1 Centre for Forensic and Family Psychology, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
2 Rampton Hospital, Nottinghamshire NHS Trust, Retford, Nottingham, United Kingdom.
Trauma Violence Abuse. 2019 Jul;20(3):358-373. doi: 10.1177/1524838017708786. Epub 2017 May 26.
There is a growing body of literature identifying a relationship between experiences of child abuse and symptoms of psychosis in adults. However, the impact of this relationship on risk of violence has not been systematically explored.
This meta-analysis aimed to consider the influence of childhood abuse on the risk of violence among individuals with psychosis.
Five bibliographic databases and two gray literature resources were systematically searched to identify quantitative research which measured risk of violence and experiences of childhood maltreatment in individuals with psychosis. Risk of bias for each study was assessed under predefined criteria. Logged odds ratios () were synthesized quantitatively in a meta-analysis.
A total of 6,298 studies were identified, 11 of which were included in the final analysis ( = 2,215), all studies were of a cross-sectional or case-control design. Individuals with psychotic illnesses who reported historical child maltreatment were at approximately twice the risk of perpetrating violence than patients who reported no early abuse, = 2.46, 95% confidence interval (CI) = [1.91, 3.16]. There was no statistical heterogeneity between main effects (τ = .00; χ = 8.87, = 10, = .54, = 0%).
Risk assessments and interventions may benefit from considering the unique contribution of trauma to violence in this population. Future research considering the interaction between childhood experiences and other risk factors for violence in this population, including specific symptoms of psychosis, would inform the current findings. Findings are limited by the lack of longitudinal research in this area, and there was some evidence of publication bias.
越来越多的文献表明，儿童期虐待经历与成年人的精神病症状之间存在关联。然而，这种关系对暴力风险的影响尚未得到系统探索。
本项荟萃分析旨在探讨儿童虐待经历对精神病患者暴力风险的影响。
系统检索了 5 个文献数据库和 2 个灰色文献资源，以确定衡量精神病患者暴力风险和儿童期虐待经历的定量研究。根据预先设定的标准评估了每项研究的偏倚风险。在荟萃分析中定量综合了对数优势比（OR）。
共确定了 6298 项研究，其中 11 项研究（n = 2215）被纳入最终分析。所有研究均为横断面或病例对照设计。报告有儿童期虐待史的精神病患者实施暴力的风险大约是未报告早期虐待的患者的两倍，OR = 2.46，95%置信区间（CI）为 [1.91，3.16]。主要效应之间无统计学异质性（τ =.00；χ² = 8.87，df = 10，P =.54，I² = 0%）。
风险评估和干预措施可能受益于考虑到创伤对该人群暴力行为的独特贡献。未来的研究考虑到该人群中与暴力相关的其他风险因素（包括精神病的具体症状）与儿童期经历之间的相互作用，将有助于补充当前的研究结果。由于该领域缺乏纵向研究，研究结果受到限制，并且存在一些发表偏倚的证据。
