A comparison between self-report and interviewer-rated retrospective reports of childhood abuse among individuals with first-episode psychosis and population-based controls

AbstractGoal:The present study aimed to examine the prevalence of child abuse across the continuum of psychosis.Patients and methods:The sample consisted of 198 individuals divided in three groups: (1) 48 FEP patients, (2) 77 individuals scoring high in Community Assessment of Psychic Experiences (CAPE), classified as “High CAPE” group and (3) 73 individuals scoring low, classified as “Low CAPE” group. Childhood abuse was assessed using self-report instruments. Chi2 tests and logistic regression models controlling by sex, age and cannabis were used to perform three comparisons: (i) FEP vs. Low CAPE; (ii) FEP vs. High CAPE and (iii) High CAPE vs. Low CAPE.Results:The frequency of individuals exposed to childhood abuse for FEP, High CAPE and Low CAPE groups were 52.1%, 41.6% and 11%, respectively. FEP and High CAPE group presented significantly higher rates of childhood abuse compared to Low CAPE group, however, no significant differences were found between FEP and High CAPE groups regarding the frequency of childhood abuse.Conclusion:There is an increasing frequency of childhood abuse from low subclinical psychosis to FEP patients. However, childhood abuse is equally common in FEP and at risk individuals.

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Gender differences in the association between childhood abuse and psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.047985 ◽

2009 ◽

Vol 194 (4) ◽

pp. 319-325 ◽

Cited By ~ 131

Author(s):

Helen Fisher ◽

Craig Morgan ◽

Paola Dazzan ◽

Thomas K. Craig ◽

Kevin Morgan ◽

...

Keyword(s):

Gender Differences ◽

Sexual Abuse ◽

Physical Abuse ◽

Childhood Abuse ◽

Population Based ◽

First Episode Psychosis ◽

First Episode ◽

Control Group ◽

Childhood Experiences ◽

Episode Psychosis

BackgroundStudies demonstrating an association between childhood trauma and psychosis in adulthood have not systematically explored gender differences.AimsTo investigate gender differences in the prevalence of childhood sexual and physical abuse among people with psychosis in comparison with healthy controls.MethodThe Childhood Experiences of Care and Abuse Questionnaire was completed to elicit experiences of sexual and physical abuse during childhood in first-episode psychosis cases and population-based controls.ResultsAmong women, those in the cases group were twice as likely to report either physical or sexual abuse compared with controls following adjustment for all confounders. In particular, the effect of physical abuse in women was stronger and more robust than that for sexual abuse. A similar trend was found for psychotic-like experiences in the female control group. No association was found in men.ConclusionsReports of severe childhood physical or sexual abuse were associated with psychosis in women but not in men.

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Estimating the incidence of first-episode psychosis using population-based health administrative data to inform early psychosis intervention services

Psychological Medicine ◽

10.1017/s0033291718002933 ◽

2018 ◽

Vol 49 (12) ◽

pp. 2091-2099 ◽

Cited By ~ 8

Author(s):

Kelly K. Anderson ◽

Ross Norman ◽

Arlene G. MacDougall ◽

Jordan Edwards ◽

Lena Palaniyappan ◽

...

Keyword(s):

Psychotic Disorder ◽

Administrative Data ◽

Catchment Area ◽

Population Based ◽

First Episode Psychosis ◽

Case Definition ◽

First Episode ◽

Affective Psychosis ◽

Health Administrative Data ◽

Episode Psychosis

AbstractBackgroundDiscrepancies between population-based estimates of the incidence of psychotic disorder and the treated incidence reported by early psychosis intervention (EPI) programs suggest additional cases may be receiving services elsewhere in the health system. Our objective was to estimate the incidence of non-affective psychotic disorder in the catchment area of an EPI program, and compare this to EPI-treated incidence estimates.MethodsWe constructed a retrospective cohort (1997–2015) of incident cases of non-affective psychosis aged 16–50 years in an EPI program catchment using population-based linked health administrative data. Cases were identified by either one hospitalization or two outpatient physician billings within a 12-month period with a diagnosis of non-affective psychosis. We estimated the cumulative incidence and EPI-treated incidence of non-affective psychosis using denominator data from the census. We also estimated the incidence of first-episode psychosis (people who would meet the case definition for an EPI program) using a novel approach.ResultsOur case definition identified 3245 cases of incident non-affective psychosis over the 17-year period. We estimate that the incidence of first-episode non-affective psychosis in the program catchment area is 33.3 per 100 000 per year (95% CI 31.4–35.1), which is more than twice as high as the EPI-treated incidence of 18.8 per 100 000 per year (95% CI 17.4–20.3).ConclusionsCase ascertainment strategies limited to specialized psychiatric services may substantially underestimate the incidence of non-affective psychotic disorders, relative to population-based estimates. Accurate information on the epidemiology of first-episode psychosis will enable us to more effectively resource EPI services and evaluate their coverage.

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Carer subjective burden after first-episode psychosis: Types and predictors. A multilevel statistical approach

International Journal of Social Psychiatry ◽

10.1177/0020764020930041 ◽

2020 ◽

pp. 002076402093004

Author(s):

Shereen Charles ◽

James B Kirkbride ◽

Juliana Onwumere ◽

Natasha Lyons ◽

Lai Chu Man ◽

...

Keyword(s):

Negative Symptoms ◽

First Episode Psychosis ◽

Self Report ◽

First Episode ◽

Negative Consequences ◽

Cross Sectional Survey ◽

Carer Burden ◽

Regression Modelling ◽

Episode Psychosis ◽

Early Intervention In Psychosis

Background: Carer burden at first-episode psychosis is common and adds to the multiple other psychiatric and psychological problems that beset new carers; yet, knowledge of the factors that predict carer burden is limited. Aim: This study sought to investigate the types and predictors of carer burden at first-episode psychosis in the largest, most ethnically diverse and comprehensively characterised sample to date. Method: This study involved a cross-sectional survey of carers of people with first-episode psychosis presenting to Harrow and Hillingdon Early Intervention in Psychosis service between 2011 and 2017. Carers completed self-report measures assessing their illness beliefs, coping styles and caregiving experiences (i.e. burden). Thirty carer and patient sociodemographic and clinical factors were also collected. Mixed effects linear regression modelling was conducted to account for clustering of carers by patient, with carer burden (and its 8 subtypes) investigated as dependent variables. Results: The sample included data on 254 carers (aged 18–74 years) and 198 patients (aged 14–36 years). Regression modelling identified 35 significant predictors of carer burden and its subtypes at first-episode psychosis. Higher total burden was independently predicted by perceiving greater negative consequences of the illness for the patient (B = .014, p < .001, 95% CI: [.010–.018]) and the carer (B = .008, p = .002, 95% CI: [.003–.013]), and engaging in avoidant-focussed coping (B = .010, p = .006, 95% CI: [.003–.016]). Lower burden was independently predicted by patients being in a relationship (B = −.075, p = .047, 95% CI: [−.149 to −.001]). Predictors of the eight burden subtypes (difficult behaviours, negative symptoms, stigma, problems with services, effects on family, dependency, loss and need to backup) are also included in the article. Conclusion: Findings can be used to inform the identification of carers ‘at-risk’ of experiencing burden and highlight potential targets for theraputic intervention to lower carer buden.

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