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Szwajca M, Kazek G, Śmierciak N, Mizera J, Pomierny-Chamiolo L, Szwajca K, Biesaga B, Pilecki M. GDNF and miRNA-29a as biomarkers in the first episode of psychosis: uncovering associations with psychosocial factors. Front Psychiatry 2024; 15:1320650. [PMID: 38645418 PMCID: PMC11027163 DOI: 10.3389/fpsyt.2024.1320650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/14/2024] [Indexed: 04/23/2024] Open
Abstract
Aim Schizophrenia involves complex interactions between biological and environmental factors, including childhood trauma, cognitive impairments, and premorbid adjustment. Predicting its severity and progression remains challenging. Biomarkers like glial cell line-derived neurotrophic factor (GDNF) and miRNA-29a may bridge biological and environmental aspects. The goal was to explore the connections between miRNAs and neural proteins and cognitive functioning, childhood trauma, and premorbid adjustment in the first episode of psychosis (FEP). Method This study included 19 FEP patients who underwent clinical evaluation with: the Childhood Trauma Questionnaire (CTQ), the Premorbid Adjustment Scale (PAS), the Positive and Negative Syndrome Scale (PANSS), and the Montreal Cognitive Assessment Scale (MoCA). Multiplex assays for plasma proteins were conducted with Luminex xMAP technology. Additionally, miRNA levels were quantitatively determined through RNA extraction, cDNA synthesis, and RT-qPCR on a 7500 Fast Real-Time PCR System. Results Among miRNAs, only miR-29a-3p exhibited a significant correlation with PAS-C scores (r = -0.513, p = 0.025) and cognitive improvement (r = -0.505, p = 0.033). Among the analyzed proteins, only GDNF showed correlations with MoCA scores at the baseline and after 3 months (r = 0.533, p = 0.0189 and r = 0.598, p = 0.007), cognitive improvement (r = 0.511, p = 0.025), and CTQ subtests. MIF concentrations correlated with the PAS-C subscale (r = -0.5670, p = 0.011). Conclusion GDNF and miR-29a-3p are promising as biomarkers for understanding and addressing cognitive deficits in psychosis. This study links miRNA and MIF to premorbid adjustment and reveals GDNF's unique role in connection with childhood trauma.
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Affiliation(s)
- Marta Szwajca
- Department of Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Grzegorz Kazek
- Department of Pharmacological Screening, Jagiellonian University Medical College, Krakow, Poland
| | - Natalia Śmierciak
- Department of Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Józef Mizera
- Department of Toxicology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Krzysztof Szwajca
- Department of Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Beata Biesaga
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Maciej Pilecki
- Department of Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Fares-Otero NE, Alameda L, Pfaltz MC, Martinez-Aran A, Schäfer I, Vieta E. Examining associations, moderators and mediators between childhood maltreatment, social functioning, and social cognition in psychotic disorders: a systematic review and meta-analysis. Psychol Med 2023; 53:5909-5932. [PMID: 37458216 PMCID: PMC10520610 DOI: 10.1017/s0033291723001678] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/11/2023] [Accepted: 05/23/2023] [Indexed: 07/24/2023]
Abstract
Childhood maltreatment (CM) has been related to social functioning and social cognition impairment in people with psychotic disorders (PD); however, evidence across different CM subtypes and social domains remains less clear. We conducted a systematic review and meta-analysis to quantify associations between CM, overall and its different subtypes (physical/emotional/sexual abuse, physical/emotional neglect), and domains of social functioning and social cognition in adults with PD. We also examined moderators and mediators of these associations. A PRISMA-compliant systematic search was performed on 24 November 2022 (PROSPERO CRD42020175244). Fifty-three studies (N = 13 635 individuals with PD) were included in qualitative synthesis, of which 51 studies (N = 13 260) with 125 effects sizes were pooled in meta-analyses. We found that CM was negatively associated with global social functioning and interpersonal relations, and positively associated with aggressive behaviour, but unrelated to independent living or occupational functioning. There was no meta-analytic evidence of associations between CM and social cognition. Meta-regression analyses did not identify any consistent moderation pattern. Narrative synthesis identified sex and timing of CM as potential moderators, and depressive symptoms and maladaptive personality traits as possible mediators between CM and social outcomes. Associations were of small magnitude and limited number of studies assessing CM subtypes and social cognition are available. Nevertheless, adults with PD are at risk of social functioning problems after CM exposure, an effect observed across multiple CM subtypes, social domains, diagnoses and illness stages. Maltreated adults with PD may thus benefit from trauma-related and psychosocial interventions targeting social relationships and functioning.
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Affiliation(s)
- Natalia E. Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Luis Alameda
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, University Hospital (CHUV), Lausanne, Switzerland
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Department of Psychiatry, CIBERSAM, Institute of Biomedicine of Sevilla (IBIS), University Hospital Virgen del Rocio, University of Seville, Seville, Spain
| | - Monique C. Pfaltz
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Anabel Martinez-Aran
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic Barcelona, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences University of Barcelona (UB), Barcelona, Catalonia, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Catalonia, Spain
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3
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Penney D, Pruessner M, Malla AK, Joober R, Lepage M. Severe childhood trauma and emotion recognition in males and females with first-episode psychosis. Early Interv Psychiatry 2023; 17:149-158. [PMID: 35384318 DOI: 10.1111/eip.13299] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/25/2022] [Accepted: 03/13/2022] [Indexed: 11/27/2022]
Abstract
AIM Childhood trauma increases social functioning deficits in first-episode psychosis (FEP) and is negatively associated with higher-order social cognitive processes such as emotion recognition (ER). We investigated the relationship between childhood trauma severity and ER capacity, and explored sex as a potential factor given sex differences in childhood trauma exposure. METHODS Eighty-three FEP participants (52 males, 31 females) and 69 nonclinical controls (49 males, 20 females) completed the CogState Research Battery. FEP participants completed the Childhood Trauma Questionnaire. A sex × group (FEP, controls) ANOVA examined ER differences and was followed by two-way ANCOVAs investigating sex and childhood trauma severity (none, low, moderate, and severe) on ER and global cognition in FEP. RESULTS FEP participants had significantly lower ER scores than controls (p = .035). No significant sex × group interaction emerged for ER F(3, 147) = .496, p = .438 [95% CI = -1.20-0.57], partial η2 = .003. When controlling for age at psychosis onset, a significant interaction emerged in FEP between sex and childhood trauma severity F(3, 71) = 3.173, p = .029, partial η2 = .118. Males (n = 9) with severe trauma showed ER deficits compared to females (n = 8) (p = .011 [95% CI = -2.90 to -0.39]). No significant interaction was observed for global cognition F(3, 69) = 2.410, p = .074, partial η2 = .095. CONCLUSIONS These preliminary findings provide support for longitudinal investigations examining whether trauma severity differentially impacts ER in males and females with FEP.
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Affiliation(s)
- Danielle Penney
- Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Marita Pruessner
- Douglas Mental Health University Institute, Montréal, Canada
- Department of Clinical Psychology, University of Konstanz, Konstanz, Germany
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Ashok K Malla
- Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Ridha Joober
- Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, Montréal, Canada
- Department of Psychiatry, McGill University, Montréal, Canada
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4
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Steenkamp LR, Parrish EM, Chalker SA, Badal VD, Pinkham AE, Harvey PD, Depp CA. Childhood trauma and real-world social experiences in psychosis. Schizophr Res 2023; 252:279-286. [PMID: 36701936 DOI: 10.1016/j.schres.2022.12.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/30/2022] [Accepted: 12/28/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Childhood trauma is associated with a variety of negative outcomes in psychosis, but it is unclear clear if childhood trauma affects day-to-day social experiences. We aimed to examine the association between childhood trauma and functional and structural characteristics of real-world social relationships in psychosis. METHODS Participants with psychotic disorders or affective disorders with psychosis completed ecological momentary assessments (EMAs) over ten days (N = 209). Childhood trauma was assessed retrospectively using the Childhood Trauma Questionnaire. Associations between childhood trauma and EMA-assessed social behavior and perceptions were examined using linear mixed models. Analyses were adjusted for sociodemographic characteristics and psychotic and depressive symptom severity. RESULTS Higher levels of childhood trauma were associated with more perceived threat (B = -0.19, 95 % CI [-0.33, -0.04]) and negative self-perception (B = -0.18, 95 % CI [-0.34, -0.01]) during recent social interactions, as well as reduced social motivation (B = -0.29, 95 % CI [-0.47, -0.10]), higher desire for social avoidance (B = 0.34, 95 % CI [0.14, 0.55]), and lower sense of belongingness (B = -0.24, 95 % CI [-0.42, -0.06]). These negative social perceptions were mainly linked with emotional abuse and emotional neglect. In addition, paranoia was more strongly associated with negative social perceptions in individuals with high versus low levels of trauma. Childhood trauma was not associated with frequency (i.e., time spent alone) or type of social interactions. CONCLUSION Childhood trauma - particularly emotional abuse and neglect - is associated with negative social perceptions but not frequency of real-world social interactions. Our findings suggest that childhood trauma may affect day-to-day social experiences beyond its association with psychosis.
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Affiliation(s)
- Lisa R Steenkamp
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Emma M Parrish
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States; San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Samantha A Chalker
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States; Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| | - Varsha D Badal
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States; Stein Institute for Research on Aging, University of California San Diego, San Diego, CA, United States
| | - Amy E Pinkham
- Department of Psychology, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, United States; Research Service, Bruce W. Carter VA Medical Center, Miami, FL, United States
| | - Colin A Depp
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States; Veterans Affairs San Diego Healthcare System, San Diego, CA, United States; Stein Institute for Research on Aging, University of California San Diego, San Diego, CA, United States.
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5
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Scholte-Stalenhoef AN, Pijnenborg GHM, Hasson-Ohayon I, Boyette LL. Personality traits in psychotic illness and their clinical correlates: A systematic review. Schizophr Res 2023; 252:348-406. [PMID: 36804473 DOI: 10.1016/j.schres.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 12/18/2022] [Accepted: 01/02/2023] [Indexed: 02/17/2023]
Abstract
This systematic review focuses on personality traits according to both the Five Factor Model and Cloninger Psychobiological Model in relation to treatment related outcome variables across all stages of clinical psychotic illness. Search of Pubmed and Psychinfo databases led to final inclusion of 65 studies, which were ranked on quality and analyzed according to the associations between personality and outcome. Main findings are that higher levels of Harm Avoidance and Neuroticism are associated with higher symptom levels, tendency towards passive coping, greater self-stigma, lower quality of life, and Harm Avoidance to higher suicidality. Higher levels of Extraversion and higher levels of Self-Directedness are associated with more preference for active coping, more intrinsic motivation and higher self-esteem. Higher Novelty Seeking is related to more substance use and aggression, in men specifically. On outcome of trauma, care consumption and duration of untreated illness no consistent associations with personality traits were found. Combined evidence from both personality models however reveals a consistent pattern of personality traits related to clinical outcome in psychotic disorder, which is discussed in a dimensional manner.
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Affiliation(s)
- Anne Neeltje Scholte-Stalenhoef
- Ziekenhuis Groep Twente, Department of Psychiatry, Almelo, the Netherlands; University of Groningen, Department of Psychology, Groningen, the Netherlands.
| | | | | | - Lindy-Lou Boyette
- University of Amsterdam, Department of Clinical Psychology, Amsterdam, the Netherlands
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6
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Rosenfield PJ, Jiang D, Pauselli L. Childhood adversity and psychotic disorders: Epidemiological evidence, theoretical models and clinical considerations. Schizophr Res 2022; 247:55-66. [PMID: 34210561 DOI: 10.1016/j.schres.2021.06.005] [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: 02/28/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 02/08/2023]
Abstract
While genetic factors play a critical role in the risk for schizophrenia and other psychotic disorders, increasing evidence points to the role of childhood adversity as one of several environmental factors that can significantly impact the development, manifestations and outcome of these disorders. This paper reviews the epidemiological evidence linking childhood adversity and psychotic disorders and explores various theoretical models that seek to explain the connection. We discuss neurobiological parallels between the impact of childhood trauma and psychosis on the brain and then explore the impact of childhood adversity on different domains of clinical presentation. Finally, implications for prevention and treatment are considered, both on individual and structural levels.
