical samples with schizophrenia or schizoaffective disorder (n = 65) or bipolar disorder (n = 75). A series of multiple linear regressions was used to examine the direct and indirect associations among childhood trauma (measured with the Childhood Trauma Questionnaire), the SDCR index, and levels of schizotypy (measured with the Schizotypal Personality Questionnaire). RESULTS Schizotypy was independently associated with trauma and the SDCR index. In addition, the SDCR index partially mediated associations between trauma and schizotypy. CONCLUSIONS These findings in a mixed sample of healthy and clinical participants represent the full spectrum of schizotypy across health and illness and suggest that effects of childhood trauma on schizotypal personality organization may operate via cumulative socioeconomic disadvantage in adulthood. PRACTITIONER POINTS The strong associations between trauma and schizotypy suggest that systematic health screening of children exposed to early life trauma may assist to identify those at risk of developing psychosis. Clinicians should pay attention to various indicators of sociodemographic disadvantage in patients prone to psychosis, in addition to any exposure to trauma during childhood.
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Affiliation(s)
- Emiliana Tonini
- School of Psychiatry, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
| | - Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.,School of Psychology, University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | - Thomas J Whitford
- School of Psychology, University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia
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Oh H, Banawa R, Lee JO, Zhou S, Huh J. Vaping and psychotic experiences among college students in the United States. Drug Alcohol Depend 2021; 227:108987. [PMID: 34488073 DOI: 10.1016/j.drugalcdep.2021.108987] [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: 06/07/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 11/16/2022]
Abstract
AIM While cigarette and marijuana use has been linked to psychotic experiences, few empirical studies have examined the relation between vaping and psychotic experiences. METHODS We analyzed data from the Healthy Minds Survey (September 2020 - December 2020; N = 29,232 students from 36 universities), and used multiple logistic regression models to examine the associations between vaping over the past 30 days and psychotic experiences over the past 12 months, adjusting for age, gender, and race/ethnicity. We then additionally adjusted for cigarette and marijuana use, as well as depression and anxiety. RESULTS Roughly 14 % of students in the sample reported psychotic experiences over the past year, and around 14-15 % of students reported vaping over the past month. In multiple logistic regression models, vaping was significantly associated with psychotic experiences (aOR 1.88; 95 % CI: 1.63-2.18). This association attenuated but remained statistically significant even after adjusting for any cigarette use and marijuana use, and after adjusting for depression and anxiety. CONCLUSIONS Among college students, vaping was significantly associated with psychotic experiences, even after accounting for simple measures of cigarette and marijuana use, and mental health problems, calling for more prospective studies to examine the association.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, 1149 Hill St Suite 1422, Los Angeles, CA 90015, United States.
| | - Rachel Banawa
- Fielding School of Public Health, University of California, Los Angeles, United States
| | - Jungeun Olivia Lee
- Suzanne Dworak Peck School of Social Work, University of Southern California, 1149 Hill St Suite 1422, Los Angeles, CA 90015, United States
| | - Sasha Zhou
- Department of Public Health, Wayne State University, United States
| | - Jimi Huh
- Keck School of Medicine, University of Southern California, United States
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Susman ES, Weissman DG, Sheridan MA, McLaughlin KA. High vagal tone and rapid extinction learning as potential transdiagnostic protective factors following childhood violence exposure. Dev Psychobiol 2021; 63:e22176. [PMID: 34423415 PMCID: PMC8410650 DOI: 10.1002/dev.22176] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/07/2021] [Accepted: 07/16/2021] [Indexed: 01/19/2023]
Abstract
Childhood exposure to violence is strongly associated with psychopathology. High resting respiratory sinus arrhythmia (RSA) is associated with lower levels of psychopathology in children exposed to violence. High RSA may help to protect against psychopathology by facilitating fear extinction learning, allowing more flexible autonomic responses to learned threat and safety cues. In this study, 165 youth (79 female, aged 9-17; 86 exposed to violence) completed assessments of violence exposure, RSA, and psychopathology, and a fear extinction learning task; 134 participants returned and completed psychopathology assessments 2 years later. Resting RSA moderated the longitudinal association of violence exposure with post-traumatic stress disorder (PTSD) symptoms and externalizing psychopathology, such that the association was weaker among youths with higher RSA. Higher skin conductance responses (SCR) during extinction learning to the threat cue (CS+) was associated with higher internalizing symptoms at follow-up and greater SCR to the safety cue (CS-) was associated with higher PTSD, internalizing, and externalizing symptoms, as well as the p-factor, controlling for baseline symptoms. Findings suggest that higher RSA may protect against emergence of psychopathology among children exposed to violence. Moreover, difficulty extinguishing learned threat responses and elevated autonomic responses to safety cues may be associated with risk for future psychopathology.
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Affiliation(s)
- Eli S. Susman
- Department of Psychology, Harvard University, Cambridge, MA
| | | | - Margaret A. Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Charlson F, Gynther B, Obrecht K, Waller M, Hunter E. Multimorbidity and vulnerability among those living with psychosis in Indigenous populations in Cape York and the Torres Strait. Aust N Z J Psychiatry 2021; 55:892-902. [PMID: 33508958 DOI: 10.1177/0004867420984832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Previous research has found an alarmingly high rate of psychosis in Indigenous1 patients from remote communities of Cape York and the Torres Strait with the treated prevalence of psychosis four times higher than that found for the Australian population. This study assesses comorbid illness and risk factors among this same cohort of psychosis patients. METHODS Data were collated from a clinical database that contains complete psychiatric records from 1992 to 2015, extracted for all Indigenous patients who received treatment for a psychotic disorder from the Remote Area Mental Health Service. Descriptive analysis and logistic regression models explored differences across subgroups of ethnicity and sex, and relationships between co-morbid disorders and risk factors. All multivariate models included variables of age, year of birth, sex and ethnicity. RESULTS Sixty per cent of participants (n = 256) experienced a comorbid mental or substance use disorder. Forty-five per cent (n = 192) of participants experienced a physical comorbidity. The most frequent physical health outcomes were injury (29%, n = 93), diabetes (18%, n = 58) and cardiovascular disease (21%, n = 68). Risk factors considered to play a potential biological or neurodevelopmental role in the development of psychosis were approximately three times more likely in Aboriginal (odds ratio = 3.2; 95% confidence interval = [2.0, 4.9]) versus Torres Strait Islander patients, and those born after 1980 (odds ratio = 2.5; 95% confidence interval = [1.6, 3.9]) versus those born prior to 1980. Environmental or contextual factors were associated with significantly greater risk among Aboriginal (odds ratio = 3.8; 95% confidence interval = [2.4, 6.0]) compared with Torres Strait Islander patients. CONCLUSION Our data expose the perinatal and early environment of Indigenous children who later developed a psychotic disorder. As risk factors for schizophrenia may be cumulative and interactive, both with each other and with critical periods of neurodevelopmental vulnerability, our results suggest possible causes for the increasing prevalence of psychotic disorders between 1992 and 2015.
