Institute of Psychiatry, King's College London, UK.
Psychol Med. 2010 Dec;40(12):1967-78. doi: 10.1017/S0033291710000231. Epub 2010 Feb 24.
Childhood adversity has been associated with onset of psychosis in adulthood but these studies have used only general definitions of this environmental risk indicator. Therefore, we sought to explore the prevalence of more specific adverse childhood experiences amongst those with and without psychotic disorders using detailed assessments in a large epidemiological case-control sample (AESOP).
Data were collected on 182 first-presentation psychosis cases and 246 geographically matched controls in two UK centres. Information relating to the timing and frequency of exposure to different types of childhood adversity (neglect, antipathy, physical and sexual abuse, local authority care, disrupted living arrangements and lack of supportive figure) was obtained using the Childhood Experience of Care and Abuse Questionnaire.
Psychosis cases were three times more likely to report severe physical abuse from the mother that commenced prior to 12 years of age, even after adjustment for other significant forms of adversity and demographic confounders. A non-significant trend was also evident for greater prevalence of reported severe maternal antipathy amongst those with psychosis. Associations with maternal neglect and childhood sexual abuse disappeared after adjusting for maternal physical abuse and antipathy. Paternal maltreatment and other forms of adversity were not associated with psychosis nor was there evidence of a dose-response effect.
These findings suggest that only specific adverse childhood experiences are associated with psychotic disorders and only in a minority of cases. If replicated, this greater precision will ensure that research into the mechanisms underlying the pathway from childhood adversity to psychosis is more fruitful.
童年逆境与成年期精神病的发病有关，但这些研究仅使用了这种环境风险指标的一般定义。因此，我们试图使用 AESOP 中的大型流行病学病例对照样本，通过详细评估，探索那些有和没有精神病障碍的个体中更具体的不良童年经历的患病率。
在英国的两个中心，收集了 182 名首发精神病病例和 246 名地理匹配对照者的数据。使用儿童经历关怀和虐待问卷获得了与不同类型的童年逆境（忽视、敌意、身体和性虐待、儿童福利院照顾、生活安排中断和缺乏支持性人物）的发生时间和频率相关的信息。
精神病病例报告严重的母亲身体虐待的可能性是对照组的三倍，这种情况始于 12 岁之前，即使在调整了其他重要形式的逆境和人口统计学混杂因素之后也是如此。在精神病患者中，也有报道严重母亲敌意的比例更高的趋势，但不显著。在调整了母亲身体虐待和敌意后，与母亲忽视和儿童性虐待的关联就消失了。父亲虐待和其他形式的逆境与精神病无关，也没有证据表明存在剂量反应效应。
这些发现表明，只有特定的不良童年经历与精神病有关，而且只在少数情况下如此。如果得到证实，这种更精确的方法将确保研究儿童期逆境与精神病之间的发病机制更有成效。
