scholarly journals Childhood trauma and psychosis - what is the evidence?

2011 ◽  
Vol 13 (3) ◽  
pp. 360-365 ◽  
Keyword(s):  
Childhood Trauma ◽  
Suicide Attempts ◽  
Population Based ◽  
Psychotic Symptoms ◽  
Post Traumatic Stress ◽  
History Of Childhood ◽  
Wide Range ◽  
History Of ◽  
Negative Perceptions ◽  
Increased Sensitivity

In the last decade, a substantial number of population-based studies have suggested that childhood trauma is a risk factor for psychosis. In several studies, the effects held after adjusting for a wide range of potentially confounding variables, including genetic liability for psychosis. Less is known about the mechanisms underlying the association between childhood trauma and psychosis. Possible pathways include relationships between negative perceptions of the self, negative affect, and psychotic symptoms, as well as biological mechanisms such as dysregulated cortisol and increased sensitivity to stress. Psychotic patients with a history of childhood trauma tend to present with a variety of additional problems, including post-traumatic stress disorder, greater substance abuse, higher levels of depression and anxiety, and more frequent suicide attempts. Initial studies suggest that trauma-specific treatments are as beneficial for these patients as for other diagnostic groups.

The effects of childhood trauma on psychotic symptoms in bipolar disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 240-240 ◽  
Author(s):  
M.M. Ozkose ◽  
O. Guclu ◽  
S. Guloksuz ◽  
O. Karaca ◽  
B. Yildirim ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Physical Abuse ◽  
Childhood Trauma ◽  
Rating Scale ◽  
Psychotic Symptoms ◽  
Psychotic Episode ◽  
History Of Childhood ◽  
History Of ◽  
Physical Neglect ◽  
Bipolar Patients

IntroductionAlthough history of childhood trauma is present in nearly 50% of bipolar patients, the effects of childhood trauma on the course of bipolar disorder are rarely investigated. Thus, we aimed to investigate the effects of childhood trauma on psychotic symptoms seen in patients with bipolar disorder.MethodsOne-hundred DSM-IV-TR diagnosed bipolar patients who were either manic or depressive were recruited from inpatient units of Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery. Patients were initially evaluated by Young Mania Rating Scale (YMRS), Montgomery-Asperg Depression Rating Scale (MADRS), Scales for Assessment of Positive Symptoms. Patients were also evaluated by Childhood Trauma Questionnaire (CTQ) and Dissociative Experiences Scale in euthymia which was defined by scores of < 7 in YMRS, < 4 in MADRASResultsThere were no differences between the patients with and without a history of psychotic episode in terms of age at onset, duration of illness and episode characteristics. Patients with a history of psychotic episode were hospitalized more. CTQ physical abuse scores were higher in male comparing to female. CTQ sexual abuse scores were higher in female comparing to male. CTQ emotional abuse, physical neglect, physical abuse and total scores were higher in patients who had at least one psychotic episode in lifetime than in patients without a history of psychotic episode.ConclusionThe history of childhood trauma should be investigated and therapeutic interventions for childhood trauma should be added to the standard treatment plan of bipolar patients.

Affective lability mediates the association between childhood trauma and suicide attempts, mixed episodes and co-morbid anxiety disorders in bipolar disorders

2016 ◽  
Vol 47 (5) ◽  
pp. 902-912 ◽  
Author(s):  
M. Aas ◽  
C. Henry ◽  
F. Bellivier ◽  
M. Lajnef ◽  
S. Gard ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Childhood Trauma ◽  
Clinical Features ◽  
Suicide Attempts ◽  
Bipolar Disorders ◽  
History Of Childhood ◽  
History Of ◽  
Axis I ◽  
Affective Lability ◽  
The Relationship

BackgroundMany studies have shown associations between a history of childhood trauma and more severe or complex clinical features of bipolar disorders (BD), including suicide attempts and earlier illness onset. However, the psychopathological mechanisms underlying these associations are still unknown. Here, we investigated whether affective lability mediates the relationship between childhood trauma and the severe clinical features of BD.MethodA total of 342 participants with BD were recruited from France and Norway. Diagnosis and clinical characteristics were assessed using the Diagnostic Interview for Genetic Studies (DIGS) or the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Affective lability was measured using the short form of the Affective Lability Scale (ALS-SF). A history of childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Mediation analyses were performed using the SPSSprocessmacro.ResultsUsing the mediation model and covariation for the lifetime number of major mood episodes, affective lability was found to statistically mediate the relationship between childhood trauma experiences and several clinical variables, including suicide attempts, mixed episodes and anxiety disorders. No significant mediation effects were found for rapid cycling or age at onset.ConclusionsOur data suggest that affective lability may represent a psychological dimension that mediates the association between childhood traumatic experiences and the risk of a more severe or complex clinical expression of BD.