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Affiliation(s)
- Fiona Charlson
- Queensland Centre for Mental Health Research, Queensland Health, Wacol, QLD, Australia.,School of Public Health, The University of Queensland, Herston, QLD, Australia.,Institute for Health Metrics and Evaluation, Department of Global Health, University of Washington, Seattle, WA, USA
| | - Bruce Gynther
- Queensland Centre for Mental Health Research, Queensland Health, Wacol, QLD, Australia
| | - Karin Obrecht
- The Prince of Wales Hospital, Randwick, NSW, Australia
| | - Michael Waller
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Ernest Hunter
- The Cairns Institute, James Cook University, Cairns, QLD, Australia
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Sallis HM, Croft J, Havdahl A, Jones HJ, Dunn EC, Davey Smith G, Zammit S, Munafò MR. Genetic liability to schizophrenia is associated with exposure to traumatic events in childhood. Psychol Med 2021; 51:1814-1821. [PMID: 32234096 PMCID: PMC8381289 DOI: 10.1017/s0033291720000537] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/04/2020] [Accepted: 02/25/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND There is a wealth of literature on the observed association between childhood trauma and psychotic illness. However, the relationship between childhood trauma and psychosis is complex and could be explained, in part, by gene-environment correlation. METHODS The association between schizophrenia polygenic scores (PGS) and experiencing childhood trauma was investigated using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) and the Norwegian Mother, Father and Child Cohort Study (MoBa). Schizophrenia PGS were derived in each cohort for children, mothers, and fathers where genetic data were available. Measures of trauma exposure were derived based on data collected throughout childhood and adolescence (0-17 years; ALSPAC) and at age 8 years (MoBa). RESULTS Within ALSPAC, we found a positive association between schizophrenia PGS and exposure to trauma across childhood and adolescence; effect sizes were consistent for both child or maternal PGS. We found evidence of an association between the schizophrenia PGS and the majority of trauma subtypes investigated, with the exception of bullying. These results were comparable with those of MoBa. Within ALSPAC, genetic liability to a range of additional psychiatric traits was also associated with a greater trauma exposure. CONCLUSIONS Results from two international birth cohorts indicate that genetic liability for a range of psychiatric traits is associated with experiencing childhood trauma. Genome-wide association study of psychiatric phenotypes may also reflect risk factors for these phenotypes. Our findings also suggest that youth at higher genetic risk might require greater resources/support to ensure they grow-up in a healthy environment.
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Affiliation(s)
- Hannah M. Sallis
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Jazz Croft
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Alexandra Havdahl
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo0853, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, OsloN-0213, Norway
| | - Hannah J. Jones
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Erin C. Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Stanley Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Marcus R. Munafò
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
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Affiliation(s)
- Ian Kelleher
- School of Medicine, University College Dublin, Dublin, Ireland
- Lucena Clinic, Rathgar, Dublin, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Beaumont Hospital, Dublin, Ireland
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LoPilato AM, Zhang Y, Pike M, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Mathalon DH, McGlashan TH, Seidman L, Perkins DO, Tsuang MT, Woods SW, Walker EF. Associations between childhood adversity, cognitive schemas and attenuated psychotic symptoms. Early Interv Psychiatry 2021; 15:818-827. [PMID: 32770658 DOI: 10.1111/eip.13017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/29/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022]
Abstract
AIM Childhood Adversity (CA) is strongly linked to psychotic-like symptoms across the clinical spectrum, though the mechanisms underlying these associations remain poorly understood. Negative cognitive schemas are associated with both CA exposure and psychotic symptoms, highlighting the possibility that cognitive schemas may be a key risk pathway. The purpose of this study was to determine whether negative cognitive schemas mediate the association between CA and specific attenuated psychotic symptoms in a large sample of clinical-high risk youth. Given the variability in experiences that encompass CA (eg, abuse, neglect and poverty) and attenuated psychotic symptoms (eg, suspiciousness and perceptual abnormalities), we also tested whether these associations differ by CA type (threat vs deprivation) and attenuated positive psychotic symptom domain. METHODS Data were collected from 531 clinical-high risk youth between 12 and 35 years of age (mean = 18.80, SD = 4.21) who completed a clinical assessment that included the Structured Interview of Prodromal Syndromes (SIPS), Childhood Trauma and Abuse scale and questionnaires on cognitive schemas and depressive symptoms. RESULTS No direct effects of threat or deprivation exposure on any of the psychotic symptom domains were found. However, there was a unique indirect effect of threat, but not deprivation, on delusional thinking and suspiciousness through negative cognitive schemas about others. CONCLUSION Cognitive vulnerability in the form of negative schemas about others may be one mechanism linking childhood threat experiences and attenuated psychotic symptoms. The results underscore the importance of targeting negative schemas in interventions to mitigate psychosis risk.
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Affiliation(s)
- Allison M LoPilato
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Yinghao Zhang
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Madeline Pike
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Department of Psychology, Semel Institute for Neuroscience and Human Behaviour, UCLA, Los Angeles, California, USA
| | | | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA.,Department of Psychology, Yale University, New Haven, Connecticut, USA
| | | | | | | | - Larry Seidman
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Diana O Perkins
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, La Jolla, California, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA
| | - Elaine F Walker
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA.,Department of Psychology, Emory University, Atlanta, Georgia, USA
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Chaiyachati BH, Gur RE. Effect of child abuse and neglect on schizophrenia and other psychotic disorders. Pharmacol Biochem Behav 2021; 206:173195. [PMID: 33961909 PMCID: PMC10961915 DOI: 10.1016/j.pbb.2021.173195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/20/2021] [Accepted: 04/29/2021] [Indexed: 12/25/2022]
Abstract
Childhood experiences impact long-term physical and behavioral health outcomes including potential risk for schizophrenia and psychosis. Negative experiences, such as child abuse and neglect, have been specifically associated with risk for schizophrenia and psychosis. This review provides a brief overview of child abuse and neglect, including its position within the larger field of trauma and adversity and its long term consequences. The link to schizophrenia is then explored. Principles of treatment and outcomes for schizophrenia with antecedent child abuse and neglect are then reviewed. Finally, next steps and points of prevention are highlighted.