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Affiliation(s)
- Paul J Rosenfield
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
| | - David Jiang
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
| | - Luca Pauselli
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, United States of America.
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7
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Adanty C, Qian J, Wang Y, Remington G, Shakeri A, Borlido C, Gerretsen P, Graff-Guerrero A, De Luca V. Childhood trauma exposure and personality traits in schizophrenia patients. Schizophr Res 2022; 241:221-227. [PMID: 35158178 DOI: 10.1016/j.schres.2022.01.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 12/31/2021] [Accepted: 01/19/2022] [Indexed: 11/15/2022]
Abstract
Childhood trauma in schizophrenia (SCZ) is associated with aberrant neurobiological downstream effects and cognitive deficits that markedly hinder patient outcome and functioning. However, the relationship between specific forms of childhood abuse and the tendency for certain personality traits in patients with SCZ has not been comprehensively studied yet. We recruited 374 SCZ patients and screened for history of physical abuse (PA), emotional abuse (EA), sexual abuse (SA), physical neglect (PN) and emotional neglect (EN) using the Childhood Trauma Questionnaire and measured personality traits using the NEO Five-Factor inventory. Using CTQ cut-off scores, the prevalence of EA, PA, SA, EN and PN was 60.7%, 42.0%, 37.7%, 64.2% and 54.3% respectively. Exposure to any form of childhood abuse was associated with increased neuroticism. Exposure to EA, SA, PN and EN was correlated with decreased agreeableness and conscientiousness scores. PN, EN and PA exposure was associated with decreased openness while EA, PN and EN exposure was associated with decreased extraversion. Furthermore, a positive correlation was found between all forms of childhood abuse and trait neuroticism whereas negative correlations were found between certain forms of childhood abuse and all other personality traits. Exposure to specific forms of childhood abuse was associated with specific personality traits in patients with SCZ.
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Affiliation(s)
| | - Jessica Qian
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Yin Wang
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Gary Remington
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Ahmad Shakeri
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Carol Borlido
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Philip Gerretsen
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Ariel Graff-Guerrero
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Vincenzo De Luca
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Ontario, Canada.
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8
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Khosravi M, Bakhshani NM, Kamangar N. Dissociation as a causal pathway from sexual abuse to positive symptoms in the spectrum of psychotic disorders. BMC Psychiatry 2021; 21:266. [PMID: 34024281 PMCID: PMC8142477 DOI: 10.1186/s12888-021-03290-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/18/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Although numerous studies have supported the role of childhood maltreatment in the etiology of psychosis, underlying mechanisms have not been well understood yet. The present study aimed to investigate the mediating role of particular forms of dissociation in the relationship between five major types of childhood abuse and psychotic symptoms among patients with schizophrenia spectrum and other psychotic disorders. METHODS In this cross-sectional correlation study, 70 first-episode psychotic patients and 70 chronic psychotic patients were selected by systematic random sampling (with the sampling interval of 3) from among inpatients and outpatients referring to Baharan Psychiatric hospital, Zahedan, Iran, and were matched based on age, gender, and education level. Moreover, 70 age-, gender-, and education level-matched community controls were recruited from hospital staff and their relatives and friends. All of the participants completed a research interview and questionnaires. Data on experiences of childhood maltreatment, psychosis, dissociation, and demographics were collected and analyzed by SPSS V25 software. RESULTS The obtained results revealed that the mean scores of sexual abuse, emotional abuse, and physical abuse were higher in psychotic patients than community controls (without any significant difference between first-episode psychotic patients and chronic psychotic patients). Furthermore, the highest mean scores of dissociative experiences belonged to chronic psychotic patients. Multiple-mediation also indicated that absorption and dissociative amnesia played a mediating role in the relationship between sexual abuse and positive symptoms. Moreover, this study demonstrated the role of physical abuse in predicting psychotic symptoms even in the absence of sexual abuse. CONCLUSIONS This study illustrated specific associations among childhood maltreatment, dissociative experiences, and psychotic symptoms in the clinical population. Thus, to provide appropriate interventions, patients with schizophrenia spectrum and other psychotic disorders were asked about a wide range of possible adverse childhood experiences and dissociative experiences. Nevertheless, further studies using prospective or longitudinal designs need to be carried out to realize the differential contribution of various forms of childhood maltreatment and their potential interactions, more precisely.
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Affiliation(s)
- Mohsen Khosravi
- Department of Psychiatry and Clinical Psychology, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Nour-Mohammad Bakhshani
- grid.488433.00000 0004 0612 8339Department of Psychology, Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Niloofar Kamangar
- grid.488433.00000 0004 0612 8339General Practitioner, Zahedan University of Medical Sciences, Zahedan, Iran
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López-Mongay D, Ahuir M, Crosas JM, Navarro JB, Monreal JA, Obiols JE, Palao D. The Effect of Child Sexual Abuse on Social Functioning in Schizophrenia Spectrum Disorders. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP3480-NP3494. [PMID: 29884109 DOI: 10.1177/0886260518779074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The objective of this study was to explore social functioning in schizophrenic patients who have suffered child sexual abuse (CSA) in comparison with those who have not suffered from it in a Spanish sample of 50 patients with schizophrenia or schizoaffective disorder. The Quality of Life (QOL) Scale, the Childhood Trauma Questionnaire (CTQ-SF), and the NEO Five Factor Inventory (NEO-FFI) were administered in this study. We found a CSA prevalence of 22% in our sample. Results showed that QOL global scores reduced by 9.34% at a statistically significant level (p = .037) in sexually abused patients in comparison with those who did not report experiencing sexual abuse. Regression analysis in the QOL scales showed no differences in intrapsychic foundation scores or in the social relations scale. Scores in the instrumental role scale were reduced by 4.42 points in patients with CSA (p = .009). Neither neuroticism nor extraversion results differ between the trauma group and those who did not suffer trauma. Clinical implications of these results are discussed.
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Affiliation(s)
- Daniel López-Mongay
- Universitat Autònoma de Barcelona, Facultat de Psicologia, Bellaterra, Spain
| | - Maribel Ahuir
- Universtiat Autònoma de Barcelona, Facultat de Medicina, Bellaterra, Spain
- Servei de Salut Mental, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - Josep Mª Crosas
- Servei de Salut Mental, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - J Blas Navarro
- Universitat Autònoma de Barcelona, Facultat de Psicologia, Bellaterra, Spain
| | | | - Jordi E Obiols
- Universitat Autònoma de Barcelona, Facultat de Psicologia, Bellaterra, Spain
| | - Diego Palao
- Universtiat Autònoma de Barcelona, Facultat de Medicina, Bellaterra, Spain
- Servei de Salut Mental, Parc Taulí Hospital Universitari, Sabadell, Spain
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10
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Weitkämper A, Kellner M, Iffland JR, Driessen M, Kley H, Neuner F, Iffland B. Childhood Maltreatment in Individuals With Schizophrenia Spectrum Disorders: The Impact of Cut-Off Scores on Prevalence Rates. Front Psychiatry 2021; 12:692492. [PMID: 34295277 PMCID: PMC8291124 DOI: 10.3389/fpsyt.2021.692492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
Childhood maltreatment is a common phenomenon in various psychiatric disorders. Accordingly, patients with disorders from the schizophrenia spectrum (SSD) appear to have high prevalence rates of childhood maltreatment. However, the interpretation and comparability of prevalence rates is impeded by methodological weaknesses and differences such as measures and thresholds used in previous studies. Therefore, we aimed to provide and compare systematically captured data on prevalence rates of all common types of childhood maltreatment in patients with SSD using a standardized and well-established questionnaire and the most frequently used thresholds. The sample consisted of 48 patients with a primary diagnosis of SSD. 58.3-77.1% of the sample experienced at least one type of childhood maltreatment. Prevalence rates for physical abuse, physical neglect, and emotional abuse were dependent on the thresholds used, while equal rates were found for emotional neglect and sexual abuse. Physical neglect (46-67%), and emotional abuse (44-48%) were most commonly reported, followed by emotional neglect (38%), physical abuse (25-38%), and sexual abuse (25%). Additionally, high levels of peer victimization were reported by SSD patients. It appears that childhood maltreatment is a common phenomenon in SSD, even though methodological details, especially cut-off scores, have a substantial impact on the prevalence rates that are determined. Therefore, the methodology of studies should be closely examined when drawing conclusions from presented prevalence rates.
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Affiliation(s)
- Angelina Weitkämper
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Michael Kellner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital Herford, Herford, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | - Martin Driessen
- Clinic of Psychiatry and Psychotherapy Bethel, Bielefeld, Germany
| | - Hanna Kley
- Department of Clinical Psychology and Psychotherapy, Outpatient Clinic, Bielefeld University, Bielefeld, Germany
| | - Frank Neuner
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Benjamin Iffland
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
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11
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Rokita KI, Dauvermann MR, Mothersill D, Holleran L, Holland J, Costello L, Cullen C, Kane R, McKernan D, Morris DW, Kelly J, Gill M, Corvin A, Hallahan B, McDonald C, Donohoe G. Childhood trauma, parental bonding, and social cognition in patients with schizophrenia and healthy adults. J Clin Psychol 2020; 77:241-253. [DOI: 10.1002/jclp.23023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/18/2020] [Accepted: 06/04/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Karolina I. Rokita
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Maria R. Dauvermann
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - David Mothersill
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Laurena Holleran
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Jessica Holland
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Laura Costello
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Caroline Cullen
- Wellcome—HRB Clinical Research Facility St. James's Hospital Dublin Ireland
- Department of Psychiatry, Trinity Centre for Health Sciences St. James's Hospital Dublin Ireland
| | - Ruán Kane
- School of Psychology National University of Ireland Galway Galway Ireland
- Department of Psychiatry, Trinity Centre for Health Sciences St. James's Hospital Dublin Ireland
| | - Declan McKernan
- Department of Pharmacology and Therapeutics, School of Medicine National University of Ireland Galway Galway Ireland
| | - Derek W. Morris
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - John Kelly
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
| | - Michael Gill
- Department of Psychiatry, Trinity Centre for Health Sciences St. James's Hospital Dublin Ireland
| | - Aiden Corvin
- Department of Psychiatry, Trinity Centre for Health Sciences St. James's Hospital Dublin Ireland
| | - Brian Hallahan
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
- Department of Psychiatry, Clinical Science Institute National University of Ireland Galway Galway Ireland
| | - Colm McDonald
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
- Department of Psychiatry, Clinical Science Institute National University of Ireland Galway Galway Ireland
| | - Gary Donohoe
- School of Psychology National University of Ireland Galway Galway Ireland
- Centre for Neuroimaging and Cognitive Genomics National University of Ireland Galway Galway Ireland
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12
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Nettis MA, Pariante CM, Mondelli V. Early-Life Adversity, Systemic Inflammation and Comorbid Physical and Psychiatric Illnesses of Adult Life. Curr Top Behav Neurosci 2020; 44:207-225. [PMID: 30895531 DOI: 10.1007/7854_2019_89] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recently, the evidence of increased immune activation in patients with schizophrenia has suggested a role for the immune system in the development of psychosis. However, what is causing this increased immune activation and how this leads to the development of psychopathology remain still unclear. In this chapter we discuss the evidence about the role of childhood trauma as possible underlying cause of the increased immune activation in patients with schizophrenia. According to preclinical and clinical models, early adverse events can disrupt the homeostatic control of immune responses and lead to enduring inflammatory dysregulation at a peripheral and central level. In fact, persisting systemic inflammation may facilitate peripheral tissues damage and breach the blood-brain barrier, leading to microglia activation and to neuroinflammation.Such chronic immune dysregulation also appear to partially explain the frequent comorbidity between psychosis and metabolic abnormalities, which have previously mainly considered as side effect of antipsychotic treatment.Overall, this evidence suggests that early stress may contribute to development of schizophrenia spectrum disorders through a modulation of the peripheral and central immune system and support the immune pathways as possible future therapeutic approach for psychosis.
