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

TitleImpact of childhood trauma on positive and negative symptom remission in first episode psychosis.
Publication TypeJournal Article
Year of Publication2021
AuthorsPruessner M, King S, Veru F, Schalinski I, Vracotas N, Abadi S, Jordan G, Lepage M, Iyer SN, Malla A, Shah JL, Joober R
JournalSchizophr Res
Volume231
Pagination82-89
Date Published2021 05
ISSN1573-2509
KeywordsHumans, Longitudinal Studies, Psychotic Disorders
Abstract

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.

DOI10.1016/j.schres.2021.02.023
Alternate JournalSchizophr Res
PubMed ID33812301
Grant List / / CIHR / Canada