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Affiliation(s)
- Barbara H Chaiyachati
- The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; The University of Pennsylvania, Lifespan Brain Institute of Penn-Medicine and CHOP, Philadelphia, PA, United States of America; The Center for Pediatric Clinical Effectiveness and Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; The Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA, United States of America.
| | - Raquel E Gur
- The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; The University of Pennsylvania, Lifespan Brain Institute of Penn-Medicine and CHOP, Philadelphia, PA, United States of America
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Kilian C, Supanya S, Probst C, Morgan C, Bärnighausen T, Kittirattanapaiboon P, Kwansanit P, Reininghaus U. Traumatic events and psychotic experiences: a nationally representative study in Thailand. Epidemiol Psychiatr Sci 2021; 30:e47. [PMID: 34100345 PMCID: PMC8192593 DOI: 10.1017/s2045796021000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 11/22/2022] Open
Abstract
AIMS Most research exploring the link between traumatic events and psychotic experiences has focused on either Australia, Europe or North America. In this study, we expand the existing knowledge to Thailand and investigate the impact of the type and the number of traumatic events on psychotic experiences in Thailand. METHODS We used data from the nationally representative 2013 Thai National Mental Health Survey (TNMHS), including questions on traumatic events and psychotic experiences. We regressed the lifetime experience of hallucinations or delusions against the following independent variables: the experience of any traumatic event during lifetime (dichotomous; hypothesis 1); the experience of either no traumatic event, one interpersonal, one unintentional or both interpersonal and unintentional traumatic events (categorical; hypothesis 2) and the number of traumatic events experienced during lifetime (categorical; hypothesis 3). We adjusted the regression models for sociodemographic indicators and psychiatric disorders, and considered survey weights. RESULTS About 6% (95% confidence interval: 4.9-7.0) of the respondents stated that they had either hallucinatory or delusional experiences during their lifetime. The risk of reporting such experiences was more than doubled as high among respondents who had experienced at least one traumatic event during their lifetime than among those who had not yet experienced one, with higher risks for interpersonal or multiple traumatic events. Our results further indicated an increase in the risk of psychotic experiences as the number of traumatic events increased, with up to an eight-fold higher risk for people exposed to five or more traumatic events in their lifetime, compared to those with no traumatic events. CONCLUSIONS Individuals reporting interpersonal or multiple traumatic events face much higher risk of psychotic experiences. Effective and widely accessible secondary prevention programmes for people having experienced interpersonal or multiple traumatic events constitute a key intervention option.
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Affiliation(s)
- C. Kilian
- Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - S. Supanya
- Department of Mental Health, Somdet Chaopraya Institute of Psychiatry, Bangkok, Thailand
| | - C. Probst
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
- Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - C. Morgan
- ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - T. Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | | | - P. Kwansanit
- Department of Mental Health, Somdet Chaopraya Institute of Psychiatry, Bangkok, Thailand
| | - U. Reininghaus
- ESRC Centre for Society and Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Pignon B, Lajnef M, Kirkbride JB, Peyre H, Ferchiou A, Richard JR, Baudin G, Tosato S, Jongsma H, de Haan L, Tarricone I, Bernardo M, Velthorst E, Braca M, Arango C, Arrojo M, Bobes J, Del-Ben CM, Di Forti M, Gayer-Anderson C, Jones PB, La Cascia C, Lasalvia A, Menezes PR, Quattrone D, Sanjuán J, Selten JP, Tortelli A, Llorca PM, van Os J, Rutten BPF, Murray RM, Morgan C, Leboyer M, Szöke A, Schürhoff F. The Independent Effects of Psychosocial Stressors on Subclinical Psychosis: Findings From the Multinational EU-GEI Study. Schizophr Bull 2021; 47:1674-1684. [PMID: 34009318 PMCID: PMC8562561 DOI: 10.1093/schbul/sbab060] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The influence of psychosocial stressors on psychosis risk has usually been studied in isolation and after the onset of the disorder, potentially ignoring important confounding relationships or the fact that some stressors that may be the consequence of the disorder rather than preexisting. The study of subclinical psychosis could help to address some of these issues. In this study, we investigated whether there was (i) an association between dimensions of subclinical psychosis and several psychosocial stressors including: childhood trauma, self-reported discrimination experiences, low social capital, and stressful life experiences, and (ii) any evidence of environment-environment (ExE) interactions between these factors. Data were drawn from the EUGEI study, in which healthy controls (N = 1497) and siblings of subjects with a psychotic disorder (N = 265) were included in six countries. The association between psychosocial stressors and subclinical psychosis dimensions (positive, negative and depressive dimension as measured by the Community Assessment of Psychic Experiences (CAPE) scale) and possible ExE interactions were assessed using linear regression models. After adjusting for sex, age, ethnicity, country, and control/sibling status, childhood trauma (β for positive dimension: 0.13, negative: 0.49, depressive: 0.26) and stressful life events (positive: 0.08, negative: 0.16, depressive: 0.17) were associated with the three dimensions. Lower social capital was associated with the negative and depression dimensions (negative: 0.26, depressive: 0.13), and self-reported discrimination experiences with the positive dimension (0.06). Our findings are in favor of independent, cumulative and non-specific influences of social adversities in subclinical psychosis in non-clinical populations, without arguments for E × E interactions.