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Affiliation(s)
- Maria Antonietta Nettis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, 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
| | - Carmine M Pariante
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, 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
| | - Valeria Mondelli
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, 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.
- Maurice Wohl Clinical Neuroscience Institute , London, UK.
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13
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Kim Y, Kwon A, Min D, Kim S, Jin MJ, Lee SH. Neurophysiological and Psychological Predictors of Social Functioning in Patients with Schizophrenia and Bipolar Disorder. Psychiatry Investig 2019; 16:718-727. [PMID: 31587532 PMCID: PMC6801316 DOI: 10.30773/pi.2019.07.28] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/28/2019] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The aim of this study is to examine social functioning in patients with schizophrenia and bipolar disorder and explore the psychological and neurophysiological predictors of social functioning. METHODS Twenty-seven patients with schizophrenia and thirty patients with bipolar disorder, as well as twenty-five healthy controls, completed measures of social functioning (questionnaire of social functioning), neurocognition (Verbal fluency, Korean-Auditory Verbal Learning Test), and social cognition (basic empathy scale and Social Attribution Task-Multiple Choice), and the childhood trauma questionnaire (CTQ). For neurophysiological measurements, mismatch negativity and heart rate variability (HRV) were recorded from all participants. Multiple hierarchical regression was performed to explore the impact of factors on social functioning. RESULTS The results showed that CTQ-emotional neglect significantly predicted social functioning in schizophrenia group, while HRV-high frequency significantly predicted social functioning in bipolar disorder patients. Furthermore, emotional neglect and HRV-HF still predicted social functioning in all of the subjects after controlling for the diagnostic criteria. CONCLUSION Our results implicated that even though each group has different predictors of social functioning, early traumatic events and HRV could be important indicators of functional outcome irrespective of what group they are.
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Affiliation(s)
- Yourim Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Aeran Kwon
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Dongil Min
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Sungkean Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea.,Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Min Jin Jin
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea.,Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang, Republic of Korea
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14
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Thomas S, Höfler M, Schäfer I, Trautmann S. Childhood maltreatment and treatment outcome in psychotic disorders: a systematic review and meta-analysis. Acta Psychiatr Scand 2019; 140:295-312. [PMID: 31357235 DOI: 10.1111/acps.13077] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Childhood maltreatment (CM) plays an important role in the aetiology and course of psychotic disorders and is associated with characteristics that could be relevant for treatment. We aimed to conduct a systematic review and meta-analysis on the association between CM and treatment outcome in psychotic disorders. METHODS Treatment outcome was defined as change in psychotic symptoms or in social or occupational functioning between first and last reported measurement in the course of a pharmacological and/or psychological treatment. RESULTS Twelve treatment results from seven studies (636 patients, average treatment duration: 59.2 weeks) were included. CM was related to poorer treatment outcomes in psychotic disorders (OR = 1.51, 95% CI = [1.08, 2.10]). There is evidence that this association might increase with illness duration and increasing age and might be stronger in schizophrenia samples. CONCLUSIONS Childhood maltreatment is highly understudied with regard to treatment outcome in psychotic disorders. The need for more studies is emphasized by the fact that this meta-analysis reveals evidence for a poorer treatment response in patients with CM. If this association is confirmed, the identification of patients with CM and the consideration of associated clinical and biological conditions could contribute to improve treatment outcome in psychotic disorders.
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Affiliation(s)
- S Thomas
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - I Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Trautmann
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychology, Medical School Hamburg, Hamburg, Germany
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15
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Further Exploration of Personal and Social Functioning: The Role of Interpersonal Violence, Service Engagement, and Social Network. J Nerv Ment Dis 2019; 207:832-837. [PMID: 31365432 DOI: 10.1097/nmd.0000000000001036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Social functioning (SF) has mainly been studied in major psychoses in relation to symptom severity, but other factors may interfere with the achievement of a functional remission. The aim of this study is to explore interpersonal violence (IV), service engagement (SE), and social network (SN), together with demographics, as predictors of SF in a sample of subjects with severe mental illness (SMI). Consecutive adult inpatients were evaluated using self-report and clinician-rated questionnaires. Findings suggest that IV, SE, SN, male sex, and illness duration explained 39.1% of SF variance in people affected by SMI. IV was the strongest predictor, followed by sex and duration of illness. Lifetime expression of violence is a stronger predictor than lifetime exposure to violence. Positive SE and SN were found to predict SF, whereas age was not associated. This study underlines the need of other non-symptom-related variables for the comprehension of SF in mental disorders.
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16
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Grattan RE, Lara N, Botello RM, Tryon VL, Maguire AM, Carter CS, Niendam TA. A History of Trauma is Associated with Aggression, Depression, Non-Suicidal Self-Injury Behavior, and Suicide Ideation in First-Episode Psychosis. J Clin Med 2019; 8:E1082. [PMID: 31340527 PMCID: PMC6678563 DOI: 10.3390/jcm8071082] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/11/2019] [Accepted: 07/18/2019] [Indexed: 12/18/2022] Open
Abstract
The association between trauma and psychosis outcomes is well-established, and yet the impact of trauma on comorbid clinical symptoms-such as aggression, non-suicidal self-injury behavior (NSSIB), suicide ideation, and suicide behavior-for those with psychosis is unclear. To effectively treat those with first-episode psychosis (FEP) and a history of trauma, we need to understand the impact of trauma on their whole presentation. FEP participants were recruited from an Early Psychosis Program (N = 187, ages 12-35, 72.2% male). Clinicians gathered history of trauma, aggression, and suicide data, and rated current symptom severity and functioning. Data was coded using clinician rated measures, self-report measures, and retrospective clinical chart review. Regression analyses examined whether trauma was associated with a history of aggression, suicidal ideation, suicide behavior, NSSIB, symptoms, and functioning. Trauma was associated with aggression, aggression severity and type of aggression (aggression towards others). Trauma was also associated with depression severity, suicide ideation, most severe suicide ideation, and NSSIB. Trauma was not associated with suicide behavior, severity of suicide behavior or psychosocial functioning. Integrating trauma treatment into FEP care could reduce rates of depression, aggression, suicide ideation, and NSSIB for those with a history of trauma. To reduce suicide attempt occurrence and improve functioning, more research is needed.
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Affiliation(s)
- Rebecca E Grattan
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento, CA 95817, USA
| | - Natalia Lara
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento, CA 95817, USA
| | - Renata M Botello
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento, CA 95817, USA
| | - Valerie L Tryon
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento, CA 95817, USA
| | - Adrienne M Maguire
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento, CA 95817, USA
| | - Cameron S Carter
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento, CA 95817, USA
| | - Tara A Niendam
- Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento, CA 95817, USA.
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17
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Cortisol response to stress in schizophrenia: Associations with oxytocin, social support and social functioning. Psychiatry Res 2018; 270:1047-1052. [PMID: 29960725 DOI: 10.1016/j.psychres.2018.05.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 04/06/2018] [Accepted: 05/02/2018] [Indexed: 11/21/2022]
Abstract
Previous studies reported attenuated cortisol reactivity as one explanation for poor social functioning in schizophrenia. Recent research has demonstrated that both glucocorticoid and oxytocin systems are central to stress regulation. Here, we studied the associations between basal oxytocin, stress-induced cortisol levels, and social functioning and social support in schizophrenia. A mock job interview was used as an ecologically-valid social stressor in 32 schizophrenia patients. Blood samples were taken before and after stress induction to assess basal oxytocin and cortisol levels. In addition social functioning and social support scales were collected. Patients were divided into cortisol responders and non-responders according to percentage change following stress induction. Our findings revealed a possible subgroup of patients who did not exhibit attenuated cortisol responses. Importantly, cortisol responders had generally better social functioning, but perceived social support was not different between groups. There was also no evidence of a relationship between cortisol and oxytocin. This study highlights the heterogeneity of cortisol responses to stress in a schizophrenia population, and the importance of the relationship between social functioning and cortisol reactivity. These findings could be relevant when considering therapeutic interventions that manipulate endocrinology in order to improve real-world functioning.
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18
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Wang D, Lu S, Gao W, Wei Z, Duan J, Hu S, Huang M, Xu Y, Li L. The Impacts of Childhood Trauma on Psychosocial Features in a Chinese Sample of Young Adults. Psychiatry Investig 2018; 15:1046-1052. [PMID: 30380816 PMCID: PMC6258995 DOI: 10.30773/pi.2018.09.26] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 09/26/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The aims of the present study were to explore the occurrence of childhood trauma and importantly to determine the impacts of childhood trauma on psychosocial features in a Chinese sample of young adults. METHODS A survey was carried out in a group of 555 university students by using Childhood Trauma Questionnaire (CTQ), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Dysfunctional Attitudes Questionnaire (DAS), Eysenck Personality Questionnaire (EPQ), and Social Support Rating Scale (SSRS). The moderate-severe cut-off scores for CTQ were used to calculate the prevalence of childhood trauma, and then psychosocial features were compared between individuals with and without childhood trauma. RESULTS A proportion of 18.6% of university students had self-reported childhood trauma exposures. Subjects with childhood trauma reported higher scores of SDS, SAS, DAS, and psychoticism and neuroticism dimensions of EPQ (t=4.311-5.551, p<0.001); while lower scores of SSRS and extraversion dimension of EPQ (t=-4.061- -3.039, p<0.01). Regression analyses further revealed that scores of SAS and DAS were positively (Adjusted B=0.211-0.230, p<0.05), while scores of SSRS were negatively (Adjusted B=-0.273- -0.240, p<0.05) associated with specific CTQ scores. CONCLUSION Childhood trauma is still a common social and psychological problem. Individuals with childhood trauma show much more depression, anxiety, distorted cognition, personality deficits, and lower levels of social support, which may represent the social and psychological vulnerability for developing psychiatric disorders after childhood trauma experiences.
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Affiliation(s)
- Dandan Wang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
| | - Shaojia Lu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
| | - Weijia Gao
- Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhaoguo Wei
- Mental Health Institute of The Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China.,Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, China
| | - Jinfeng Duan
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
| | - Manli Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
| | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, China
| | - Lingjiang Li
- Mental Health Institute of The Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
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19
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Zalzala AB, Gagen EC, Lysaker PH. Recovery and Personhood in the Diagnostic Formulation and Treatment of Serious Mental Illness: A Commentary. JOURNAL OF HUMANISTIC PSYCHOLOGY 2018. [DOI: 10.1177/0022167818788758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present article is a commentary on Pavlo and colleagues’ alternative person centered and recovery oriented diagnostic framework. Three strengths of the framework are identified, including the incorporation of an individual’s environment into the diagnostic formulation, an emphasis on individual strengths and the belief that they exist regardless of illness severity, and a resulting avoidance of stigmatization related to diagnostic labeling. Three potential areas of challenge and clarification are also identified, including how this approach is linked to outcome, how it is created through dialogue, and with what it is systematically concerned. Discussion of these challenges and suggestions for potential resolution are provided.