scholarly journals Childhood trauma is associated with a specific admixture of affective, anxiety, and psychosis symptoms cutting across traditional diagnostic boundaries

2014 ◽  
Vol 45 (6) ◽  
pp. 1277-1288 ◽  
Author(s):  
M. van Nierop ◽  
W. Viechtbauer ◽  
N. Gunther ◽  
C. van Zelst ◽  
R. de Graaf ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Childhood Trauma ◽  
Multinomial Logistic Regression ◽  
Population Sample ◽  
Psychotic Symptoms ◽  
History Of Childhood ◽  
Manic Symptoms ◽  
Schizophrenia Group ◽  
History Of ◽  
Meta Analyses

Background.Meta-analyses link childhood trauma to depression, mania, anxiety disorders, and psychosis. It is unclear, however, whether these outcomes truly represent distinct disorders following childhood trauma, or that childhood trauma is associated with admixtures of affective, psychotic, anxiety and manic psychopathology throughout life.Method.We used data from a representative general population sample (NEMESIS-2, n = 6646), of whom respectively 1577 and 1120 had a lifetime diagnosis of mood or anxiety disorder, as well as from a sample of patients with a diagnosis of schizophrenia (GROUP, n = 825). Multinomial logistic regression was used to assess whether childhood trauma was more strongly associated with isolated affective/psychotic/anxiety/manic symptoms than with their admixture.Results.In NEMESIS-2, largely comparable associations were found between childhood trauma and depression, mania, anxiety and psychosis. However, childhood trauma was considerably more strongly associated with their lifetime admixture. These results were confirmed in the patient samples, in which it was consistently found that patients with a history of childhood trauma were more likely to have a combination of multiple symptom domains compared to their non-traumatized counterparts. This pattern was also found in exposed individuals who did not meet criteria for a psychotic, affective or anxiety disorder and who did not seek help for subclinical psychopathology.Conclusions.Childhood trauma increases the likelihood of a specific admixture of affective, anxiety and psychotic symptoms cutting across traditional diagnostic boundaries, and this admixture may already be present in the earliest stages of psychopathology. These findings may have significant aetiological, pathophysiological, diagnostic and clinical repercussions.

The Significance of a History of Childhood Sexual Abuse in Bulimia Nervosa

1995 ◽  
Vol 167 (5) ◽  
pp. 679-682 ◽  
Author(s):  
Patrick F. Sullivan ◽  
Cynthia M. Bulik ◽  
Frances A. Carter ◽  
Peter R. Joyce
Keyword(s):  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Bulimia Nervosa ◽  
Suicide Attempts ◽  
Structured Interviews ◽  
Global Functioning ◽  
History Of Childhood ◽  
Bulimic Symptoms ◽  
History Of ◽  
Bulimic Women

BackgroundChildhood sexual abuse (CSA) is found to have occurred to a substantial minority of women with bulimia nervosa. Its clinical significance is unclear.MethodWe studied 87 bulimic women in a clinical trial. Structured interviews determined the presence of CSA, DSM–III–R disorders, global functioning, and depressive and bulimic symptoms.ResultsForty-four per cent reported a history of CSA. Bulimic women with CSA reported earlier onset of bulimia, greater depressive symptoms, worse global functioning and more suicide attempts, and were more likely to meet criteria for bipolar II disorder, alcohol and drug dependence, conduct disorder and avoidant personality disorder.ConclusionsAlthough those with CSA had greater comorbidity, it was not an important modifier of bulimic symptoms.

scholarly journals Rethinking childhood adversity in chronic fatigue syndrome

2015 ◽  
Author(s):  
James E Clark ◽  
Sean Davidson ◽  
Laura Maclachlan ◽  
Megan Lynn ◽  
Julia L Newton ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Childhood Trauma ◽  
Childhood Adversity ◽  
Chronic Fatigue ◽  
Childhood Trauma Questionnaire ◽  
History Of Childhood ◽  
Fatigue Syndrome ◽  
Increased Risk ◽  
Co Morbidity ◽  
History Of

