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Influence of childhood trauma on diagnosis and substance use in first-episode psychosis

  • S. Tomassi (a1), S. Tosato (a2), V. Mondelli (a3), C. Faravelli (a4), A. Lasalvia (a5), G. Fioravanti (a4), C. Bonetto (a6), A. Fioritti (a7), C. Cremonese (a8), R. Lo Parrino (a9), K. De Santi (a5), A. Meneghelli (a10), S. Torresani (a11), G. De Girolamo (a12), E. Semrov (a13), M. Pratelli (a6), D. Cristofalo (a14) and the GET UP Group (a14)...

Abstract

Background

Childhood trauma has been significantly associated with first-episode psychosis, affective dysfunction and substance use.

Aims

To test whether people with first-episode psychosis who had experienced childhood trauma, when compared with those who had not, showed a higher rate of affective psychosis and an increased lifetime rate of substance use.

Method

The sample comprised 345 participants with first-episode psychosis (58% male, mean age 29.8 years, s.d.=9.7).

Results

Severe sexual abuse was significantly associated with a diagnosis of affective psychosis (χ2=4.9, P=0.04) and with higher rates of lifetime use of cannabis (68% v. 41%; P = 0.02) and heroin (20% v. 5%; P=0.02). Severe physical abuse was associated with increased lifetime use of heroin (15% v. 5%; P = 0.03) and cocaine (32% v. 17%; P = 0.05).

Conclusions

Patients with first-episode psychosis exposed to childhood trauma appear to constitute a distinctive subgroup in terms of diagnosis and lifetime substance use.

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Copyright

Corresponding author

Professor Sarah Tosato, Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, P. le Scuro, 10 37134 – Verona, Italy. Email: sarah.tosato@univr.it

Footnotes

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Declaration of interest

None.