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Affiliation(s)
- Aieyat B. Zalzala
- Purdue University, West Lafayette, IN, USA
- Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Emily C. Gagen
- Roudebush VA Medical Center, Indianapolis, IN, USA
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Paul H. Lysaker
- Roudebush VA Medical Center, Indianapolis, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
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20
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Rhodes JE, O'Neill ND, Nel PW. Psychosis and sexual abuse: An interpretative phenomenological analysis. Clin Psychol Psychother 2018; 25:540-549. [PMID: 29575483 DOI: 10.1002/cpp.2189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 12/16/2017] [Accepted: 02/07/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVES This study aimed to investigate the first-person perspective of psychosis sufferers who survived childhood sexual abuse. METHODS Interpretative phenomenological analysis was employed to explore the experiences of 7 women with a history of sexual abuse and psychosis. RESULTS Analysis generated six themes: (a) degradation of self, interlinking shame, guilt, and sometimes disgust; (b) body-self entrapment, experiencing bodily constraint and distortion; (c) a sense of being different to others, involving interpersonal problems; (d) unending struggle and depression, a pervasive sense of defeat; (e) psychotic condemnations and abuse, describing psychotic phenomena related to harm and sexual abuse; and (f) perception of links to the past, the links made from past abuse to current functioning. CONCLUSION Participants suffered extreme psychological, physical, and interpersonal difficulties past and present. Psychotic experiences reported exhibited themes of condemnation by external entities and reflected the topic of sexual abuse. Participants did not generally link psychosis to their past abusive experiences.
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Affiliation(s)
- J E Rhodes
- Early Intervention Service (Tower Hamlets), East London NHS Foundation Trust, London, UK
- Department of Psychology & Sport Sciences, University of Hertfordshire, Hatfield, UK
| | - N D O'Neill
- Department of Psychology & Sport Sciences, University of Hertfordshire, Hatfield, UK
| | - P W Nel
- Department of Psychology & Sport Sciences, University of Hertfordshire, Hatfield, UK
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21
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van Os J, van der Steen Y, Islam MA, Gülöksüz S, Rutten BP, Simons CJ. Evidence that polygenic risk for psychotic disorder is expressed in the domain of neurodevelopment, emotion regulation and attribution of salience. Psychol Med 2017; 47:2421-2437. [PMID: 28436345 DOI: 10.1017/s0033291717000915] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The liability-threshold model of psychosis risk predicts stronger phenotypic manifestation of the polygenic risk score (PRS) in the healthy relatives of patients, as compared with healthy comparison subjects. METHODS First-degree relatives of patients with psychotic disorder (871 siblings and 812 parents) and healthy comparison subjects (n = 523) were interviewed three times in 6 years. Repeated measures of two psychosis phenotypes, the Community Assessment of Psychic Experiences (CAPE; self-report - subscales of positive, negative and depressive symptoms) and the Structured Interview for Schizotypy - Revised (SIS-R; clinical interview - subscales of positive and negative schizotypy), were examined for association with PRS. Interview-based lifetime rate of depressive and manic episodes were also examined, as was association with repeated measures of intelligence quotient (IQ). RESULTS In the relatives, PRS was associated with CAPE/SIS-R total score (respectively, B = 0.12, 95% CI 0.02-0.22 and B = 0.11, 95% CI 0.02-0.20), the SIS-R positive subscale (B = 0.16, 95% CI 0.04-0.28), the CAPE depression subscale (B = 0.21, 95% CI 0.07-0.34), any lifetime affective episode (OR 3.1, 95% CI 1.04-9.3), but not with IQ (B = -1.8, 95% CI -8.0 to 4.4). In the controls, similar associations were apparent between PRS on the one hand and SIS-R total score, SIS-R positive, SIS-R negative, any lifetime affective episode and, in contrast, lower IQ (B = -8.5, 95% CI -15.5 to -1.6). CONCLUSIONS In non-ill people, polygenic risk for psychotic disorder is expressed pleiotropically in the domain of neurodevelopment, emotion regulation and attribution of salience. In subjects at elevated genetic risk, emerging expression of neurodevelopmental alterations may create floor effects, obscuring genetic associations.
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Affiliation(s)
- J van Os
- Department of Psychiatry and Psychology,Maastricht University Medical Centre,Maastricht,The Netherlands
| | - Y van der Steen
- Department of Psychiatry and Psychology,Maastricht University Medical Centre,Maastricht,The Netherlands
| | - Md A Islam
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry,Groningen,The Netherlands
| | - S Gülöksüz
- Department of Psychiatry and Psychology,Maastricht University Medical Centre,Maastricht,The Netherlands
| | - B P Rutten
- Department of Psychiatry and Psychology,Maastricht University Medical Centre,Maastricht,The Netherlands
| | - C J Simons
- Department of Psychiatry and Psychology,Maastricht University Medical Centre,Maastricht,The Netherlands
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22
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Alameda L, Golay P, Baumann PS, Progin P, Mebdouhi N, Elowe J, Ferrari C, Do KQ, Conus P. Mild Depressive Symptoms Mediate the Impact of Childhood Trauma on Long-Term Functional Outcome in Early Psychosis Patients. Schizophr Bull 2017; 43:1027-1035. [PMID: 27884931 PMCID: PMC5581905 DOI: 10.1093/schbul/sbw163] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The mechanism linking childhood trauma (CT) to the functional deficits observed in early psychosis (EP) patients is as yet unknown. We aim to examine the potential mediating effect of depressive symptoms in this well-established association. METHODS Two hundred nine EP subjects aged 18-35 were assessed for functioning and psychopathology after 2, 6, 12, 18, 24, 30, and 36 months of treatment. Patients were classified into early trauma if they had faced at least one experience of abuse (physical, sexual, or emotional) or neglect (physical or emotional) before age 12, and late trauma if the exposure had occurred between ages 12 and 16. Diagnosis was based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Psychopathology was assessed with the Positive and Negative Syndrome Scale and the Montgomery-Asberg Depression Rating Scale. Functioning was measured with the Global Assessment of Functioning (GAF) and the Social and Occupational Functioning Assessment Scale (SOFAS). Mediation analyses were performed in order to study whether the relationship between CT and functioning was mediated by depressive symptoms. RESULTS When compared with nonexposed patients, early but not late trauma patients showed lower levels of GAF and SOFAS scores over all the time points, excepting after the first assessment. After 30 and 36 months, the effect of early trauma on functioning was completely mediated by depressive symptoms. No mediating effect of positive or negative symptoms was highlighted at those time points. CONCLUSION Mild depressive symptoms mediated the impact of early trauma on long-term functional outcome. Intensifying pharmacologic and/or psychotherapeutic treatment, focused on the depressive dimension, may help traumatized EP patients to improve their functioning.
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Affiliation(s)
- Luis Alameda
- Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland;,Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland;,Psychiatric Liaison Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland;,These authors contributed equally to this work.,To whom correspondence should be addressed; tel: 41-795025957, fax: 41-213141098, e-mail:
| | - Philippe Golay
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland;,These authors contributed equally to this work
| | - Philipp S Baumann
- Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland;,Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Pierre Progin
- Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland;,Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Nadir Mebdouhi
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Julien Elowe
- Mobile Psychiatry Unit, Department of Psychiatry, Prangins Psychiatric Hospital (CHUV), Prangins, Switzerland
| | - Carina Ferrari
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Kim Q Do
- Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland;,Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland
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23
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Abstract
Although it has been proposed that the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis may act as a possible pathway linking early life stress to psychosis, this relationship has not yet been fully confirmed. This study aimed to investigate the relationship between childhood adversity (CA), cortisol levels, and psychosis. Eighty-five patients with psychosis and 170 control subjects were enrolled in the study. CA was evaluated using the Florence Psychiatric Interview, and Childhood Experience of Care and Abuse Questionnaire. Positive symptoms (PS) were assessed using the Positive and Negative Syndrome Scale. Cortisol levels were evaluated in saliva samples. Patients experienced more CA and showed higher cortisol levels than controls. Patients with CA showed higher morning cortisol levels and more severe PS than those without CA. Patients with higher morning cortisol levels showed severe delusions. These findings suggest that both CA and dysregulation of the HPA axis could be related to psychosis.
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Fisher HL, Roberts A, Day F, Reynolds N, Iacoponi E, Garety PA, Craig TKJ, McGuire P, Valmaggia L, Power P. Impact of crime victimization on initial presentation to an early intervention for psychosis service and 18-month outcomes. Early Interv Psychiatry 2017; 11:123-132. [PMID: 25583091 DOI: 10.1111/eip.12219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/27/2014] [Accepted: 12/02/2014] [Indexed: 11/30/2022]
Abstract
AIM To investigate the clinical and social correlates of a lifetime history of crime victimization among first-episode psychosis patients at entry to an Early Intervention Service and following 18 months of specialist care. METHODS Face-to-face interviews were conducted with 149 individuals who presented to an Early Intervention Service for the first time with psychosis in the London borough of Lambeth, UK. A range of demographic and clinical measures were completed including self-reported history of victimization along with the type of crime and its subjective effect on the patient. Clinical and functional outcomes at 18-month follow up were ascertained from clinical case notes by a psychiatrist. RESULTS A large proportion of patients (n = 64, 43%) reported a history of crime victimization. This was associated with significantly higher levels of depression and substance misuse at initial presentation. Being a victim of a crime was not significantly associated with poorer clinical or functional outcomes after 18 months of specialist care. However, non-significant differences were found for those who reported crime victimization in terms of their increased use of illegal substances or having assaulted someone else during the follow-up period. CONCLUSION Past experience of being a victim of crime appears to be common in patients presenting for the first time with psychosis and is associated with increased likelihood of comorbidity. Thus, Early Intervention Services should consider screening for past victimization and be prepared to deal with comorbid problems. The impact of crime victimization on clinical and functional outcomes requires investigation over a longer period of time.
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Affiliation(s)
- Helen L Fisher
- MRC Social, Genetic & Developmental Psychiatry Centre, King's College London, London, UK
| | - Anna Roberts
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Fern Day
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Nicky Reynolds
- Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Eduardo Iacoponi
- Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Philippa A Garety
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Thomas K J Craig
- Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Health Service and Population Research, King's College London, London, UK
| | - Philip McGuire
- Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK
| | - Paddy Power
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
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Pec O, Bob P, Lysaker PH. Trauma, Dissociation and Synthetic Metacognition in Schizophrenia. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/bf03379624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Both childhood trauma and dissociation are associated with schizophrenia. More rudimentary form of dissociation known already from Eugen Bleuler as splitting of association is theoretically close to the modern concept of synthetic metacognition in schizophrenia. The synthetic metacognition as a psychological process is described as a capability to synthesize intentions, thoughts, feelings, and connections between events, and to integrate them into larger complex representations of self and others. Disturbed synthetic metacognition was found in early as well as in late forms of schizophrenia and has its typical formula. Deficit of synthetic metacognition is related to symptoms of schizophrenia and psychosocial functions. Synthetic metacognition is measurable by analyzing discourse using standardized procedures. The level of metacognition is assessed from the sample of narrative on the basis of the Metacognitive Assessment Scale — Abbreviated (MAS-A). Psychotherapies focused on strengthening of metacognitive functions concentrate on integration of fragmented mental content or on promoting of formation of stable mental representations in this disorder.
