Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul, Turkey.
Early Interv Psychiatry. 2013 Nov;7(4):414-20. doi: 10.1111/eip.12022. Epub 2013 Jan 24.
Childhood trauma (CT) is more common in patients with psychosis than in general population and is found to be related to the severity of symptoms. The objective of this study was to investigate the severity of CT, and its relationship with clinical features in two different groups: first-episode schizophrenia (FES) and ultra high risk for psychosis (UHR) groups.
In this cross-sectional study, 83 patients with FES, 41 individuals with UHR and 69 healthy controls were included. Clinical features were evaluated with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms (SAPS). We evaluated CT with the Childhood Trauma Questionnaire (CTQ). UHR group was also assessed with the Calgary Depression Scale for Schizophrenia.
The emotional and physical abuse, physical and emotionalneglect subscale scores and CTQ total score of both the UHR group and FES group were higher than the control group. However, the CTQ total score and subscale scores did not differ between FES and UHR groups. UHR group had more Schneiderian symptoms in terms of both number and severity, and severity of sexual abuse was found to be correlated with SAPS scores especially for the 'commenting voices' item. The CTQ emotional abuse and neglect scores were correlated with the severity of depression. FES patients with higher CTQ scores obtained higher total scores on SAPS and higher total scores on Schneiderian items.
We found that CT is related to the severity of psychotic symptoms in both FES and UHR groups. Therefore, it is possible that interventions aimed at preventing CT in children would reduce the manifestation of psychosis among young people.
童年期创伤(CT)在精神病患者中比一般人群更为常见,且与症状严重程度相关。本研究旨在调查两组人群(首发精神分裂症[FES]和精神病超高危[UHR])中 CT 的严重程度及其与临床特征的关系。
在这项横断面研究中,纳入了 83 例 FES 患者、41 例 UHR 个体和 69 名健康对照者。采用简明精神病评定量表、阴性症状评定量表和阳性症状评定量表(SAPS)评估临床特征。采用童年创伤问卷(CTQ)评估 CT。UHR 组还采用精神分裂症 Calgary 抑郁量表进行评估。
UHR 组和 FES 组的情感和躯体虐待、躯体和情感忽视子量表评分以及 CTQ 总分均高于对照组。然而,FES 组和 UHR 组之间 CTQ 总分和子量表评分无差异。UHR 组的 Schneiderian 症状数量和严重程度均更多,且性虐待的严重程度与 SAPS 评分相关,尤其是“评论性声音”项目。CTQ 的情感虐待和忽视评分与抑郁严重程度相关。CTQ 评分较高的 FES 患者的 SAPS 总分和 Schneiderian 项目总分更高。
我们发现 CT 与 FES 和 UHR 两组的精神病症状严重程度相关。因此,针对儿童 CT 的干预措施可能会减少年轻人精神疾病的发生。