Impact of childhood trauma on positive and negative symptom remission in first episode psychosis

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2021
Autor:innen
King, Suzanne
Veru, Franz
Vracotas, Nadia
Abadi, Sherezad
Jordan, Gerald
Lepage, Martin
Iyer, Srividya
Malla, Ashok K.
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Schizophrenia Research. Elsevier. 2021, 231, pp. 82-89. ISSN 0920-9964. eISSN 1573-2509. Available under: doi: 10.1016/j.schres.2021.02.023
Zusammenfassung

Objective
Early life adversity is suspected to play an important role for onset and course of psychosis, but its relationship with longer-term clinical outcome is not entirely clear. In this longitudinal study, we investigated the impact of childhood trauma (CT) on positive and negative symptom remission in first episode psychosis (FEP) patients over two years.

Methods
A total of 210 FEP patients were assessed with the Childhood Trauma Questionnaire. Patients reporting moderate to severe trauma (CT; N = 114; 54.3%) were compared to those without trauma (N-CT; N = 96; 45.7%). Positive (PSR) and negative symptom remission (NSR) were determined monthly over 24 months following established criteria using the Scale for Assessment of Positive Symptoms and the Scale for Assessment of Negative Symptoms. Global Functioning was evaluated at baseline and 24 months of follow-up.

Results
Compared to N-CT patients, CT patients had achieved significantly lower rates of PSR at 12 months and significantly lower rates of NSR at 24 months. A dose-response relationship was observed between the number of trauma categories fulfilled and the number of patients not achieving PSR and NSR at these time points. Higher trauma scores were significantly associated with poor functioning and higher positive and negative symptom severity at 24 months, but not at baseline and 12 months of follow-up.

Conclusion
Differential effects of CT on clinical outcome may not be apparent at psychosis onset, but only become evident through poor symptomatic remission and general functioning over time. Targeted diagnostic and therapeutic efforts after illness onset might limit these detrimental consequences.

Zusammenfassung in einer weiteren Sprache
Fachgebiet (DDC)
150 Psychologie
Schlagwörter
Schizophrenia, First episode psychosis, Early life adversity, Childhood trauma, Symptom remission
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ISO 690PRUESSNER, Marita, Suzanne KING, Franz VERU, Inga SCHALINSKI, Nadia VRACOTAS, Sherezad ABADI, Gerald JORDAN, Martin LEPAGE, Srividya IYER, Ashok K. MALLA, 2021. Impact of childhood trauma on positive and negative symptom remission in first episode psychosis. In: Schizophrenia Research. Elsevier. 2021, 231, pp. 82-89. ISSN 0920-9964. eISSN 1573-2509. Available under: doi: 10.1016/j.schres.2021.02.023
BibTex
@article{Pruessner2021-03-31Impac-53343,
  year={2021},
  doi={10.1016/j.schres.2021.02.023},
  title={Impact of childhood trauma on positive and negative symptom remission in first episode psychosis},
  volume={231},
  issn={0920-9964},
  journal={Schizophrenia Research},
  pages={82--89},
  author={Pruessner, Marita and King, Suzanne and Veru, Franz and Schalinski, Inga and Vracotas, Nadia and Abadi, Sherezad and Jordan, Gerald and Lepage, Martin and Iyer, Srividya and Malla, Ashok K.}
}
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    <dcterms:abstract xml:lang="eng">Objective&lt;br /&gt;Early life adversity is suspected to play an important role for onset and course of psychosis, but its relationship with longer-term clinical outcome is not entirely clear. In this longitudinal study, we investigated the impact of childhood trauma (CT) on positive and negative symptom remission in first episode psychosis (FEP) patients over two years.&lt;br /&gt;&lt;br /&gt;Methods&lt;br /&gt;A total of 210 FEP patients were assessed with the Childhood Trauma Questionnaire. Patients reporting moderate to severe trauma (CT; N = 114; 54.3%) were compared to those without trauma (N-CT; N = 96; 45.7%). Positive (PSR) and negative symptom remission (NSR) were determined monthly over 24 months following established criteria using the Scale for Assessment of Positive Symptoms and the Scale for Assessment of Negative Symptoms. Global Functioning was evaluated at baseline and 24 months of follow-up.&lt;br /&gt;&lt;br /&gt;Results&lt;br /&gt;Compared to N-CT patients, CT patients had achieved significantly lower rates of PSR at 12 months and significantly lower rates of NSR at 24 months. A dose-response relationship was observed between the number of trauma categories fulfilled and the number of patients not achieving PSR and NSR at these time points. Higher trauma scores were significantly associated with poor functioning and higher positive and negative symptom severity at 24 months, but not at baseline and 12 months of follow-up.&lt;br /&gt;&lt;br /&gt;Conclusion&lt;br /&gt;Differential effects of CT on clinical outcome may not be apparent at psychosis onset, but only become evident through poor symptomatic remission and general functioning over time. Targeted diagnostic and therapeutic efforts after illness onset might limit these detrimental consequences.</dcterms:abstract>
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