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The non-specific nature of mental health and structural brain outcomes following childhood trauma

Published online by Cambridge University Press:  06 July 2021

Theresa K. Haidl*
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Dennis M. Hedderich
Affiliation:
Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine Technical University of Munich, Munich, Germany
Marlene Rosen
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Nathalie Kaiser
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Mauro Seves
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Thorsten Lichtenstein
Affiliation:
Department of Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Nora Penzel
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Julian Wenzel
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Lana Kambeitz-Ilankovic
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
Anne Ruef
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
David Popovic
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
Frauke Schultze-Lutter
Affiliation:
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
Katharine Chisholm
Affiliation:
Institute of Mental Health, University of Birmingham, Birmingham, UK Department of Psychology, Aston University, Birmingham, UK
Rachel Upthegrove
Affiliation:
Institute of Mental Health, University of Birmingham, Birmingham, UK Early Intervention Service, Birmingham Womens and Childrens NHS Foundation Trust, UK
Raimo K. R. Salokangas
Affiliation:
Department of Psychiatry, University of Turku, Turku, Finland
Christos Pantelis
Affiliation:
Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Victoria, Australia
Eva Meisenzahl
Affiliation:
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
Stephen J. Wood
Affiliation:
Institute of Mental Health, University of Birmingham, Birmingham, UK Orygen, Melbourne, Australia Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
Paolo Brambilla
Affiliation:
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
Stefan Borgwardt
Affiliation:
Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
Stephan Ruhrmann
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Joseph Kambeitz
Affiliation:
Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
Nikolaos Koutsouleris
Affiliation:
Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany Institute of Psychiatry, Psychology and Neuroscience, London, UK Max-Planck Institute of Psychiatry Munich, Munich, Germany
*
Author for correspondence: Theresa K. Haidl, E-mail: theresa.haidl@uk-koeln.de

Abstract

Background

Childhood trauma (CT) is associated with an increased risk of mental health disorders; however, it is unknown whether this represents a diagnosis-specific risk factor for specific psychopathology mediated by structural brain changes. Our aim was to explore whether (i) a predictive CT pattern for transdiagnostic psychopathology exists, and whether (ii) CT can differentiate between distinct diagnosis-dependent psychopathology. Furthermore, we aimed to identify the association between CT, psychopathology and brain structure.

Methods

We used multivariate pattern analysis in data from 643 participants of the Personalised Prognostic Tools for Early Psychosis Management study (PRONIA), including healthy controls (HC), recent onset psychosis (ROP), recent onset depression (ROD), and patients clinically at high-risk for psychosis (CHR). Participants completed structured interviews and self-report measures including the Childhood Trauma Questionnaire, SCID diagnostic interview, BDI-II, PANSS, Schizophrenia Proneness Instrument, Structured Interview for Prodromal Symptoms and structural MRI, analyzed by voxel-based morphometry.

Results

(i) Patients and HC could be distinguished by their CT pattern with a reasonable precision [balanced accuracy of 71.2% (sensitivity = 72.1%, specificity = 70.4%, p ≤ 0.001]. (ii) Subdomains ‘emotional neglect’ and ‘emotional abuse’ were most predictive for CHR and ROP, while in ROD ‘physical abuse’ and ‘sexual abuse’ were most important. The CT pattern was significantly associated with the severity of depressive symptoms in ROD, ROP, and CHR, as well as with the PANSS total and negative domain scores in the CHR patients. No associations between group-separating CT patterns and brain structure were found.

Conclusions

These results indicate that CT poses a transdiagnostic risk factor for mental health disorders, possibly related to depressive symptoms. While differences in the quality of CT exposure exist, diagnostic differentiation was not possible suggesting a multi-factorial pathogenesis.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

*

Shared first authorship.

Shared senior authorship.

See PRONIA consortium author list.

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The non-specific nature of mental health and structural brain outcomes following childhood trauma
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