The effects of childhood adversity on treatment delays and its components in first-episode psychosis

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2022
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Veru, Franz
MacDonald, Kathleen
Malla, Ashok
King, Suzanne
Joober, Ridha
Shah, Jai
Iyer, Srividya N.
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Psychiatry Research. Elsevier. 2022, 308, 114341. ISSN 0165-1781. eISSN 1872-7123. Available under: doi: 10.1016/j.psychres.2021.114341
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Apart from increasing risk for psychotic disorders, childhood adversity has been associated with worse outcomes. One way in which childhood adversity may worsen outcomes is by lengthening treatment delays, which are associated with negative impacts. We tested the influence of childhood trauma on treatment delays, measured as the duration of untreated psychosis (DUP), and its help-seeking and referral components, in a first-episode psychosis cohort (N = 203). We accounted for pertinent social (e.g., migrant status) and other determinants (i.e., age at onset, diagnosis, symptoms) of treatment delays. Multiple linear regression analyses revealed that for a one-unit increase in Childhood Trauma Questionnaire (CTQ) scores, average overall DUP increased by 25%. Higher CTQ scores also significantly predicted help-seeking and referral DUPs. Patients with schizophrenia-spectrum psychosis had longer help-seeking and total DUPs than those with affective psychosis. More severe positive symptoms predicted longer help-seeking DUPs, while more severe negative symptoms predicted longer referral DUPs. Indicators of social disadvantage did not affect DUP. Our results show that childhood trauma increases DUP by prolonging the help-seeking process and delaying access to mental healthcare even after help is sought. Early identification of psychosis among populations with trauma histories seems warranted and can likely positively impact outcomes.

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ISO 690VERU, Franz, Kathleen MACDONALD, Ashok MALLA, Marita PRUESSNER, Suzanne KING, Ridha JOOBER, Jai SHAH, Srividya N. IYER, 2022. The effects of childhood adversity on treatment delays and its components in first-episode psychosis. In: Psychiatry Research. Elsevier. 2022, 308, 114341. ISSN 0165-1781. eISSN 1872-7123. Available under: doi: 10.1016/j.psychres.2021.114341
BibTex
@article{Veru2022effec-56127,
  year={2022},
  doi={10.1016/j.psychres.2021.114341},
  title={The effects of childhood adversity on treatment delays and its components in first-episode psychosis},
  volume={308},
  issn={0165-1781},
  journal={Psychiatry Research},
  author={Veru, Franz and MacDonald, Kathleen and Malla, Ashok and Pruessner, Marita and King, Suzanne and Joober, Ridha and Shah, Jai and Iyer, Srividya N.},
  note={Article Number: 114341}
}
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