Footnotes

References

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1 Fisher, HL, Jones, PB, Fearon, P, Craig, TK, Dazzan, P, Morgan, K, et al. The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder. Psychol Med 2010; 40: 1967–78.
2 Mondelli, V, Dazzan, P, Hepgul, N, Di Forti, M, Aas, M, D'Albenzio, A, et al. Abnormal Cortisol levels during the day and Cortisol awakening response in first-episode psychosis: the role of stress and of antipsychotic treatment. Schizophr Res 2010; 116: 234–42.
3 Nanni, V, Uher, R, Danese, A. Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis. Am J Psychiatry 2011; 169: 141–51.
4 Tunnard, C, Rane, LJ, Wooderson, SC, Markopoulou, K, Poon, L, Fekadu, A, et al. The impact of childhood adversity on suicidality and clinical course in treatment-resistant depression. J Affect Disord 2014; 152–4: 122–30.
5 Gaudiano, BA, Zimmerman, M. The relationship between childhood trauma history and the psychotic subtype of major depression. Acta Psychiatr Scand 2010; 121: 462–70.
6 Upthegrove, R, Chard, C, Jones, L, Gordon-Smith, K, Forty, L, Jones, I, et al. Adverse childhood events and psychosis in bipolar affective disorder. Br J Psychiatry 2015; 206: 191–7.
7 Madruga, CS, Laranjeira, R, Caetano, R, Ribeiro, W, Zaleski, M, Pinsky, I, et al. Early life exposure to violence and substance misuse in adulthood – the first Brazilian national survey. Addict Behav 2011; 36: 251–5.
8 Houston, JE, Murphy, J, Shevlin, M, Adamso, G. Cannabis use and psychosis: re-visiting the role of childhood trauma. Psychol Med 2011; 41: 2339–48.
9 Konings, M, Stefanis, N, Kuepper, R, de Graaf, R, ten Have, M, van Os, J, et al. Replication in two independent population-based samples that childhood maltreatment and cannabis use synergistically impact on psychosis risk. Psychol Med 2011; 42: 149–59.
10 Ruggeri, M, Bonetto, C, Lasalvia, A, De Girolamo, G, Fioritti, A, Rucci, P, et al. A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial. Trials 2012; 13: 73.
11 Ruggeri, M, Bonetto, C, Lasalvia, A, Fioritti, A, de Girolamo, G, Santonastaso, P, et al. Feasibility and effectiveness of a multi-element psychosocial intervention for first-episode psychosis: results from the cluster-randomized controlled GET UP PIANO Trial in a catchment area of 10 million inhabitants. Schizophr Bull 2015; 41: 1192–203.
12 Jablensky, A, Sartorius, N, Ernberg, G, Anker, M, Korten, A, Cooper, JE, et al. Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl 1992; 20: 197.
13 Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, et al. SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Arch Gen Psychiatry 1990; 47: 589–93.
14 Bifulco, A, Bernazzani, O, Moran, PM, Jacobs, C. The childhood experience of care and abuse questionnaire (CECA.Q): validation in a community series. Br J Clin Psychol 2005; 44: 563–81.
15 Barkus, EJ, Stirling, J, Hopkins, RS, Lewis, S. Cannabis-induced psychosis-like experiences are associated with high schizotypy. Psychopathology 2006; 39: 175–8.
16 Aas, M, Navari, S, Gibbs, A, Mondelli, V, Fisher, HL, Morgan, C, et al. Is there a link between childhood trauma, cognition, and amygdala and hippocampus volume in first-episode psychosis? Schizophr Res 2012; 137: 73–9.
17 Neria, Y, Bromet, EJ, Sievers, S. Trauma exposure and posttraumatic stress disorder in psychosis: findings from a first-admission cohort. J Consult Clin Psychol 2002; 70: 246–51.
18 Fisher, HL, Craig, T. Childhood adversity and psychosis. In Society and Psychosis (ed Morgan, C, McKenzie, K, Fearon, P): 95111. Cambridge University Press, 2008.
19 Bollini, A, Giannotta, F, Angeli, A. Maltrattamento sui bambini: quante le vittime in Italia? Prima Indagine nazionale quali–quantitativa sul maltrattamento a danno di bambini. Terre des Hommes/CISMAI, 2013 (http://www.garanteinfanzia.org/sites/default/files/documenti/dossier-bambini-maltrattati-tdh-cismai.pdf).
20 World Health Organization. Global Status Report on Violence Prevention. WHO, 2014.
21 Bertani, M, Lasalvia, A, Bonetto, C, Tosato, S, Cristofalo, D, Bissoli, S, et al. The influence of gender on clinical and social characteristics of patients at psychosis onset: a report from the Psychosis Incident Cohort Outcome Study (PICOS). Psychol Med 2012; 42: 769–80.
22 Taylor, TF. The influence of shame on post trauma disorders: have we failed to see the obvious? Eur J Psychotraumatol 2015; 6: 28847.
23 Hammersley, P, Dias, A, Todd, G, Bowen-Jones, K, Reilly, B, Bentall, RP. Childhood trauma and hallucinations in bipolar affective disorder: preliminary investigation. Br J Psychiatry 2003; 182: 543–7.