Objectives: Previous studies have consistently shown increased rates of childhood adversity in chronic fatigue syndrome (CFS). However, such aetiopathogenic studies of CFS are potentially confounded by co-morbidity and misdiagnosis particularly with depression. We used a modelling approach with existing data and data generated in our examination of the rates of childhood adversity in a sample of CFS patients who had no lifetime history of depression. Methods: The childhood trauma questionnaire (CTQ) was completed by a sample of 52 participants and 19 controls with chronic fatigue syndrome who did not meet criteria for a psychiatric disorder (confirmed using the Structured Clinical Interview for DSM-IV). Subsequently, Mediation Analysis (Baye’s Rules) was used to establish the risk childhood adversity poses for CFS with and without depression. Results: In a cohort of CFS patients with depression robustly excluded, CTQ scores were markedly lower than in all previous studies and, in contrast to these previous studies, not increased compared with healthy controls. Post-hoc analysis showed that CTQ scores correlated with the number of depressive symptoms during the lifetime worst period of low mood. The probability of developing CFS given a history of childhood trauma was shown to be 4%, a two-fold increased risk compared to the general population. However, much of this risk is mediated by the concomitant development of major depression. Discussion: The data suggests that previous studies showing a relationship between childhood adversity and CFS may be mediated by depression

Childhood trauma and being at-risk for psychosis are associated with higher peripheral endocannabinoids

2019 ◽  
Vol 50 (11) ◽  
pp. 1862-1871 ◽  
Author(s):  
E. Appiah-Kusi ◽  
R. Wilson ◽  
M. Colizzi ◽  
E. Foglia ◽  
E. Klamerus ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Childhood Trauma ◽  
Childhood Maltreatment ◽  
Peripheral Blood ◽  
Endocannabinoid System ◽  
History Of Childhood ◽  
Increased Risk ◽  
History Of

AbstractBackgroundEvidence has been accumulating regarding alterations in components of the endocannabinoid system in patients with psychosis. Of all the putative risk factors associated with psychosis, being at clinical high-risk for psychosis (CHR) has the strongest association with the onset of psychosis, and exposure to childhood trauma has been linked to an increased risk of development of psychotic disorder. We aimed to investigate whether being at-risk for psychosis and exposure to childhood trauma were associated with altered endocannabinoid levels.MethodWe compared 33 CHR participants with 58 healthy controls (HC) and collected information about previous exposure to childhood trauma as well as plasma samples to analyse endocannabinoid levels.ResultsIndividuals with both CHR and experience of childhood trauma had higher N-palmitoylethanolamine (p < 0.001) and anandamide (p < 0.001) levels in peripheral blood compared to HC and those with no childhood trauma. There was also a significant correlation between N-palmitoylethanolamine levels and symptoms as well as childhood trauma.ConclusionsOur results suggest an association between CHR and/or childhood maltreatment and elevated endocannabinoid levels in peripheral blood, with a greater alteration in those with both CHR status and history of childhood maltreatment compared to those with either of those risks alone. Furthermore, endocannabinoid levels increased linearly with the number of risk factors and elevated endocannabinoid levels correlated with the severity of CHR symptoms and extent of childhood maltreatment. Further studies in larger cohorts, employing longitudinal designs are needed to confirm these findings and delineate the precise role of endocannabinoid alterations in the pathophysiology of psychosis.

A population-based twin study in women of smoking initiation and nicotine dependence

1999 ◽  
Vol 29 (2) ◽  
pp. 299-308 ◽  
Author(s):  
K. S. KENDLER ◽  
M. C. NEALE ◽  
P. SULLIVAN ◽  
L. A. COREY ◽  
C. O. GARDNER ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nicotine Dependence ◽  
Structural Equation ◽  
Substance Dependence ◽  
Smoking Initiation ◽  
Population Based ◽  
Familial Factors ◽  
Wide Range ◽  
History Of ◽  
Low Levels

Background. The development of drug dependence requires prior initiation. What is the relationship between the risk factors for initiation and dependence?Methods. Using smoking as a model addiction, we assessed smoking initiation (SI) and nicotine dependence (ND) by personal interview in 1898 female twins from the population-based Virginia Twin Registry. We developed a twin structural equation model that estimates the correlation between the liability to SI and the liability to ND, given SI.Results. The liabilities to SI and ND were substantially correlated but not identical. Heritable factors played an important aetiological role in SI and in ND. While the majority of genetic risk factors for ND were shared with SI, a distinct set of familial factors, which were probably partly genetic, solely influenced the risk for ND. SI was associated with low levels of education and religiosity, high levels of neuroticism and extroversion and a history of a wide range of psychiatric disorders. ND was associated with low levels of education, extroversion, mastery, and self-esteem, high levels of neuroticism and dependency and a history of mood and alcohol use disorders.Conclusions. The aetiological factors that influence SI and ND, while overlapping, are not perfectly correlated. One set of genetic factors plays a significant aetiological role in both SI and ND, while another set of familial factors, probably in part genetic, solely influences ND. Some risk factors for SI and ND impact similarly on both stages, some act at only one stage and others impact differently and even in opposite directions at the two stages. The pathway to substance dependence is complex and involves multiple genetic and environmental risk factors.

