Decoding the impact of adverse childhood experiences on the progression of schizophrenia

Abstract

Adverse childhood experiences are frequently present in patients with mental disorders, including those with schizophrenia. Whereas an impact of childhood adversities on psychopathology and potential neuroendocrine/biological mediators has been reported for posttraumatic stress disorder, depression, and anxiety disorders, the relationships in schizophrenia remain to be clarified. The present study compared amount and types of adverse childhood experiences (screened by interview) between individuals at risk for psychosis (n = 29), early schizophrenia patients with 1-2 admissions (n = 34), chronic schizophrenia patients with multiple admissions (n = 24), and healthy comparison participants (n = 38). It was expected that at-risk individuals and early-stage as well as chronic patients report more childhood adversities than controls, and that adversity load predicts psychotic symptom severity and altered neuroendocrine regulation based on hair cortisol concentration. Results confirmed more childhood adversities in clinical groups than in controls, and relationships between total childhood adversities and increased positive symptom severity. Hair cortisol concentration did not differ between groups, but early abuse experiences predicted lower hair cortisol concentration, and the latter predicted severity of specific psychotic symptoms in the clinical sample. In conclusion, individuals at risk and with manifest schizophrenia experienced substantial childhood maltreatment, as reported for other diagnoses. The present findings suggest childhood adversities as sensitizing (environmental) factor in vulnerable individuals. Lower hair cortisol concentration may indicate lasting effects of past stress experiences on stress axis function in schizophrenia, which might modulate unfolding psychopathology.