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青年时期有和处于精神病临床高危状态下的潜在创伤性事件。

Potentially traumatic events in youth with and at clinical high risk for psychosis.

机构信息

Boston Children's Hospital, Boston, Massachusetts.

Department of Pediatrics, Stanford University School of Medicine, Stanford, California.

出版信息

Early Interv Psychiatry. 2019 Aug;13(4):805-809. doi: 10.1111/eip.12565. Epub 2018 Mar 25.

Abstract

AIM

Previous research has demonstrated a strong association between early trauma exposure and the development of psychotic symptoms. However, few of these studies have included young adolescents and children. This study investigated rates and number of potentially traumatic experiences (PTEs) among typically developing youth (TD; n = 21), youth at clinical high risk for psychosis (CHR; n = 38), and youth with a psychotic disorder (PD; n = 28) between 7 and 18 years of age. CHR participants were further evaluated to determine whether a history of PTEs was associated with prodromal symptom severity.

METHODS

Study group inclusion was determined by structured interviews. Trauma history was assessed using the post-traumatic stress disorder module of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. CHR participants with vs without a history of PTEs were compared on severity of prodromal symptoms.

RESULTS

CHR and PD participants reported significantly higher rates and numbers of PTEs than TD participants. Contrary to expectations and prior research, CHR participants with vs without a history of PTEs did not differ in prodromal symptom severity. Explanations and implications for the findings are discussed.

CONCLUSIONS

These findings suggest that the relationship between trauma and the development of psychotic symptoms extends to children and adolescents as young as 7 years of age. This study underscores the importance of screening for trauma exposure among youth seeking treatment for psychotic symptoms.

摘要

目的

先前的研究表明,早期创伤暴露与精神病症状的发展之间存在很强的关联。然而,这些研究中很少有包括青少年和儿童。本研究调查了在 7 至 18 岁的正常发育青少年(TD;n=21)、处于精神病高危状态的青少年(CHR;n=38)和患有精神病的青少年(PD;n=28)中潜在创伤经历(PTE)的发生率和数量。对 CHR 参与者进行了进一步评估,以确定 PTE 史是否与前驱症状严重程度有关。

方法

通过结构式访谈确定研究组的纳入标准。使用儿童青少年情感障碍和精神分裂症的定式检查-现病史和终身版(Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version)的创伤后应激障碍模块评估创伤史。对有和无 PTE 史的 CHR 参与者的前驱症状严重程度进行了比较。

结果

CHR 和 PD 参与者报告的 PTE 发生率和数量明显高于 TD 参与者。与预期和先前的研究相反,有和无 PTE 史的 CHR 参与者的前驱症状严重程度没有差异。对这些发现的解释和意义进行了讨论。

结论

这些发现表明,创伤与精神病症状发展之间的关系扩展到了 7 岁以下的儿童和青少年。本研究强调了对寻求精神病症状治疗的青年进行创伤暴露筛查的重要性。

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