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Affiliation(s)
- Baptiste Pignon
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France,To whom correspondence should be addressed; Hôpital Albert
Chenevier, Groupe hospitalier Henri-Mondor, CHU de Créteil, Assistance
Publique-Hôpitaux de Paris (AP-HP), 40 rue de Mesly, 94 000 Créteil,
France; tel: 33-1-49-81-31-31, fax:
+33-1-49-81-30-59, e-mail:
| | - Mohamed Lajnef
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
| | | | - Hugo Peyre
- AP-HP, Hôpital universitaire Robert Debré,
Service de pédopsychiatrie, Paris,
France
| | - Aziz Ferchiou
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
| | - Jean-Romain Richard
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
| | - Grégoire Baudin
- Université de Paris, Laboratoire de Psychopathologie
et Processus de Santé, Boulogne
Billancourt, France
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience,
Biomedicine and Movement Sciences, University of Verona,
Verona, Italy
| | - Hannah Jongsma
- Centre for Transcultural Psychiatry
“Veldzicht.” Balkbrug, the Netherlands; VR Mental Health Group,
University Center for Psychiatry, Univerisity Medical Centre
Groningen, Groningen, The Netherlands,Centre for Longitudinal Studies, UCL,
London, UK
| | - Lieuwe de Haan
- Amsterdam UMC,
Amsterdam, The
Netherlands,Arkin, Amsterdam,
The Netherlands
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Bologna
University, Bologna, Italy
| | - Miguel Bernardo
- Barcelona Clínic Schizophrenia Unit, Hospital
Clínic of Barcelona, Institute of Neuroscience, University of Barcelona;
Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPS),
Barcelona; Centro de Investigación Biomédica en Red de Salud Mental
(CIBERSAM), Spain
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at
Mount Sinai, New York, NY
| | - Mauro Braca
- Department of Mental Health and Pathological Addictions,
Local Health Authority, Bologna, Italy
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute
of Psychiatry and Mental Health, Hospital General.Universitario Gregorio
Marañón, Gregorio Marañón, (IiGSM), School of Medicine,
Universidad Complutense de Madrid; CIBERSAM,
Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group,
Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo
Hospitalario Universitario de Santiago de Compostela, Spain
| | - Julio Bobes
- Faculty of Medicine and Health Sciences - Psychiatry,
Universidad de Oviedo; ISPA, INEUROPA CIBERSAM,
Oviedo, Spain
| | - Cristina Marta Del-Ben
- Department of Neuroscience and Behaviour, Ribeirão
Preto Medical School, University of São Paulo,
São Paulo, Brazil
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre,
Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, London, UK,South London and Maudsley NHS Mental Health Foundation
Trust, London, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research,
Institute of Psychiatry, King’s College London, De Crespigny
Park, Denmark Hill, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of
Cambridge, Cambridge, UK,CAMEO, Cambridgeshire & Peterborough NHS Foundation
Trust, Cambridge, UK
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced
Diagnostics, School of Medicine, University of Palermo,
Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience,
Biomedicine and Movement Sciences, University of Verona,
Verona, Italy
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina,
Universidade of São Paulo, São
Paulo, Brazil
| | - Diego Quattrone
- Social, Genetic, and Developmental Psychiatry Centre,
Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, London, UK
| | - Julio Sanjuán
- Biomedical Research Networking Centre in Mental Health
(CIBERSAM), Madrid, Spain,Department of Psychiatry, Hospital Clínico
Universitario de Valencia, School of Medicine, Universidad de
Valencia, Valencia, Spain,Biomedical Research Institute INCLIVA,
Valencia, Spain
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health,
Leiden, The
Netherlands,Maastricht University Medical Center, Departmentof
Psychiatry & Neuropsychology, School for Mental Health and
Neuroscience, Maastricht, The Netherlands
| | - Andrea Tortelli
- French National Institute of Health and Medical Research
(INSERM), Créteil, France,EPS Maison Blanche,
Paris, France
| | - Pierre-Michel Llorca
- CHU Clermont-Ferrand, Psychiatrie B,
Clermont-Ferrand, France,Université Clermont Auvergne,
Clermont-Ferrand, France
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for
Mental Health and Neuroscience, Maastricht University Medical
Centre, Maastricht, The Netherlands,Department of Psychiatry, UMC Utrecht Brain Centre,
University Medical Centre Utrecht, Utrecht University,
Utrecht, The
Netherlands,Department of Psychosis Studies, Institute of Psychiatry,
Psychology & Neuroscience, King’s College London,
London, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for
Mental Health and Neuroscience, Maastricht University Medical
Centre, Maastricht, The Netherlands
| | - Robin M Murray
- The Institute of Psychiatry, Psychology and Neuroscience,
King’s College London, London,
UK
| | - Craig Morgan
- Department of Health Service and Population Research,
Institute of Psychiatry, King’s College London, De Crespigny
Park, Denmark Hill, London, UK
| | - Marion Leboyer
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
| | - Andrei Szöke
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
| | - Franck Schürhoff
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
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38
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McMahon EM, Corcoran P, Keeley H, Clarke M, Coughlan H, Wasserman D, Hoven CW, Carli V, Sarchiapone M, Healy C, Cannon M. Risk and protective factors for psychotic experiences in adolescence: a population-based study. Psychol Med 2021; 51:1220-1228. [PMID: 32026792 DOI: 10.1017/s0033291719004136] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Psychotic experiences (PEs) are reported by a significant minority of adolescents and are associated with the development of psychiatric disorders. The aims of this study were to examine associations between PEs and a range of factors including psychopathology, adversity and lifestyle, and to investigate mediating effects of coping style and parental support on associations between adversity and PEs in a general population adolescent sample. METHOD Cross-sectional data were drawn from the Irish centre of the Saving and Empowering Young Lives in Europe study. Students completed a self-report questionnaire and 973 adolescents, of whom 522 (53.6%) were boys, participated. PEs were assessed using the 7-item Adolescent Psychotic Symptom Screener. RESULTS Of the total sample, 81 (8.7%) of the sample were found to be at risk of PEs. In multivariate analysis, associations were found between PEs and number of adverse events reported (OR 4.48, CI 1.41-14.25; p < 0.011), maladaptive/pathological internet use (OR 2.70, CI 1.30-5.58; p = 0.007), alcohol intoxication (OR 2.12, CI 1.10-4.12; p = 0.025) and anxiety symptoms (OR 4.03, CI 1.57-10.33; p = 0.004). There were small mediating effects of parental supervision, parental support and maladaptive coping on associations between adversity and PEs. CONCLUSION We have identified potential risk factors for PEs from multiple domains including adversity, mental health and lifestyle factors. The mediating effect of parental support on associations between adversity and PEs suggests that poor family relationships may account for some of this mechanism. These findings can inform the development of interventions for adolescents at risk.