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Early-Life Trauma in Hospitalized Patients With Mood Disorders and Its Association With Clinical Outcomes. J Psychiatr Pract 2017; 23:36-43. [PMID: 28072643 DOI: 10.1097/pra.0000000000000202] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The prevalence of childhood trauma and its impact on clinical outcomes in hospitalized patients with mood disorders is unknown. We studied the frequency of childhood trauma among inpatient adults with mood disorders and its association with clinical outcomes. METHODS Patients admitted to our hospital with a primary diagnosis of mood disorders completed the short form of the Early Trauma Inventory-Self-Report (ETISR-SF), the Sheehan Disability Scale, and the Clinician-Rated Dimensions of Psychosis Symptom Severity scale. A regression model adjusted for multiple comparisons was used to examine the association between scores on the ETISR-SF and clinical outcomes. RESULTS Subjects were 167 patients, all of whom reported ≥1 types of childhood trauma: 90% general trauma, 75% physical abuse, 71% emotional abuse, 50% sexual abuse, and 35% all 4 types of abuse. The subtypes of abuse did not differ by sex or race. Diagnoses in the sample were bipolar disorder 56%, major depressive disorder 24%, schizoaffective disorder 14%, and substance-induced mood disorder 5%. The mean age in the sample was 35±11.5 years, 53% were male, and 64% also had substance abuse disorders. Higher scores on the ETISR-SF were associated with longer hospital stays [odds ratio (OR)=1.13; 95% confidence interval (CI), 1.05-1.22], and greater disruption of work/school life (OR=1.12; 95% CI, 1.04-1.21). There was also a trend for higher ETISR-SF scores to be associated with more severe psychotic symptoms (OR=1.13; 95% CI, 1.01-1.27) and more disruption in social (OR=1.14; 95% CI, 1.06-1.22) and family life (OR=1.09; 95% CI, 1.02-1.17). CONCLUSION Childhood trauma was reported by all of the 167 patients, with general trauma the most common and approximately half reporting sexual abuse. Childhood trauma was associated with poor clinical outcomes. Early recognition of trauma and trauma-related therapeutic interventions may improve outcomes.
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Seidenfaden D, Knorr U, Soendergaard MG, Poulsen HE, Fink-Jensen A, Jorgensen MB, Jorgensen A. The relationship between self-reported childhood adversities, adulthood psychopathology and psychological stress markers in patients with schizophrenia. Compr Psychiatry 2017; 72:48-55. [PMID: 27736667 DOI: 10.1016/j.comppsych.2016.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 08/15/2016] [Accepted: 09/21/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Childhood adversity is a well-established risk factor for the development of schizophrenia. In particular, there is evidence that childhood adversity increases the occurrence of positive symptoms, possibly through glucocorticoid influences on dopaminergic neurotransmission. AIMS To compare levels of childhood trauma in schizophrenia patients vs. healthy control persons, and to study the association between childhood adversity and the symptomatology of adulthood schizophrenia, as well as subjective and biological markers of psychological stress. METHODS Thirty-seven patients fulfilling ICD-10 criteria for schizophrenia and 39 healthy control persons filled out the comprehensive Childhood Abuse and Trauma Scale (CATS). Data were analyzed after a data-driven dichotomization into two groups of either high or low CATS score in patients and controls, respectively. The psychopathology of the patients was measured by the Positive and Negative Syndrome Scale (PANSS) and analyzed by a five-factor PANSS model. Measures of perceived stress (Perceived Stress Scale) and hypothalamic-pituitary-adrenal (HPA)-axis activity (9AM plasma cortisol and daytime salivary cortisol output) were recorded. RESULTS As expected, patients had significantly higher total CATS scores than the control persons (>3-fold, P<0.001), reflecting significantly higher scores across all subscales of the CATS. In patients, the total PANSS score did not significantly differ between the high and the low CATS score group (P=0.2). However, there was a statistically significant higher level of positive symptoms in the high CATS group (P=0.014), and no difference in other psychopathological domains. Correspondingly, when using the CATS score as a continuous variable, a strong association with positive PANSS scores was found (P=0.009). The high CATS score group showed higher levels of perceived stress (P=0.02), but there was no difference between the high vs. low CATS group in HPA-axis activity. CONCLUSION Although causal inferences cannot be made from this cross-sectional study, the study adds support to the suggestion that childhood adversity specifically increases the occurrence of positive symptoms in adulthood schizophrenia in a manner that appears to leave HPA-axis activity unaltered.
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Affiliation(s)
- Dea Seidenfaden
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Denmark
| | - Ulla Knorr
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Denmark
| | | | - Henrik Enghusen Poulsen
- Laboratory of Clinical Pharmacology Q7642, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Pharmacology, Bispebjerg Hospital, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Anders Fink-Jensen
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology, University of Copenhagen, Denmark
| | - Martin Balslev Jorgensen
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology, University of Copenhagen, Denmark
| | - Anders Jorgensen
- Psychiatric Centre Copenhagen, University Hospital of Copenhagen, Denmark; Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology, University of Copenhagen, Denmark.
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Honings S, Drukker M, ten Have M, de Graaf R, van Dorsselaer S, van Os J. The interplay of psychosis and victimisation across the life course: a prospective study in the general population. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1363-1374. [PMID: 28861657 PMCID: PMC5663809 DOI: 10.1007/s00127-017-1430-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 08/07/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE Psychosis has been associated with adult victimisation. However, it remains unclear whether psychosis predicts incident adult victimisation, or whether adult victimisation predicts incident psychosis. Furthermore, a moderating effect of childhood victimisation on the association between psychosis and adult victimisation has not been investigated. METHODS The longitudinal association between baseline psychotic experiences and six-year incidence of adult victimisation was assessed in a prospective general population cohort of 6646 adults using logistic regression analysis. The association between baseline adult victimisation and six-year incidence of psychotic experiences was examined as well. Furthermore, the moderating effect of childhood victimisation on these bidirectional associations was analysed. RESULTS Psychotic experiences and childhood victimisation were both associated with an increased risk of incident adult victimisation. However, this was through competing pathways, as suggested by a negative interaction between psychotic experiences and childhood victimisation. Baseline adult victimisation and childhood victimisation both independently increased the risk of incident psychotic experiences, but there was no interaction between adult victimisation and childhood victimisation. CONCLUSIONS Psychosis and victimisation are interconnected throughout the life course. Childhood victimisation is connected to psychosis through two pathways: one direct and one indirect through adult victimisation. In individuals without childhood victimisation, psychosis and adult victimisation bidirectionally impact on each other.
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Affiliation(s)
- Steven Honings
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marjan Drukker
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Margreet ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | | | - Jim van Os
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands. .,King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK. .,Department of Psychiatry, Brain Center Rudolf Magnus Institute, University Medical Center Utrecht, PO BOX 85500, 3508 GA, Utrecht, The Netherlands.
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Aydin O, Balikci K, Tas C, Aydin PU, Danaci AE, Brüne M, Lysaker PH. The developmental origins of metacognitive deficits in schizophrenia. Psychiatry Res 2016; 245:15-21. [PMID: 27526312 DOI: 10.1016/j.psychres.2016.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/14/2016] [Accepted: 08/04/2016] [Indexed: 11/18/2022]
Abstract
The deficits in metacognition have been observed in schizophrenia but developmental roots of impaired metacognition are not well understood. Accordingly, this study compared metacognitive abilities of patients with schizophrenia and healthy group and examined the relationship between childhood trauma, attachment style and caregiver attitudes with metacognitive capacity which might contribute to metacognitive deficits in patient group. 35 patients with schizophrenia and 35 healthy people were included in the study. Metacognitive capacity was measured using the Metacognition Assessment Scale Abbreviated (MAS-A). This scale comprises four domains: self-reflectivity, understanding other's mind, decentration and mastery. Group comparisons revealed that schizophrenia patients had greater deficits in metacognitive ability. We found that the report of childhood emotional abuse, a pattern of anxious attachment and over protection by caregivers were uniquely related to metacognitive capacity.
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Affiliation(s)
- Orkun Aydin
- Izzet Baysal Mental Health and Disease Research and Training Hospital, Bolu, Turkey.
| | | | - Cumhur Tas
- Department of Psychology, Uskudar University, Istanbul, Turkey
| | - Pınar Unal Aydin
- Izzet Baysal Mental Health and Disease Research and Training Hospital, Bolu, Turkey
| | | | - Martin Brüne
- LWL University Hospital, Division of Cognitive Neuropsychiatry and Psychiatric Preventative Medicine, Ruhr University Bochum, NRW, Germany
| | - Paul H Lysaker
- Roudebush VA Medical Center, Indianapolis, IN, USA; Indiana University School of Medicine, USA
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30
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Relationship between neuroticism, childhood trauma and cognitive-affective responses to auditory verbal hallucinations. Sci Rep 2016; 6:34401. [PMID: 27698407 PMCID: PMC5048145 DOI: 10.1038/srep34401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 09/12/2016] [Indexed: 11/23/2022] Open
Abstract
Neuroticism has been shown to adversely influence the development and outcome of psychosis. However, how this personality trait associates with the individual’s responses to psychotic symptoms is less well known. Auditory verbal hallucinations (AVHs) have been reported by patients with psychosis and non-clinical individuals. There is evidence that voice-hearers who are more distressed by and resistant against the voices, as well as those who appraise the voices as malevolent and powerful, have poorer outcome. This study aimed to examine the mechanistic association of neuroticism with the cognitive-affective reactions to AVH. We assessed 40 psychotic patients experiencing frequent AVHs, 135 non-clinical participants experiencing frequent AVHs, and 126 healthy individuals. In both clinical and non-clinical voice-hearers alike, a higher level of neuroticism was associated with more distress and behavioral resistance in response to AVHs, as well as a stronger tendency to perceive voices as malevolent and powerful. Neuroticism fully mediated the found associations between childhood trauma and the individuals’ cognitive-affective reactions to voices. Our results supported the role of neurotic personality in shaping maladaptive reactions to voices. Neuroticism may also serve as a putative mechanism linking childhood trauma and psychological reactions to voices. Implications for psychological models of hallucinations are discussed.
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31
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Mesquita CDS, Basto-Pereira M, da Costa Maia Â. Prevalence of Childhood Victimization Experiences in Psychiatric Patients: a Systematic Review. Int J Ment Health Addict 2016. [DOI: 10.1007/s11469-016-9697-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Trauelsen AM, Bendall S, Jansen JE, Nielsen HGL, Pedersen MB, Trier CH, Haahr UH, Simonsen E. Childhood adversities: Social support, premorbid functioning and social outcome in first-episode psychosis and a matched case-control group. Aust N Z J Psychiatry 2016; 50:770-82. [PMID: 26773690 DOI: 10.1177/0004867415625814] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The establishment of childhood adversities as risk factors for non-affective psychosis has derived a need to consider alternative interpretations of several psychosis-related factors. This paper sought to examine premorbid adjustment trajectories and social outcome factors in relation to childhood adversities. Perceived support has been found to decrease the risk of post-traumatic stress disorder, and we wished to compare perceived support in people with first-episode psychosis to non-clinical control persons and explore its relation to childhood adversities. METHOD Every individual presenting with a non-affective first-episode psychosis (F20-29, except F21) in Region Zealand over a 2-year period was approached for participation and the 101 consenting participants were matched to 101 people with no psychiatric disorders. Comprehensive demographic data were collected. Assessment instruments included the Premorbid Assessment Scale, the Global Assessment of Functioning scale and the Childhood Trauma Questionnaire. The latter represented the childhood adversities in addition to parental separation and institutionalization. RESULTS There were no associations between number of childhood adversities and different social or academic premorbid trajectories. Those with more adversities had lower global functioning the year prior to treatment start and reported lower rates of perceived support during childhood along with less current face-to-face contact with family members. Lack of peer support remained a significant predictor of psychosis when adversities were adjusted for; peer support diminished the risk of psychosis caused by childhood adversities by 10%. CONCLUSION Childhood adversities may not predict specific premorbid trajectories, but have an effect on global functioning when the psychosis has begun. Perceived support, especially from peers, may be important in the development of psychosis, and those with more adversities may represent a vulnerable subgroup who need more assistance to increase and maintain supportive networks.
