Patients at risk for psychosis report increased childhood trauma

By Mark Cowen, Senior medwireNews Reporter

Patients at clinical high risk (CHR) for psychosis are more likely to have a history of traumatic childhood experiences than mentally healthy individuals, Finnish researchers report.

Indeed, all 20 CHR patients (mean age 23.1 years) in the study reported at least one traumatic childhood experience compared with 60% of 30 mentally healthy controls of similar age and education level.

The team also found that increased levels of childhood trauma were significantly associated with reduced premorbid adjustment in CHR patients.

The findings are important, as "deteriorating premorbid functioning from childhood, and through adolescence, is related to greater severity of overall symptomatology and poorer outcomes in patients with psychosis," say Maria Tikka and colleagues from the University of Turku.

All of the participants, who were from southwest Finland, completed the self-report Trauma and Distress Scale (TADS), a 43-item self-rating scale that covers five domains (sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect) in childhood and adolescence.

They also completed the premorbid adjustment scale (PAS), which assesses the achievement of developmental goals in childhood, early adolescence, late adolescence, adulthood, and in "general."

The team found that 100% of CHR patients reported emotional or physical neglect versus 33.3% of controls, 35.0% versus 10.0% reported physical abuse, 75.0% versus 13.3% reported emotional abuse, and 20.0% versus 3.3% reported sexual abuse.

CHR patient had significantly higher TADS total scores than controls, at 24.1 versus 7.1, as well as higher scores for all subscales. They also had significantly poorer PAS scores than controls.

In CHR patients, there was significant correlation between TADS scores and PAS general scores, and an "observable," albeit nonsignificant, correlation with PAS adolescence and adulthood scores.

Tikka et al conclude in Early Intervention in Psychiatry: "Our findings show that the CHR patients are more likely to have a history of traumatic childhood experiences, including emotional, physical and sexual trauma, than the NCSs [normal control subjects]."

They add: "In CHR patients, traumatic childhood experiences are associated with poor general premorbid adjustment."

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