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Affiliation(s)
- Elaine M McMahon
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University CollegeCork, Ireland
| | - Paul Corcoran
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University CollegeCork, Ireland
| | - Helen Keeley
- Child and Adolescent Mental Health Services North Cork, Health Service Executive, Ireland
| | - Mary Clarke
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Helen Coughlan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Christina W Hoven
- Dept of Child and Adolescent Psychiatry, New York State Psychiatric Institute; Dept of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Institute of Neuroscience, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
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39
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Adams DM, Reay WR, Geaghan MP, Cairns MJ. Investigation of glycaemic traits in psychiatric disorders using Mendelian randomisation revealed a causal relationship with anorexia nervosa. Neuropsychopharmacology 2021; 46:1093-1102. [PMID: 32920595 PMCID: PMC8115098 DOI: 10.1038/s41386-020-00847-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/02/2020] [Accepted: 08/24/2020] [Indexed: 12/22/2022]
Abstract
Data from observational studies have suggested an involvement of abnormal glycaemic regulation in the pathophysiology of psychiatric illness. This may be an attractive target for clinical intervention as glycaemia can be modulated by both lifestyle factors and pharmacological agents. However, observational studies are inherently confounded, and therefore, causal relationships cannot be reliably established. We employed genetic variants rigorously associated with three glycaemic traits (fasting glucose, fasting insulin, and glycated haemoglobin) as instrumental variables in a two-sample Mendelian randomisation analysis to investigate the causal effect of these measures on the risk for eight psychiatric disorders. A significant protective effect of a natural log transformed pmol/L increase in fasting insulin levels was observed for anorexia nervosa after the application of multiple testing correction (OR = 0.48 [95% CI: 0.33-0.71]-inverse-variance weighted estimate). There was no consistently strong evidence for a causal effect of glycaemic factors on the other seven psychiatric disorders considered. The relationship between fasting insulin and anorexia nervosa was supported by a suite of sensitivity analyses, with no statistical evidence of instrument heterogeneity or horizontal pleiotropy. Further investigation is required to explore the relationship between insulin levels and anorexia.
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Affiliation(s)
- Danielle M Adams
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - William R Reay
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
- Centre for Brain and Mental Health Research, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Michael P Geaghan
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
- Centre for Brain and Mental Health Research, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia.
- Centre for Brain and Mental Health Research, Hunter Medical Research Institute, Newcastle, NSW, Australia.
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40
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Rosellini AJ, Szentkúti P, Horváth-Puhó E, Smith ML, Galatzer-Levy I, Lash TL, Galea S, Schnurr PP, Sørensen HT, Gradus JL. Latent classes of posttraumatic psychiatric comorbidity in the general population. J Psychiatr Res 2021; 136:334-342. [PMID: 33636689 PMCID: PMC8485142 DOI: 10.1016/j.jpsychires.2021.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 02/06/2023]
Abstract
Some narrow patterns of posttraumatic psychiatric comorbidity are well-established (e.g., posttraumatic stress disorder and substance use). However, broad multi-diagnosis profiles of posttraumatic comorbidity are poorly characterized. The goal of the current study was to use latent class analysis (LCA) to identify profiles of posttraumatic psychopathology from 11 International Classification of Diseases (ICD-10) diagnostic categories (e.g., stress, substance, depressive, psychosis, personality). Danish national registries were used to identify 166,539 individuals (median age = 41 years, range = <1 to >100) who experienced a traumatic event between 1994 and 2016 and were diagnosed with one or more mental disorders within 5 years. Two through 14-class LCA solutions were evaluated. A 13-class solution (a) provided the best fit, with the Bayes and Akaike Information Criteria reaching a minimum, (b) was broadly consistent with prior LCA studies, and (c) included several novel classes reflecting differential patterns of posttraumatic psychopathology. Three classes were characterized by high comorbidity: broad high comorbidity (M # diagnoses = 4.3), depression with stress/substance use/personality/neurotic disorders (M# diagnoses = 3.8), and substance use with personality/stress/psychotic disorders (M # diagnoses = 3.1). The other 10 classes were characterized by distinct patterns of mild comorbidity or negligible comorbidity. Compared to the mild and negligible comorbidity classes, individuals in high comorbidity classes were younger, had lower income, and had more pre-event psychiatric disorders. Results suggest that several different comorbidity patterns should be assessed when studying and treating posttraumatic psychopathology.
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Affiliation(s)
- Anthony J Rosellini
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
| | - Péter Szentkúti
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Meghan L Smith
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | | | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Paula P Schnurr
- National Center for PTSD Executive Division, White River Junction, VT, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Henrik T Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Jaimie L Gradus
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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41
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Ayano G, Belete A, Duko B, Tsegay L, Dachew BA. Systematic review and meta-analysis of the prevalence of depressive symptoms, dysthymia and major depressive disorders among homeless people. BMJ Open 2021; 11:e040061. [PMID: 33622940 PMCID: PMC7907847 DOI: 10.1136/bmjopen-2020-040061] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To assess the global prevalence estimates of depressive symptoms, dysthymia and major depressive disorders (MDDs) among homeless people. DESIGN Systematic review and meta-analysis. DATA SOURCES Databases including PubMed, Scopus and Web of Science were systematically searched up to February 2020 to identify relevant studies that have reported data on the prevalence of depressive symptoms, dysthymia and MDDs among homeless people. ELIGIBILITY CRITERIA Original epidemiological studies written in English that addressed the prevalence of depressive problems among homeless people. DATA EXTRACTION AND SYNTHESIS A random-effect meta-analysis was performed to pool the prevalence estimated from individual studies. Subgroup and sensitivity analyses were employed to compare the prevalence across the groups as well as to identify the source of heterogeneities. The Joanna Briggs Institute's quality assessment checklist was used to measure the study quality. Cochran's Q and the I2 test were used to assess heterogeneity between the studies. RESULTS Forty publications, including 17 215 participants, were included in the final analysis. This meta-analysis demonstrated considerably higher prevalence rates of depressive symptoms 46.72% (95% CI 37.77% to 55.90%), dysthymia 8.25% (95% CI 4.79% to 11.86%), as well as MDDs 26.24% (95% CI 21.02% to 32.22%) among homeless people. Our subgroup analysis showed that the prevalence of depressive symptoms was high among younger homeless people (<25 years of age), whereas the prevalence of MDD was high among older homeless people (>50 years of age) when compared with adults (25-50 years). CONCLUSION This review showed that nearly half, one-fourth and one-tenth of homeless people are suffering from depressive symptoms, dysthymia and MDDs, respectively, which are notably higher than the reported prevalence rates in the general population. The findings suggest the need for appropriate mental health prevention and treatment strategies for this population group.