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Affiliation(s)
- Anne Marie Trauelsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark
| | - Sarah Bendall
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia Orygen-The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Jens E Jansen
- Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark
| | - Hanne-Grethe L Nielsen
- Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark
| | - Marlene B Pedersen
- Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark
| | | | - Ulrik H Haahr
- Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Erik Simonsen
- Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Dissociation in patients with schizophrenia spectrum disorders: What is the role of different types of childhood adversity? Compr Psychiatry 2016; 68:201-8. [PMID: 27234203 DOI: 10.1016/j.comppsych.2016.04.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 04/27/2016] [Indexed: 11/20/2022] Open
Abstract
AIMS Our study aimed to explore the effects of different types of adverse childhood experiences (e.g. domestic violence, early loss, parental dysfunction, sexual and physical abuse) as well as experiences of sexual and physical abuse in adulthood on dissociative symptoms in adult patients with schizophrenia-spectrum disorders. METHODS 145 patients were examined for psychotic symptoms with the Positive and Negative Syndrome Scale (PANSS), for dissociative symptoms with the German version of the Dissociative Experiences Scale (DES) and for adverse experiences in childhood and adulthood with the Structured Trauma Interview (STI). RESULTS Childhood physical abuse was reported by 32%, childhood sexual abuse by 17% of the patients. Other forms of childhood adversity were also quite common; 18% had witnessed domestic violence, 26% reported early loss, and nearly half of patients reported at least one condition potentially related to parental dysfunction. The DES total score was significantly associated with childhood sexual abuse, witnessing of domestic violence and paternal dysfunction, as well as with physical violence in adulthood. In the final regression model, reports of paternal dysfunction and sexual abuse in childhood were independently associated with adult dissociation. Variance in dissociative symptoms was mainly explained by paternal dysfunction (18%). CONCLUSION Substantial rates of childhood adversity were found and specific associations were evident with adult dissociation amongst psychosis patients who reported sexual abuse or paternal dysfunction in childhood. Therefore, it is important that patients with schizophrenia-spectrum disorders are routinely asked about a broad range of possible adverse childhood experiences in order to provide appropriate interventions.
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Aas M, Andreassen OA, Aminoff SR, Færden A, Romm KL, Nesvåg R, Berg AO, Simonsen C, Agartz I, Melle I. A history of childhood trauma is associated with slower improvement rates: Findings from a one-year follow-up study of patients with a first-episode psychosis. BMC Psychiatry 2016; 16:126. [PMID: 27146044 PMCID: PMC4855869 DOI: 10.1186/s12888-016-0827-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 04/22/2016] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate whether childhood trauma was associated with more severe clinical features in patients with first-episode psychosis, both at the initial assessment and after one year. METHODS Ninety-six patients with a first-episode of a DSM-IV diagnosis of psychosis, in addition to 264 healthy controls from the same catchment area, were recruited to the TOP NORMENT study. A history of childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ). Function and symptom severity were measured using the Global Assessment of Functioning (GAF) Scale divided into function (GAF-F) and symptoms (GAF-S), the Positive and Negative Syndrome Scale (PANSS) and the Young Mania Rating Scale (YMRS). All clinical assessments were completed at two time points: At an initial assessment within the first year of initiating treatment for psychosis and after one year. RESULTS Childhood trauma was associated with significantly reduced global functioning and more severe clinical symptoms at both baseline and follow-up, whereas emotional neglect was associated with a significantly reduced improvement rate for global functioning (GAF-F) over the follow-up period. CONCLUSION Our data indicate that patients with first-episode psychosis who report a history of childhood trauma constitute a subgroup characterized by more severe clinical features over the first year of treatment, as well as slower improvement rates.
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Affiliation(s)
- Monica Aas
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT K.G Jebsen Centre for Psychosis Research, TOP study group, University of Oslo and Oslo University Hospital, Bygg 49, Ullevål sykehus, PO Box 4956, Nydalen, 0424, Oslo, Norway.
| | - Ole A. Andreassen
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT K.G Jebsen Centre for Psychosis Research, TOP study group, University of Oslo and Oslo University Hospital, Bygg 49, Ullevål sykehus, PO Box 4956, Nydalen, 0424 Oslo Norway
| | - Sofie R. Aminoff
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT K.G Jebsen Centre for Psychosis Research, TOP study group, University of Oslo and Oslo University Hospital, Bygg 49, Ullevål sykehus, PO Box 4956, Nydalen, 0424 Oslo Norway ,Department of Specialized Inpatient Treatment, Division of Mental Health Services, Akershus University Hospital, Oslo, Norway
| | - Ann Færden
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT K.G Jebsen Centre for Psychosis Research, TOP study group, University of Oslo and Oslo University Hospital, Bygg 49, Ullevål sykehus, PO Box 4956, Nydalen, 0424 Oslo Norway
| | - Kristin L. Romm
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT K.G Jebsen Centre for Psychosis Research, TOP study group, University of Oslo and Oslo University Hospital, Bygg 49, Ullevål sykehus, PO Box 4956, Nydalen, 0424 Oslo Norway
| | - Ragnar Nesvåg
- Department of Genetics, Environment and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Akiah O. Berg
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT K.G Jebsen Centre for Psychosis Research, TOP study group, University of Oslo and Oslo University Hospital, Bygg 49, Ullevål sykehus, PO Box 4956, Nydalen, 0424 Oslo Norway
| | - Carmen Simonsen
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT K.G Jebsen Centre for Psychosis Research, TOP study group, University of Oslo and Oslo University Hospital, Bygg 49, Ullevål sykehus, PO Box 4956, Nydalen, 0424 Oslo Norway
| | - Ingrid Agartz
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT K.G Jebsen Centre for Psychosis Research, TOP study group, University of Oslo and Oslo University Hospital, Bygg 49, Ullevål sykehus, PO Box 4956, Nydalen, 0424 Oslo Norway ,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingrid Melle
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT K.G Jebsen Centre for Psychosis Research, TOP study group, University of Oslo and Oslo University Hospital, Bygg 49, Ullevål sykehus, PO Box 4956, Nydalen, 0424 Oslo Norway
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35
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Kelly DL, Rowland LM, Patchan KM, Sullivan K, Earl A, Raley H, Liu F, Feldman S, McMahon RP. Schizophrenia clinical symptom differences in women vs. men with and without a history of childhood physical abuse. Child Adolesc Psychiatry Ment Health 2016; 10:5. [PMID: 26941836 PMCID: PMC4776423 DOI: 10.1186/s13034-016-0092-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 02/09/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Childhood abuse has been implicated as an environmental factor that increases the risk for developing schizophrenia. A recent large population-based case-control study found that abuse may be a risk factor for schizophrenia in women, but not men. Given the sex differences in onset and clinical course of schizophrenia, we hypothesized that childhood abuse may cause phenotypic differences in the disorder between men and women. METHODS We examined the prevalence of childhood physical abuse in a cohort of men and women with schizophrenia and schizoaffective disorder. Specifically, we examined differences in positive, negative, cognitive and depressive symptoms in men and women who reported a history of childhood physical abuse. We recruited 100 subjects for a single visit and assessed a history of childhood physical abuse using the childhood trauma questionnaire (CTQ) and clinical symptoms and cognition using the brief psychiatric rating scale (BPRS), the calgary depression scale (CDS) and the repeatable battery of the assessment of neuropsychological status (RBANS) for cognition. RESULTS Ninety-two subjects completed the full CTQ with abuse classified as definitely present, definitely absent or borderline. Twelve subjects who reported borderline abuse scores were excluded. Of the 80 subjects whose data was analyzed, 10 of 24 (41.6 %) women and 11 of 56 (19.6 %) men reported a history of childhood physical abuse (χ(2) = 4.21, df = 1, p = 0.04). Women who reported such trauma had significantly more psychotic (sex by abuse interaction; F = 4.03, df = 1.76, p = 0.048) and depressive (F = 4.23, df = 1.76, p = 0.04) symptoms compared to women who did not have a trauma history and men, regardless of trauma history. There were no differences in negative or cognitive symptoms. CONCLUSIONS Women with schizophrenia and schizoaffective disorder may represent a distinct phenotype or subgroup with distinct etiologies and may require different, individually tailored treatments.
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Affiliation(s)
- Deanna L. Kelly
- Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA
| | - Laura M. Rowland
- Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA
| | - Kathleen M. Patchan
- Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA
| | - Kelli Sullivan
- Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA
| | - Amber Earl
- Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA
| | - Heather Raley
- Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA
| | - Fang Liu
- Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA
| | - Stephanie Feldman
- Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA
| | - Robert P. McMahon
- Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA
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Trotta A, Murray RM, David AS, Kolliakou A, O’Connor J, Di Forti M, Dazzan P, Mondelli V, Morgan C, Fisher HL. Impact of Different Childhood Adversities on 1-Year Outcomes of Psychotic Disorder in the Genetics and Psychosis Study. Schizophr Bull 2016; 42:464-75. [PMID: 26373540 PMCID: PMC4753600 DOI: 10.1093/schbul/sbv131] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
While the role of childhood adversity in increasing the risk of psychosis has been extensively investigated, it is not clear what the impact of early adverse experiences is on the outcomes of psychotic disorders. Therefore, we investigated associations between childhood adversity and 1-year outcomes in 285 first-presentation psychosis patients. Exposure to childhood adversity prior to 17 years of age was assessed using the Childhood Experience of Care and Abuse Questionnaire. Data on illness course, symptom remission, length of psychiatric hospitalization, compliance with medication, employment, and relationship status were extracted from clinical records for the year following first contact with mental health services for psychosis. Seventy-one percent of patients reported exposure to at least 1 type of childhood adversity (physical abuse, sexual abuse, parental separation, parental death, disrupted family arrangements, or being taken into care). No robust associations were found between childhood adversity and illness course or remission. However, childhood physical abuse was associated with almost 3-fold increased odds of not being in a relationship at 1-year follow-up compared to patients who did not report such adverse experiences. There was also evidence of a significant association between parental separation in childhood and longer admissions to psychiatric wards during 1-year follow-up and 2-fold increased odds of noncompliance with medication compared to those not separated from their parents. Therefore, our findings suggest that there may be some specificity in the impact of childhood adversity on service use and social functioning among psychosis patients over the first year following presentation to mental health services.
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Affiliation(s)
- Antonella Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Anthony S. David
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Anna Kolliakou
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Jennifer O’Connor
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Marta Di Forti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK;,MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Craig Morgan
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Helen L. Fisher
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK;,*To whom correspondence should be addressed; MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AF, UK; tel: +44 (0)207-848-5430, fax: +44 (0)207-848-0866, e-mail:
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Alameda L, Ferrari C, Baumann PS, Gholam-Rezaee M, Do KQ, Conus P. Childhood sexual and physical abuse: age at exposure modulates impact on functional outcome in early psychosis patients. Psychol Med 2015; 45:2727-2736. [PMID: 26350397 DOI: 10.1017/s0033291715000690] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Evidence suggests a relationship between exposure to trauma during childhood and functional impairments in psychotic patients. However, the impact of age at the time of exposure has been understudied in early psychosis (EP) patients. METHOD Two hundred and twenty-five patients aged 18-35 years were assessed at baseline and after 2, 6, 18, 24, 30 and 36 months of treatment. Patients exposed to sexual and/or physical abuse (SPA) were classified according to age at the time of first exposure (Early SPA: before age 11 years; Late SPA: between ages 12 and 15 years) and then compared to patients who were not exposed to such trauma (Non-SPA). The functional level in the premorbid phase was measured with the Premorbid Adjustment Scale (PAS) and with the Global Assessment of Functioning (GAF) scale and the Social and Occupational Functioning Assessment Scale (SOFAS) during follow-up. RESULTS There were 24.8% of patients with a documented history of SPA. Late SPA patients were more likely to be female (p = 0.010). Comparison with non-SPA patients revealed that: (1) both Early and Late SPA groups showed poorer premorbid social functioning during early adolescence, and (2) while patients with Early SPA had poorer functional level at follow-up with lower GAF (p = 0.025) and lower SOFAS (p = 0.048) scores, Late SPA patients did not. CONCLUSION Our results suggest a link between exposure to SPA and the later impairment of social functioning before the onset of the disease. EP patients exposed to SPA before age 12 may present long-lasting functional impairment, while patients exposed at a later age may improve in this regard and have a better functional outcome.