scholarly journals Lithium for suicide and readmission prevention after electroconvulsive therapy for unipolar depression: population-based register study

BJPsych Open ◽  
2019 ◽  
Vol 5 (3) ◽  
Author(s):  
Ole Brus ◽  
Yang Cao ◽  
Åsa Hammar ◽  
Mikael Landén ◽  
Johan Lundberg ◽  
...  
Keyword(s):  
Electroconvulsive Therapy ◽  
Suicide Attempts ◽  
Cox Regression ◽  
Lithium Treatment ◽  
Unipolar Depression ◽  
Population Based ◽  
Register Study ◽  
Quality Register ◽  
National Quality ◽  
History Of

Background Electroconvulsive therapy (ECT) is effective for unipolar depression but relapse and suicide are significant challenges. Lithium could potentially lower these risks, but is used only in a minority of patients. Aims This study quantifies the effect of lithium on risk of suicide and readmission and identifies factors that are associate with readmission and suicide. Method This population-based register study used data from the Swedish National Quality Register for ECT and other Swedish national registers. Patients who have received ECT for unipolar depression as in-patients between 2011 and 2016 were followed until death, readmission to hospital or the termination of the study at the end of 2016. Cox regression was used to estimate hazard ratios (HR) of readmission and suicide in adjusted models. Results Out of 7350 patients, 56 died by suicide and 4203 were readmitted. Lithium was prescribed to 638 (9%) patients. Mean follow-up was 1.4 years. Lithium was significantly associated with lower risk of suicide (P = 0.014) and readmission (HR 0.84 95% CI 0.75–0.93). The number needed to be treated with lithium to prevent one readmission was 16. In addition, the following factors were statistically associated with suicide: male gender, being a widow, substance use disorder and a history of suicide attempts. Readmission was associated with young age, being divorced or unemployed, comorbid anxiety disorder, nonpsychotic depression, more severe symptoms before ECT, no improvement with ECT, not receiving continuation ECT or antidepressants, usage of antipsychotics, anxiolytics or benzodiazepines, severity of medication resistance and number of previous admissions. Conclusions More patients could benefit from lithium treatment. Declaration of interest None.

scholarly journals Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies

2012 ◽  
Vol 201 (1) ◽  
pp. 26-32 ◽  
Author(s):  
I. Kelleher ◽  
H. Keeley ◽  
P. Corcoran ◽  
F. Lynch ◽  
C. Fitzpatrick ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Early Adolescence ◽  
Longitudinal Research ◽  
Age Groups ◽  
Population Based ◽  
Diagnostic Interview ◽  
Psychotic Symptoms ◽  
Childhood And Adolescence ◽  
Wide Range ◽  
Clinicopathological Significance

BackgroundEpidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.AimsTo investigate the relationship between psychotic symptoms and non-psychotic psychopathology in community samples of adolescents in terms of prevalence, co-occurring disorders, comorbid (multiple) psychopathology and variation across early v. middle adolescence.MethodData from four population studies were used: two early adolescence studies (ages 11–13 years) and two mid-adolescence studies (ages 13–16 years). Studies 1 and 2 involved school-based surveys of 2243 children aged 11–16 years for psychotic symptoms and for emotional and behavioural symptoms of psychopathology. Studies 3 and 4 involved in-depth diagnostic interview assessments of psychotic symptoms and lifetime psychiatric disorders in community samples of 423 children aged 11–15 years.ResultsYounger adolescents had a higher prevalence (21–23%) of psychotic symptoms than older adolescents (7%). In both age groups the majority of adolescents who reported psychotic symptoms had at least one diagnosable non-psychotic psychiatric disorder, although associations with psychopathology increased with age: nearly 80% of the mid-adolescence sample who reported psychotic symptoms had at least one diagnosis, compared with 57% of the early adolescence sample. Adolescents who reported psychotic symptoms were at particularly high risk of having multiple co-occurring diagnoses.ConclusionsPsychotic symptoms are important risk markers for a wide range of non-psychotic psychopathological disorders, in particular for severe psychopathology characterised by multiple co-occurring diagnoses. These symptoms should be carefully assessed in all patients.

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