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Affiliation(s)
- Getinet Ayano
- Ethiopia Ministry of Health, Addis Ababa, Ethiopia
- Department of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Asmare Belete
- Department of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bereket Duko
- School of Public Health, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Light Tsegay
- Department of Psychiatry, Aksum University, Aksum, Ethiopia
| | - Berihun Assefa Dachew
- Department of Public Health, Curtin University Faculty of Health Sciences, Perth, Western Australia, Australia
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42
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Lau S, Kirchebner J, Kling S, Euler S, Günther MP. Childhood Maltreatment, Psychopathology, and Offending Behavior in Patients With Schizophrenia: A Latent Class Analysis Evidencing Disparities in Inpatient Treatment Outcome. Front Psychiatry 2021; 12:612322. [PMID: 33584386 PMCID: PMC7875859 DOI: 10.3389/fpsyt.2021.612322] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/04/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Extant research has provided evidence for disparities between patients with schizophrenia spectrum disorder (SSD) who have and have not experienced childhood maltreatment (CM) in terms of treatment outcome, psychopathology and their propensity to engage in offending behavior. However, research addressing all phenomena is scarce. Objective: The current study aims to explore differences between offender patients with SSD and CM and those with SSD and no CM in terms of their offending, psychopathology at different points in time and treatment outcome. Method: In the present explorative study, latent class analysis was used to analyze differences between 197 offender patients with SSD and CM and 173 offender patients with SSD and no CM, who were admitted to forensic psychiatric inpatient treatment between 1982 and 2016 in Switzerland. Results: Three distinct homogenous classes of patients were identified, two of which were probable to have experienced significant CM. One third of patients with SSD and CM were probable to benefit from inpatient treatment, even surpassing results observable in the group without CM, whereas the other group with SSD and CM was probable to benefit less. Patients with SSD and no CM displayed more psychopathology at first diagnosis and prior to their index offense. Interclass differences in offending behavior were minimal. Conclusions: Offender patients with SSD and CM differ not only from offender patients with SSD and no CM, but also amongst themselves. While some with SSD and CM experience a remission in psychopathology and improve their prognosis for future offending behavior, others do not. Directions for future research on SSD and CM are discussed.
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Affiliation(s)
- Steffen Lau
- Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Johannes Kirchebner
- Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Sabine Kling
- Computer Vision Laboratory, Department of Information Technology and Electrical Engineering, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation Psychiatry and Psychosomatics, University Hospital of Zurich, Zurich, Switzerland
| | - Moritz Philipp Günther
- Department of Consultation Psychiatry and Psychosomatics, University Hospital of Zurich, Zurich, Switzerland
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43
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Henry LM, Gracey K, Shaffer A, Ebert J, Kuhn T, Watson KH, Gruhn M, Vreeland A, Siciliano R, Dickey L, Lawson V, Broll C, Cole DA, Compas BE. Comparison of three models of adverse childhood experiences: Associations with child and adolescent internalizing and externalizing symptoms. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:9-25. [PMID: 33271039 PMCID: PMC8687696 DOI: 10.1037/abn0000644] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Exposure to adverse childhood experiences (ACEs) is prevalent and confers risk for psychopathology later in life. Approaches to understanding the impact of ACEs on development include the independent risk approach, the Dimensional Model of Adversity and Psychopathology (DMAP) distinguishing between threat and deprivation events, and the cumulative risk approach. The present research provides an empirical confirmation of DMAP and a comparison of these three approaches in predicting internalizing and externalizing symptoms in youth. In Study 1, mental health professionals (N = 57) rated ACEs as threat or deprivation events. These ratings were used to create composites to represent the DMAP approach in Study 2. With cross-sectional and longitudinal data from children and adolescents in state custody (N = 23,850), hierarchical linear regression analyses examined independent risk, DMAP, and cumulative risk models in predicting internalizing symptoms, disinhibited externalizing symptoms, and antagonistic externalizing symptoms. All three approaches produced significant models and revealed associations between exposure to ACEs and symptoms. Individual risk accounted for significantly more variance in symptoms than cumulative risk and DMAP. Cumulative risk masked differential associations between ACEs and psychological symptoms found in the individual risk and DMAP approaches. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Lauren M. Henry
- Department of Psychology and Human Development, Vanderbilt
University
| | - Kathy Gracey
- Department of Psychiatry, Vanderbilt University Medical
Center
| | - April Shaffer
- Department of Psychiatry, Vanderbilt University Medical
Center
| | - Jon Ebert
- Department of Psychiatry, Vanderbilt University Medical
Center
| | - Tarah Kuhn
- Department of Psychiatry, Vanderbilt University Medical
Center
| | - Kelly H. Watson
- Department of Psychology and Human Development, Vanderbilt
University
| | - Meredith Gruhn
- Department of Psychology and Human Development, Vanderbilt
University
| | - Allison Vreeland
- Department of Psychology and Human Development, Vanderbilt
University
| | - Rachel Siciliano
- Department of Psychology and Human Development, Vanderbilt
University
| | - Lindsay Dickey
- Department of Psychology and Human Development, Vanderbilt
University
| | - Victoria Lawson
- Department of Psychology and Human Development, Vanderbilt
University
| | - Cassandra Broll
- Department of Psychology and Human Development, Vanderbilt
University
| | - David A. Cole
- Department of Psychology and Human Development, Vanderbilt
University
| | - Bruce E. Compas
- Department of Psychology and Human Development, Vanderbilt
University
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44
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Bhavsar V, Dorrington S, Morgan C, Hatch SL, McGuire P, Fusar-Poli P, Mills J, MacCabe JH, Hotopf M. Psychotic experiences, psychiatric comorbidity and mental health need in the general population: a cross-sectional and cohort study in Southeast London. Psychol Med 2021; 51:147-157. [PMID: 31713511 PMCID: PMC7116680 DOI: 10.1017/s0033291719003106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/02/2019] [Accepted: 10/09/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Co-occurrence of common mental disorders (CMD) with psychotic experiences is well-known. There is little research on the public mental health relevance of concurrent psychotic experiences for service use, suicidality, and poor physical health. We aim to: (1) describe the distribution of psychotic experiences co-occurring with a range of non-psychotic psychiatric disorders [CMD, depressive episode, anxiety disorder, probable post-traumatic stress disorder (PTSD), and personality dysfunction], and (2) examine associations of concurrent psychotic experiences with secondary mental healthcare use, psychological treatment use for CMD, lifetime suicide attempts, and poor self-rated health. METHODS We linked a prospective cross-sectional community health survey with a mental healthcare provider database. For each non-psychotic psychiatric disorder, patients with concurrent psychotic experiences were compared to those without psychotic experiences on use of secondary mental healthcare, psychological treatment for CMD, suicide attempt, physical functioning, and a composite multimorbidity score, using logistic regression and Cox regressions. RESULTS In all disorders except for anxiety disorder, concurrent psychotic experiences were accompanied by a greater odds of all outcomes (odds ratios) for a unit change in composite multimorbidity score ranged between 2.21 [95% confidence interval (CI) 1.49-3.27] and 3.46 (95% CI 1.52-7.85). Hazard ratios for secondary mental health service use for non-psychotic disorders with concurrent psychotic experiences, ranged from 0.53 (95% CI 0.15-1.86) for anxiety disorders with psychotic experiences to 4.99 (95% CI 1.22-20.44) among those with PTSD with psychotic experiences. CONCLUSIONS Co-occurring psychotic experiences indicate greater public mental health burden, suggesting psychotic experiences could be a marker for future preventive strategies improving public mental health.
