Grattan Rebecca E, Lara Natalia, Botello Renata M, Tryon Valerie L, Maguire Adrienne M, Carter Cameron S, Niendam Tara A
Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento, CA 95817, USA.
J Clin Med. 2019 Jul 23;8(7):1082. doi: 10.3390/jcm8071082.
The association between trauma and psychosis outcomes is well-established, and yet the impact of trauma on comorbid clinical symptoms-such as aggression, non-suicidal self-injury behavior (NSSIB), suicide ideation, and suicide behavior-for those with psychosis is unclear. To effectively treat those with first-episode psychosis (FEP) and a history of trauma, we need to understand the impact of trauma on their whole presentation. FEP participants were recruited from an Early Psychosis Program ( = 187, ages 12-35, 72.2% male). Clinicians gathered history of trauma, aggression, and suicide data, and rated current symptom severity and functioning. Data was coded using clinician rated measures, self-report measures, and retrospective clinical chart review. Regression analyses examined whether trauma was associated with a history of aggression, suicidal ideation, suicide behavior, NSSIB, symptoms, and functioning. Trauma was associated with aggression, aggression severity and type of aggression (aggression towards others). Trauma was also associated with depression severity, suicide ideation, most severe suicide ideation, and NSSIB. Trauma was not associated with suicide behavior, severity of suicide behavior or psychosocial functioning. Integrating trauma treatment into FEP care could reduce rates of depression, aggression, suicide ideation, and NSSIB for those with a history of trauma. To reduce suicide attempt occurrence and improve functioning, more research is needed.
创伤与精神病结局之间的关联已得到充分证实，然而，对于患有精神病的人而言，创伤对诸如攻击行为、非自杀性自伤行为（NSSIB）、自杀意念和自杀行为等共病临床症状的影响尚不清楚。为了有效治疗有创伤史的首发精神病（FEP）患者，我们需要了解创伤对其整体临床表现的影响。FEP参与者来自一个早期精神病项目（n = 187，年龄12 - 35岁，72.2%为男性）。临床医生收集了创伤、攻击行为和自杀数据的病史，并对当前症状严重程度和功能进行了评分。数据使用临床医生评定量表、自我报告量表和回顾性临床病历审查进行编码。回归分析检验了创伤是否与攻击行为史、自杀意念、自杀行为、NSSIB、症状和功能相关。创伤与攻击行为、攻击严重程度和攻击类型（对他人的攻击）相关。创伤还与抑郁严重程度、自杀意念、最严重自杀意念和NSSIB相关。创伤与自杀行为、自杀行为严重程度或心理社会功能无关。将创伤治疗纳入FEP护理可以降低有创伤史患者的抑郁、攻击行为、自杀意念和NSSIB发生率。为了减少自杀未遂的发生并改善功能，还需要更多的研究。