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Affiliation(s)
- L Alameda
- Unit for Research in Schizophrenia,Center for Psychiatric Neuroscience,Department of Psychiatry,Lausanne University Hospital (CHUV),Lausanne,Switzerland
| | - C Ferrari
- Service of General Psychiatry,Treatment and Early Intervention in Psychosis,Program (TIPP-Lausanne),Lausanne University Hospital (CHUV),Lausanne,Switzerland
| | - P S Baumann
- Unit for Research in Schizophrenia,Center for Psychiatric Neuroscience,Department of Psychiatry,Lausanne University Hospital (CHUV),Lausanne,Switzerland
| | - M Gholam-Rezaee
- Department of Psychiatry,Center for Psychiatric Epidemiology and Psychopathology,Lausanne University Hospital (CHUV),Lausanne,Switzerland
| | - K Q Do
- Unit for Research in Schizophrenia,Center for Psychiatric Neuroscience,Department of Psychiatry,Lausanne University Hospital (CHUV),Lausanne,Switzerland
| | - P Conus
- Service of General Psychiatry,Treatment and Early Intervention in Psychosis,Program (TIPP-Lausanne),Lausanne University Hospital (CHUV),Lausanne,Switzerland
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Rate and predictors of psychotic symptoms after Kashmir earthquake. Eur Arch Psychiatry Clin Neurosci 2015; 265:471-81. [PMID: 25421792 DOI: 10.1007/s00406-014-0561-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 11/07/2014] [Indexed: 12/13/2022]
Abstract
Psychotic symptoms are more common in general population than validated diagnosis of psychosis. There is evidence to suggest that these symptoms, hallucinations, paranoia, elated mood, thought insertion, are part of a spectrum of psychosis and may have association with the same risk factors that determine development of psychosis. These symptoms have an association with exposure to psychological trauma, post-traumatic stress disorder, anxiety and depression. The aim of this study was to explore the prevalence of psychotic symptoms in the population affected by a natural disaster, earthquake in this case and possible correlates of these symptoms. We conducted a cross-sectional survey of a population sample affected by the disaster, comprising of 1,291 individuals, 18 months after 2005 earthquake in Northern Pakistan and Kashmir to look at the prevalence of these symptoms and their correlates. Screening Instrument for Traumatic Stress in Earthquake Survivors and Self-Reporting Questionnaire and Psychosis Screening Questionnaire were used as tools. We examined association between the symptoms of anxiety, depression, PTSD and psychotic symptoms. We performed logistic regression analysis where hallucinations and delusions were dependent variables and demographic and trauma exposure variables were independent variables. The prevalence of psychotic symptoms ranged between 16.8 and 30.4 %. They were directly correlated with symptoms of post-traumatic stress disorder as well as concurrent symptoms of anxiety and depression. Lower level of education had a strong association in all the regression models. For hallucinations, living in a joint family had a negative association and participation in rescue, history of exposure to previous trauma and past psychiatric history had positive association. Paranoia was associated with female gender. Any psychiatric symptom was associated death of a family member, history of past psychiatric illness and living in a tent at the time of interview. Pattern of association of psychotic symptoms is consistent with prior literature and can be understood in the light of stress vulnerability model.
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Li XB, Li QY, Liu JT, Zhang L, Tang YL, Wang CY. Childhood trauma associates with clinical features of schizophrenia in a sample of Chinese inpatients. Psychiatry Res 2015; 228:702-7. [PMID: 26096662 DOI: 10.1016/j.psychres.2015.06.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 05/31/2015] [Accepted: 06/01/2015] [Indexed: 12/20/2022]
Abstract
This study examined the association between childhood trauma and clinical features, comorbid anxiety and post-traumatic stress disorder (PTSD) symptoms, and suicidal and aggressive behaviors in Chinese patients with schizophrenia. The Childhood Trauma Questionnaire - Short Form (CTQ-SF), the Impact of Events Scale - Revised (IES-R), and the State-Trait Anxiety Inventory (STAI) were administered to 182 Chinese inpatients with schizophrenia. The relationship between the severity and the number of traumic experiences and clinical features were analyzed. Physical neglect (PN) in childhood was reported in 71.7% of this sample, followed by emotional neglect (EN, 58.6%), sexual abuse (SA, 39.9%), emotional abuse (EA, 31.7%) and physical abuse (PA, 22.2%). Significant negative correlations existed between age of onset and the EA scores. Significant positive correlations were found between the subscores of IES-R, STAI and CTQ-SF. Patients with history of suicidal or aggressive behaviors had significantly higher trauma scores than patients without such behaviors. Exposure to childhood trauma is associated with early age of onset, more PTSD and anxiety symptoms, and history of suicidal and aggressive behaviors. A dose-effect may exist between severity, number of trauma experiences, and clinical features.
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Affiliation(s)
- Xian-Bin Li
- Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, China; Center of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders (Capital Medical University), Ministry of Science and Technology, China
| | | | - Jin-Tong Liu
- Department of Psychiatry, Shandong University School of Medicine, China
| | - Liang Zhang
- Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, China; Center of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders (Capital Medical University), Ministry of Science and Technology, China
| | - Yi-Lang Tang
- Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, China; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States
| | - Chuan-Yue Wang
- Beijing Key Laboratory of Mental Disorders, Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, China; Center of Schizophrenia, Beijing Institute for Brain Disorders, Laboratory of Brain Disorders (Capital Medical University), Ministry of Science and Technology, China.
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Long-Term Effects of Prenatal Hypoxia on Schizophrenia-Like Phenotype in Heterozygous Reeler Mice. Mol Neurobiol 2015; 53:3267-3276. [PMID: 26059812 DOI: 10.1007/s12035-015-9265-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Indexed: 12/16/2022]
Abstract
Prenatal hypoxia (PHX) is a well-known environmental factor implicated in the pathophysiology of schizophrenia. However, the long-term effects of PHX on schizophrenia-related neuroplasticity are poorly understood. Using behavioral tasks, MRI imaging, and biochemical studies, we examined the long-term effects of PHX in heterozygous reeler mice (HRM; mice deficient for reelin, a candidate gene for schizophrenia). PHX at E17 failed to induce any significant deficits in prepulse inhibition, spatial memory, anxiety-like behavior, or blood flow in wild type (WT) and HRM at 6 months of age. However, PHX induced a significant increase in frontal cortex volume in WT whereas the higher frontal cortical volume found in HRM was significantly reduced by PHX. A significant decrease in reelin levels was observed in frontal cortex of WT and HRM and hippocampus of HRM following PHX. In addition, PHX induced significant reductions in hypoxia inducible factor-1α (HIF-1α) levels in frontal cortex and hippocampus of HRM. Although no significant effect of PHX was observed in vascular endothelial growth factor (VEGF) protein levels in frontal cortex and hippocampus of WT and HRM, serum VEGF levels were found higher in HRM following PHX. Moreover, glucocorticoid receptor (GR) protein levels were significantly lower in frontal cortex of WT and HRM and hippocampus of HRM following PHX. We found a significant reduction in serum corticosterone levels of PHX-treated WT mice. These findings suggest that future experiments addressing gene-environment interaction in schizophrenia should consider age-dependent effects of the environmental factor, in addition to the specificity of the gene of interest.
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Habtamu K, Alem A, Hanlon C. Conceptualizing and contextualizing functioning in people with severe mental disorders in rural Ethiopia: a qualitative study. BMC Psychiatry 2015; 15:34. [PMID: 25885525 PMCID: PMC4354755 DOI: 10.1186/s12888-015-0418-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 02/19/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The functional outcome of people with severe mental disorders (SMD) is purported to be better in low- and middle-income countries compared to high-income countries; however, cross-cultural measures of functioning may not capture adequately the relevant functional activities in rural, non-Western settings. This study aimed to gain in-depth understanding of day-to-day functioning in a rural Ethiopian setting and the functional impairments associated with SMD. METHOD A qualitative study was carried out in the Butajira area, south Ethiopia. In-depth interviews were conducted with people with SMD (n = 6), religious healers (n = 2) and psychiatric nurses (n = 2). Four focus group discussions were carried out with caregivers of people with SMD (n = 37) and one with project outreach workers (n = 5). A thematic analysis approach was used. RESULTS Participants emphasized that functional impairment in people with SMD arose not only because of the symptoms associated with the illness, but also due to poverty, social exclusion and lack of social support. Within this rural community, the ability to work productively, engage in family life, maintain self-care and fulfill social obligations were the most highly valued domains of functioning. A wide range of farming tasks were elaborated in detail and noted to be of varying levels of difficulty. Although many people with symptomatic SMD were reported to be able to carry out simple farming tasks, this was distinguished from effective farming. Gender differences were most apparent in the domains of work and family life. Impaired functioning was reported to have a critical immediate impact on survival and longer-term impacts on the lifetime opportunities of people with SMD, their caregivers and the younger generation within the family. CONCLUSIONS The study indicates that tackling social exclusion and poverty is needed alongside medical treatment through contextual community based rehabilitation programs. The gendering of functional roles and the complexity of work activities in this subsistence farming community lend support to arguments for locally contextualized measures of functioning in people with SMD.
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Affiliation(s)
- Kassahun Habtamu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O. BOX: 1176, Addis Ababa, Ethiopia. .,PhD students, Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Atalay Alem
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. .,Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
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Gairns S, Alvarez-Jimenez M, Hulbert C, McGorry P, Bendall S. Perceptions of clinicians treating young people with first-episode psychosis for post-traumatic stress disorder. Early Interv Psychiatry 2015; 9:12-20. [PMID: 23802596 DOI: 10.1111/eip.12065] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 05/20/2013] [Indexed: 11/30/2022]
Abstract
AIM Evidence shows that approximately half of young people with first-episode psychosis have post-traumatic stress disorder. Yet, post-traumatic stress disorder is often left untreated in the presence of psychosis. To support the development of a post-traumatic stress disorder intervention for young people with first-episode psychosis, clinicians' perceptions of trauma-focused interventions were sought. Two research questions were explored: What treatment barriers were associated with treating young people with first-episode psychosis? What supports would be useful to implement post-traumatic stress disorder intervention? METHODS A mixed-methods design incorporated quantitative and qualitative data from a questionnaire with qualitative data from two focus groups. Sixteen (of 20) case managers from an early psychosis intervention centre participated in the study (16 completed a questionnaire, eight participated in focus groups). Descriptive statistics were generated for quantitative data and qualitative material was examined using a grounded theory approach. RESULTS The results showed that perceived barriers to delivering trauma-focused intervention were increased mental health risks for clients with psychosis, workload pressures and poor client engagement. Targeted training and formal professional guidance were thought to best scaffold an intervention. CONCLUSIONS Post-traumatic stress disorder intervention for first-episode psychosis clients should address engagement, make safeguarded provisions for family involvement and be sufficiently paced and flexible. Trauma-focused intervention is perceived with a degree of caution, is often not prioritized, lacks institutional support and requires more targeted training. It is important to conduct further research regarding the safety of trauma interventions alongside psychosis in order to address widespread concerns.
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Affiliation(s)
- Sarah Gairns
- School of Psychological Sciences, The University of Melbourne, Australia
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Childhood trauma and functional disability in psychosis, bipolar disorder and borderline personality disorder: a review of the literature. Ir J Psychol Med 2014; 32:21-30. [DOI: 10.1017/ipm.2014.74] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
ObjectivesWe aimed to examine the association between childhood trauma and functional impairment in psychotic disorders, bipolar disorder and borderline personality disorder, to speculate on possible mechanisms that underlie this association and discuss the implications for clinical work.MethodsNarrative review of the peer-reviewed English language literature in the area.ResultsHigh rates of childhood trauma in psychotic disorders, bipolar disorder and borderline personality disorder were identified. This was associated with impaired social and occupational functioning in both the premorbid and established phases of each of these psychiatric disorders over and above the deficits typically observed in these populations. Possible mechanisms mediating this relationship include neurocognitive deficits, insecure attachment, higher rates of comorbidities and problems with adherence and response to treatment.ConclusionsRoutine clinical inquiry about childhood maltreatment should be adopted within mental health settings. This has potentially important treatment implications for identifying those individuals at elevated risk of functional disability. While there is no clear guidance currently available on how to target childhood trauma in the treatment of psychotic disorders, bipolar disorder or borderline personality disorder, there are several promising lines of enquiry and further research is warranted.
