Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.
Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.
Psychiatry Res. 2017 Dec;258:374-381. doi: 10.1016/j.psychres.2017.08.070. Epub 2017 Aug 26.
In addition to severe traumatic experiences, milder, more common childhood adversities reflecting psychosocial burden may also be common in people with psychotic disorders and have an effect on symptomatology and functioning. We explored eleven negative childhood experiences and their influence on clinical symptoms among young adults with first-episode psychosis (FEP, n = 75) and matched population controls (n = 51). Individuals with FEP reported more adversities than controls. Specifically serious conflicts within the family, bullying at school, maternal mental health problems, and one's own and parents' serious illness during childhood were experienced by the patients more often than by controls. In the FEP group, the severity of adversity was associated with increased anxiety, manic, and obsessive-compulsive symptoms, but not with the severity of positive psychotic symptoms. Adversity produced a more pronounced effect on symptoms in male patients than in female patients. To conclude, in line with earlier studies of more chronic psychosis, a majority of the participants with FEP reported exposure to childhood adversities, with the FEP group reporting more adversities than controls. High levels of mood and anxiety symptoms in patients with FEP may be related to cumulative exposure to childhood adversities. This should be taken into account in the treatment for FEP.
除了严重的创伤经历外，反映心理社会负担的轻度、更常见的儿童逆境也可能在精神病患者中常见，并对症状和功能产生影响。我们探讨了 11 种负面的儿童经历及其对首发精神病（FEP，n = 75）和匹配的人群对照组（n = 51）中年轻成年人的临床症状的影响。与对照组相比，FEP 患者报告了更多的逆境。具体来说，患者比对照组更常经历家庭内部的严重冲突、学校里的欺凌、母亲的心理健康问题，以及自己和父母在童年时的严重疾病。在 FEP 组中，逆境的严重程度与焦虑、躁狂和强迫症症状的加重有关，但与阳性精神病症状的严重程度无关。逆境对男性患者的症状影响比女性患者更明显。总之，与更慢性精神病的早期研究一致，大多数 FEP 参与者报告曾经历过儿童逆境，FEP 组报告的逆境比对照组多。FEP 患者的情绪和焦虑症状水平较高可能与儿童逆境的累积暴露有关。在治疗 FEP 时应考虑到这一点。