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Affiliation(s)
- Vishal Bhavsar
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sarah Dorrington
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- Department of Health Services and Population Research, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Stephani L. Hatch
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - John Mills
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - James H. MacCabe
- Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Matthew Hotopf
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
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Stickley A, Sumiyoshi T, Narita Z, Oh H, DeVylder JE, Jacob L, Koyanagi A. Physical injury and psychotic experiences in 48 low- and middle-income countries. Psychol Med 2020; 50:2751-2758. [PMID: 31637996 DOI: 10.1017/s0033291719002897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Psychotic experiences (PEs) may be associated with injuries, but studies focusing specifically on low- and middle-income countries (LAMICs) are scarce. Thus, the current study examined the link between injuries and PEs in a large number of LAMICs. METHOD Cross-sectional data were used from 242 952 individuals in 48 LAMICs that were collected during the World Health Survey in 2002-2004 to examine the association between traffic-related and other (non-traffic-related) forms of injury and PEs. Multivariable logistic regression analysis and meta-analysis were used to examine associations while controlling for a variety of covariates including depression. RESULTS In fully adjusted analyses, any injury [odds ratio (OR) 2.07, 95% confidence interval (CI) 1.85-2.31], traffic injury (OR 1.84, 95% CI 1.53-2.21) and other injury (OR 2.09, 95% CI 1.84-2.37) were associated with higher odds for PEs. Results from a country-wise analysis showed that any injury was associated with significantly increased odds for PEs in 39 countries with the overall pooled OR estimated by meta-analysis being 2.46 (95% CI 2.22-2.74) with a moderate level of between-country heterogeneity (I2 = 56.3%). Similar results were observed across all country income levels (low, lower-middle and upper-middle). CONCLUSIONS Different types of injury are associated with PEs in LAMICs. Improving mental health systems and trauma capacity in LAMICs may be important for preventing injury-related negative mental health outcomes.
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Affiliation(s)
- A Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - T Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Z Narita
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - H Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - J E DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA
| | - L Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux78180, France
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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46
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Scott BG, Fike EA, McCullen JR. Depressive symptoms among stress-exposed youth: Relations with tonic and phasic indices of autonomic functioning. Dev Psychobiol 2020; 63:1029-1042. [PMID: 33200408 DOI: 10.1002/dev.22056] [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: 06/15/2020] [Revised: 10/03/2020] [Accepted: 10/11/2020] [Indexed: 11/10/2022]
Abstract
Theoretical models of adolescent depression postulate that one possible individual vulnerability factor for the development of depressive symptoms is autonomic dysregulation. However, there is limited and mixed support for these models among ethnically diverse and higher risk stress-exposed youth. Therefore, this study investigated the relations between both tonic and phasic indices of parasympathetic autonomic functioning (i.e., resting high-frequency heart rate variability [HF-HRV] and root mean square of successive differences [RMSSD]; HF-HRV and RMSSD reactivity to a mental arithmetic stressor) and depressive symptoms among 80 severely stress-exposed youth (51% female; 11-17 years of age) from diverse backgrounds (61.3% ethnic minority; caregiver-reported median family income = $20,000-$49,999 per year). Results demonstrated that lower resting HF-HRV and RMSSD, but not HF-HRV and RMSSD reactivity, was associated with greater youth depressive symptoms. Our findings suggest that lower resting parasympathetic autonomic functioning may be a potential vulnerability factor of depressive symptoms among stress-exposed youth, instead of specific emotional responses to stressors. These findings will need to be replicated in larger samples of stress-exposed youth and youth at higher risk for or exhibiting clinical levels of depressive symptoms to better elucidate relations with autonomic functioning and depressive symptoms among adolescents.