24 Garety, PA, Bebbington, P, Fowler, D, Freeman, D, Kuipers, E. Implications for neurobiological research of cognitive models of psychosis: a theoretical paper. Psychol Med 2007; 37: 1377–91.
25 Gracie, A, Freeman, D, Green, S, Garety, PA, Kuipers, E, Hardy, A, et al. The association between traumatic experience, paranoia and hallucinations: a test of the predictions of psychological models. Acta Psychiatr Scand 2007; 116: 280–9.
26 Fergusson, DM, McLeod, GF, Horwood, U. Childhood sexual abuse and adult developmental outcomes: findings from a 30-year longitudinal study in New Zealand. Child Abuse Negl 2013; 37: 664–74.
27 Haug, E, Oie, M, Andreassen, OA, Bratlien, U, Nelson, B, Aas, M, et al. Anomalous self-experience and childhood trauma in first-episode schizophrenia. Compr Psychiatry 2015; 56: 3541.
28 Myin-Germeys, I, Krabbendam, L, Delespaul, PA, Van Os, J. Sex differences in emotional reactivity to daily life stress in psychosis. J Clin Psychiatry 2004; 65: 805–9.
29 Myin-Germeys, I, Van Os, J. Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clin Psychol Rev 2007; 27: 409–24.
30 Kaufman, J, Plotsky, PM, Nemeroff, CB, Charney, DS. Effects of early adverse experiences on brain structure and function: clinical implications. Biol Psychiatry 2000; 48: 778–90.
31 Douglas, KR, Chan, G, Gelernter, J, Arias, AJ, Anton, RF, Weiss, RD. Adverse childhood events as risk factors for substance dependence: partial mediation by mood and anxiety disorders. Addict Behav 2010; 35: 713.
32 Wicks, S, Hjern, A, Gunnell, D, Lewis, G, Dalman, C. Social adversity in childhood and the risk of developing psychosis: a national cohort study. Am J Psychiatry 2005; 162: 1652–7.
33 Tosato, S, Lasalvia, A, Bonetto, C, Mazzoncini, R, Cristofalo, D, De Santi, K, et al. The impact of cannabis use on age of onset and clinical characteristics in first-episode psychotic patients. Data from the Psychosis Incident Cohort Outcome Study (PICOS). J Psychiatr Res 2013; 47: 438–44.
34 Collip, D, Myin-Germeys, I, Van Os, J. Does the concept of ‘sensitization’ provide a plausible mechanism for the putative link between the environment and schizophrenia? Schizophr Bull 2008; 34: 220–5.
35 Suplita, RL, Eisenstein, SA, Neely, MH, Moise, AM, Hohmann, AG. Cross-sensitization and cross-tolerance between exogenous cannabinoid antinociception and endocannabinoid mediated stress-induced analgesia. Neuropharmacol 2008; 54: 161–71.
36 MacLean, KI, Littleton, JM. Environmental stress as a factor in the response of rat brain catecholamine metabolism to delta8-tetrahydrocannabinol. Eur J Pharmacol 1977; 41: 171–82.
37 Read, J, Perry, BD, Moskowitz, A, Connolly, J. The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry 2001; 64: 319–45.
38 Banducci, AN, Hoffman, E, Lejuez, CW, Koenen, KC. The relationship between child abuse and negative outcomes among substance users: psychopathology, health, and comorbidities. Addict Behav 2014; 39: 1522–7.
39 Duhig, M, Patterson, S, Connell, M, Foley, S, Capra, C, Dark, F, et al. The prevalence and correlates of childhood trauma in patients with early psychosis. Aust NZ J Psychiatry 2015; 49: 651–9.
40 Fisher, HL, Morgan, C, Dazzan, P, Craig, TK, Morgan, K, Hutchinson, G, et al. Gender differences in the association between childhood abuse and psychosis. Br J Psychiatry 2009; 194: 319–25.
41 Fisher, HL, Craig, TK, Fearon, P, Morgan, K, Dazzan, P, Lappin, J, et al. Reliability and comparability of psychosis patients' retrospective reports of childhood abuse. Schizophr Bull 2011; 37: 546–53.
42 Hardt, J, Rutter, M. Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry 2004; 45: 260–73.
43 Poulton, R, Moffitt, TE, Silva, PA. The Dunedin Multidisciplinary Health and Development Study: overview of the first 40 years, with an eye to the future. Soc Psychiatry Psychiatr Epidemiol 2015; 50: 679–93.
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Influence of childhood trauma on diagnosis and substance use in first-episode psychosis

  • S. Tomassi (a1), S. Tosato (a2), V. Mondelli (a3), C. Faravelli (a4), A. Lasalvia (a5), G. Fioravanti (a4), C. Bonetto (a6), A. Fioritti (a7), C. Cremonese (a8), R. Lo Parrino (a9), K. De Santi (a5), A. Meneghelli (a10), S. Torresani (a11), G. De Girolamo (a12), E. Semrov (a13), M. Pratelli (a6), D. Cristofalo (a14) and the GET UP Group (a14)...
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