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Hacioglu Yildirim M, Yildirim EA, Kaser M, Guduk M, Fistikci N, Cinar O, Yuksel S. The relationship between adulthood traumatic experiences and psychotic symptoms in female patients with schizophrenia. Compr Psychiatry 2014; 55:1847-54. [PMID: 25214374 DOI: 10.1016/j.comppsych.2014.08.049] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 08/16/2014] [Accepted: 08/20/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Previously, research aiming to investigate the effects of interpersonal traumatic experiences on psychotic symptoms mainly focused on adverse experiences in childhood. As mentioned above, patients with schizophrenia, particularly women, are at high risk for physical and sexual abuse in adulthood. In this study we aimed to investigate the effects of adulthood trauma in a sample of patients with schizophrenia who did not report childhood trauma. METHODS Seventy female patients with schizophrenia participated in the study. Assessment included Traumatic Experiences Checklist, Positive and Negative Syndrome Scale and Calgary Depression Scale for Schizophrenia. RESULTS The rates of traumatic events were as follows: physical abuse (81.4%), emotional abuse (78.6%), emotional neglect (55.7%), sexual harassment (28.6%), and sexual abuse (24.3%). Positive and Negative Syndrome Scale hallucinations, blunted affect, emotional withdrawal hostility, anxiety and affective lability item scores were significantly higher for patients who reported a history of sexual harassment. Patients who were exposed to sexual assault as adults had significantly higher scores in the Positive and Negative Syndrome Scale, anxiety, anger and difficulty in delaying gratification items. CONCLUSION We concluded that traumatic life events and exposure to violence were common among female patients with schizophrenia and sexual trauma in adulthood was associated with particular clinical symptoms.
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Affiliation(s)
| | - Ejder Akgun Yildirim
- Bakirkoy Research and Training Hospital For Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey.
| | - Muzaffer Kaser
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Bahcesehir University, Istanbul, Turkey.
| | - Mehmet Guduk
- Memorial Hospital, Pychiatry Clinic, Istanbul, Turkey.
| | - Nurhan Fistikci
- Bakirkoy Research and Training Hospital For Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey.
| | | | - Sahika Yuksel
- Istanbul Universty, Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul, Turkey.
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Childhood maltreatment, adult attachment and psychotic symptomatology: a study in patients, siblings and controls. Soc Psychiatry Psychiatr Epidemiol 2014; 49:1759-67. [PMID: 24934617 DOI: 10.1007/s00127-014-0894-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 05/22/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The association between childhood maltreatment (ChM) and psychotic disorders is well established. However, there is an ongoing debate about which factors account for this relationship. One explanation is that the relationship between ChM and psychosis is mediated by adult attachment style. Therefore, in this study, we aimed to investigate whether adult attachment style mediates the relationship between ChM and positive and negative symptomatology. METHODS We investigated the relation between ChM and psychotic symptoms, taking into account levels of (insecure) attachment, in 131 patients with psychotic illness, 123 siblings and 72 controls. ChM was assessed with the Childhood Trauma Questionnaire (CTQ). Attachment dimensions of anxiety and avoidance were measured using the Psychosis Attachment Measure (PAM). RESULTS In both patients and siblings, ChM predicted positive symptoms and this relationship was partly mediated by attachment style. This relationship was found to be stronger for siblings than for patients. ChM predicted negative symptoms in patients and siblings. In the patient sample, attachment style did not mediate the relationship between ChM and negative symptoms, whereas attachment style was found to be a mediator in the sibling sample. CONCLUSIONS ChM was associated with positive and negative symptomatology in both patients and siblings. Particularly in siblings, the relationship between ChM and psychosis seems to be mediated by adult attachment style. Perhaps attachment style may play a more prominent role on a subclinical level.
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Boyette LL, van Dam D, Meijer C, Velthorst E, Cahn W, de Haan L, Kahn R, de Haan L, van Os J, Wiersma D, Bruggeman R, Cahn W, Meijer C, Myin-Germeys I. Personality compensates for impaired quality of life and social functioning in patients with psychotic disorders who experienced traumatic events. Schizophr Bull 2014; 40:1356-65. [PMID: 24771304 PMCID: PMC4193722 DOI: 10.1093/schbul/sbu057] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Patients with psychotic disorders who experienced childhood trauma show more social dysfunction than patients without traumatic experiences. However, this may not hold for all patients with traumatic experiences. Little is known about the potential compensating role of Five-Factor Model personality traits within this group, despite their strong predictive value for social functioning and well-being in the general population. METHODS Our sample consisted of 195 patients with psychotic disorders (74% diagnosed with schizophrenia) and 132 controls. Cluster analyses were conducted to identify and validate distinct personality profiles. General linear model analyses were conducted to examine whether patients with different profiles differed in social functioning and quality of life (QoL), while controlling for possible confounders. Mediation models were tested to assess potential causal links. RESULTS In general, patients with higher levels of self-reported traumatic experiences (PT+) showed lower QoL and more social withdrawal compared with patients with lower traumatic experiences (PT-). Two clusters reflecting personality profiles were identified. PT+ with the first profile (lower neuroticism and higher extraversion, openness, agreeableness, and conscientiousness) presented higher levels of QoL and better social functioning in several areas, including less withdrawal, compared with both PT+ and PT- with the second profile. PT+ and PT- with the first personality profile did not differ in QoL and social functioning. Mediation analyses suggested that personality traits mediate the relation between traumatic experiences and QoL and social withdrawal. CONCLUSIONS Our findings indicate that personality may "buffer" the impact of childhood traumatic experiences on functional outcome in patients with psychotic disorders.
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Affiliation(s)
- Lindy-Lou Boyette
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands;
| | - Daniëlla van Dam
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Carin Meijer
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - René Kahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Jim van Os
- Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
| | - Durk Wiersma
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Carin Meijer
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Inez Myin-Germeys
- Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
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Walker-Williams HJ, van Eeden C, van der Merwe K. Coping Behaviour, Posttraumatic Growth and Psychological Well-Being in Women with Childhood Sexual Abuse. JOURNAL OF PSYCHOLOGY IN AFRICA 2014. [DOI: 10.1080/14330237.2013.10820622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Thompson AD, Nelson B, Yuen HP, Lin A, Amminger GP, McGorry PD, Wood SJ, Yung AR. Sexual trauma increases the risk of developing psychosis in an ultra high-risk "prodromal" population. Schizophr Bull 2014; 40:697-706. [PMID: 23455040 PMCID: PMC3984502 DOI: 10.1093/schbul/sbt032] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Studies indicate a high prevalence of childhood trauma in patient cohorts with established psychotic disorder and in those at risk of developing psychosis. A causal link between childhood trauma and development of psychosis has been proposed. We aimed to examine the association between experience of childhood trauma and the development of a psychotic disorder in a large "Ultra High Risk" (UHR) for psychosis cohort. The data were collected as part of a longitudinal cohort study of all UHR patients recruited to research studies at the Personal Assessment and Clinical Evaluation clinic between 1993 and 2006. Baseline data were collected at recruitment to these studies. The participants completed a comprehensive follow-up assessment battery (mean time to follow-up 7.5 years, range 2.4-14.9 years), which included the Childhood Trauma Questionnaire (CTQ), a self-report questionnaire that assesses experience of childhood trauma. The outcome of interest was transition to a psychotic disorder during the follow-up period. Data were available on 233 individuals. Total CTQ trauma score was not associated with transition to psychosis. Of the individual trauma types, only sexual abuse was associated with transition to psychosis (P = .02). The association remained when adjusting for potential confounding factors. Those with high sexual abuse scores were estimated to have a transition risk 2-4 times that of those with low scores. The findings suggest that sexual trauma may be an important contributing factor in development of psychosis for some individuals.
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Affiliation(s)
- Andrew D Thompson
- *To whom correspondence should be addressed; East Sussex Early Intervention Service, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Mill View Hospital, Nevill Avenue, Hove, BN3 7HZ, UK; tel: +441323446062, fax: 01323446064, e-mail:
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Li X, Wang Z, Hou Y, Wang Y, Liu J, Wang C. Effects of childhood trauma on personality in a sample of Chinese adolescents. CHILD ABUSE & NEGLECT 2014; 38:788-796. [PMID: 24161247 DOI: 10.1016/j.chiabu.2013.09.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 09/01/2013] [Accepted: 09/04/2013] [Indexed: 06/02/2023]
Abstract
Childhood trauma is a major public health problem which has an impact on personality development, yet no studies have examined the association between exposure to trauma and personality in a sample of Chinese adolescents. Four hundred eighty-five students completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF) and the Eysenck Personality Questionnaire (EPQ). The CTQ-SF cut-off scores for exposure were used to calculate the prevalence of trauma. The possible associations between specific types of trauma and the EPQ subscale scores were examined. The rates of emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN) were 18.76%, 11.13%, 27.01%, 49.48%, and 68.66%, respectively. Individuals subjected to EA, PA, and SA had significantly higher neuroticism (EPQ-N) and psychoticism (EPQ-P) scores on the EPQ compared with those who had not experienced EA, PA, or SA (all p values<0.05). Significant positive correlations existed between CTQ-SF subscale scores for EA, SA, CTQ-SF total scores, and EPQ-N, EPQ-P scores (all p values<0.05). Significant number of subjects in this adolescent sample reported experience of childhood abuse and neglect. Exposure to childhood trauma is associated with personality development in Chinese adolescents.
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Affiliation(s)
- XianBin Li
- Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - ZhiMin Wang
- Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - YeZhi Hou
- Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Ying Wang
- Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - JinTong Liu
- Department of Psychiatry, Shandong University School of Medicine, Jinan 250014, China
| | - ChuanYue Wang
- Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
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Criminal victimisation in people with severe mental illness: a multi-site prevalence and incidence survey in the Netherlands. PLoS One 2014; 9:e91029. [PMID: 24609108 PMCID: PMC3946683 DOI: 10.1371/journal.pone.0091029] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 02/07/2014] [Indexed: 11/28/2022] Open
Abstract
Background Although crime victimisation is as prevalent in psychiatric patients as crime perpetration (and possibly more so), few European figures for it are available. We therefore assessed its one-year prevalence and incident rates in Dutch severely mentally ill outpatients, and compared the results with victimisation rates in the general population. Method This multisite epidemiological survey included a random sample of 956 adult severely mentally ill outpatients. Data on victimisation were obtained using the victimisation scale of the Dutch Crime and Victimisation Survey, which assesses crime victimisation over the preceding 12 months. Comparison data were derived from the nationwide survey on safety and victimisation in the Netherlands. Prevalence and incident rates were weighted for sex, age, ethnicity and socioeconomic status, and compared with a general population sample matched by region (N = 38,227). Results In the past year, almost half of the severely mentally ill outpatients (47%) had been victim of a crime. After control for demographic differences, prevalence rates of overall and specific victimisation measures were significantly higher in severely mentally ill outpatients than in the general population. The relative rates were especially high for personal crimes such as violent threats (RR = 2.12, 95% CI: 1.72–2.61), physical assaults (RR = 4.85, 95% CI: 3.69–6.39) and sexual harassment and assaults (RR = 3.94, 95% CI: 3.05–5.09). In concordance, severely mentally ill outpatients reported almost 14 times more personal crime incidents than persons from the general population (IRR = 13.68, 95% CI: 12.85–14.56). Conclusion Crime victimisation is a serious problem in Dutch severely mentally ill outpatients. Mental-healthcare institutions and clinicians should become aware of their patients’ victimisation risk, and should implement structural measures to detect and prevent (re-)victimisation.
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