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Stickley A, Oh H, Sumiyoshi T, Narita Z, Shirama A, Shin JI, Waldman K. The September 11, 2001, terrorist attacks, media exposure, and psychotic experiences among Asian and Latino Americans. Psychiatry Clin Neurosci 2020; 74:572-573. [PMID: 32678467 DOI: 10.1111/pcn.13115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/12/2020] [Accepted: 07/09/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, USA
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Zui Narita
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Kyle Waldman
- Department of Sociology, Harvard University, Cambridge, USA
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Alameda L, Rodriguez V, Carr E, Aas M, Trotta G, Marino P, Vorontsova N, Herane-Vives A, Gadelrab R, Spinazzola E, Di Forti M, Morgan C, Murray RM. A systematic review on mediators between adversity and psychosis: potential targets for treatment. Psychol Med 2020; 50:1966-1976. [PMID: 32744193 DOI: 10.1017/s0033291720002421] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Various psychological and biological pathways have been proposed as mediators between childhood adversity (CA) and psychosis. A systematic review of the evidence in this domain is needed. Our aim is to systematically review the evidence on psychological and biological mediators between CA and psychosis across the psychosis spectrum. This review followed PRISMA guidelines. Articles published between 1979 and July 2019 were identified through a literature search in OVID (PsychINFO, Medline and Embase) and Cochrane Libraries. The evidence by each analysis and each study is presented by group of mediator categories found. The percentage of total effect mediated was calculated. Forty-eight studies were included, 21 in clinical samples and 27 in the general population (GP) with a total of 82 352 subjects from GP and 3189 from clinical studies. The quality of studies was judged as 'fair'. Our results showed (i) solid evidence of mediation between CA and psychosis by negative cognitive schemas about the self, the world and others (NS); by dissociation and other post-traumatic stress disorder symptoms; and through an affective pathway in GP but not in subjects with disorder; (iii) lack of studies exploring biological mediators. We found evidence suggesting that various overlapping and not competing pathways involving post-traumatic and mood symptoms, as well as negative cognitions contribute partially to the link between CA and psychosis. Experiences of CA, along with relevant mediators should be routinely assessed in patients with psychosis. Evidence testing efficacy of interventions targeting such mediators through cognitive behavioural approaches and/or pharmacological means is needed in future.
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Affiliation(s)
- Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), CH-1008Lausanne, Switzerland
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Spain
- Instituto de Investigacion Sanitaria de Sevilla, IBiS, Spain
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ewan Carr
- Department of Biostatistics and Health Informatics, 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
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paolo Marino
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Natasha Vorontsova
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrés Herane-Vives
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Departamento de Clínicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
| | - Romayne Gadelrab
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Marta Di Forti
- 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, Psychology and Neuroscience, King's College London, London, UK
| | - Craig Morgan
- ESRC Centre for Society and Mental Health, King's College London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Hinton DE, Reis R, de Jong J. Ghost Encounters Among Traumatized Cambodian Refugees: Severity, Relationship to PTSD, and Phenomenology. Cult Med Psychiatry 2020; 44:333-359. [PMID: 31701326 DOI: 10.1007/s11013-019-09661-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Ghost encounters were found to be a key part of the trauma ontology among Cambodian refugees at a psychiatric clinic, a key idiom of distress. Fifty-four percent of patients had been bothered by ghost encounters in the last month. The severity of being bothered by ghosts in the last month was highly correlated to PTSD severity (r = .8), and among patients bothered by ghosts in the last month, 85.2% had PTSD, versus among those not so bothered, 15.4%, odds ratio of 31.8 (95% confidence level 11.3-89.3), Chi square = 55.0, p < .001. Ghost visitations occurred in multiple experiential modalities that could be classified into three states of consciousness: full sleep (viz., in dream), hypnagogia, that is, upon falling asleep or awakening (viz., in sleep paralysis [SP] and in non-SP hallucinations), and full waking (viz., in hallucinations, visual aura, somatic sensations [chills or goosebumps], and leg cramps). These ghost visitations gave rise to multiple concerns-for example, of being frightened to death or of having the soul called away-as part of an elaborate cosmology. Several heuristic models are presented including a biocultural model of the interaction of trauma and ghost visitation. An extended case illustrates the article's findings.
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Affiliation(s)
- Devon E Hinton
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Harvard Medical School, One Bowdoin Square, 6th Floor, Boston, MA, 02114, USA.
| | - Ria Reis
- Leiden University Medical Center, Leiden, The Netherlands
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
- The Children's Institute, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Joop de Jong
- Center for Anxiety and Related Disorders, Boston University, Boston, USA
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Khaled SM, Wilkins SS, Woodruff P. Lifetime prevalence and potential determinants of psychotic experiences in the general population of Qatar. Psychol Med 2020; 50:1110-1120. [PMID: 31133090 PMCID: PMC7253618 DOI: 10.1017/s0033291719000977] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 03/23/2019] [Accepted: 04/09/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND To estimate the lifetime prevalence and potential determinants of psychotic experience(s) (PEs) in the general population of Qatar - a small non-war afflicted, conservative, high-income, middle-eastern country with recent rapid urbanization including an influx of migrants. METHODS A probability-based sample (n = 1353) of non-migrants and migrants were interviewed face-to-face and administered a 7-item psychosis screener adapted from the Composite International Diagnostic Interview, the Kessler 6-item psychological distress scale, and the 5 items assessing odd (paranormal) beliefs and magical thinking (OBMT) from the Schizotypal Personality Questionnaire. Using bivariate and logistic regression analyses, lifetime prevalence rates of PEs were estimated then compared before and after adjustment for socio-demographics, Arab ethnicity, psychological distress, and OBMT. RESULTS Prevalence of PEs was 27.9%. Visual hallucinations were most common (12.8%), followed by persecutory delusions (6.7%) and auditory hallucinations (6.9%). Ideas of reference (3.6%) were least prevalent. PEs were significantly higher in Arabs (34.7%) compared with non-Arabs (16.4%, p < 0.001) with the exception of ideas of reference and paranoid delusions. Female gender was associated with a higher prevalence of PEs in the Arab group only (p < 0.001). Prevalence of PEs was significantly higher among Arabs (48.8% v. 15.8%, p < 0.001) and non-Arabs (35.2% v. 7.3%, p < 0.001) with OBMT. Arab ethnicity (OR = 2.10, p = 0.015), psychological distress (OR = 2.29 p = 0.003), and OBMT (OR = 6.25, p < 0.001) were independently associated with PEs after adjustment for all variables. CONCLUSIONS Ethnicity, but not migration was independently associated with PEs. Evidence linking Arab ethnicity, female gender, and psychological distress to PEs through associations with OBMT was identified for future prospective investigations.
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Affiliation(s)
- Salma M. Khaled
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar
| | - Stacy Schantz Wilkins
- Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA, USA
| | - Peter Woodruff
- Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
- Weil Cornell – Medicine, Education City, Qatar Foundation, Doha, Qatar
- National Institute of Health Research – Sheffield Biomedical Research Centre, University of Sheffield, Sheffield, UK
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