Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Acta Psychiatr Scand. 2019 Oct;140(4):295-312. doi: 10.1111/acps.13077. Epub 2019 Sep 4.
Childhood maltreatment (CM) plays an important role in the aetiology and course of psychotic disorders and is associated with characteristics that could be relevant for treatment. We aimed to conduct a systematic review and meta-analysis on the association between CM and treatment outcome in psychotic disorders.
Treatment outcome was defined as change in psychotic symptoms or in social or occupational functioning between first and last reported measurement in the course of a pharmacological and/or psychological treatment.
Twelve treatment results from seven studies (636 patients, average treatment duration: 59.2 weeks) were included. CM was related to poorer treatment outcomes in psychotic disorders (OR = 1.51, 95% CI = [1.08, 2.10]). There is evidence that this association might increase with illness duration and increasing age and might be stronger in schizophrenia samples.
Childhood maltreatment is highly understudied with regard to treatment outcome in psychotic disorders. The need for more studies is emphasized by the fact that this meta-analysis reveals evidence for a poorer treatment response in patients with CM. If this association is confirmed, the identification of patients with CM and the consideration of associated clinical and biological conditions could contribute to improve treatment outcome in psychotic disorders.
儿童期虐待（CM）在精神障碍的发病机制和病程中起着重要作用，并且与可能与治疗相关的特征相关。我们旨在对精神障碍中 CM 与治疗结果之间的关系进行系统回顾和荟萃分析。
治疗结果定义为药物和/或心理治疗过程中首次和最后一次报告测量之间的精神病症状或社会或职业功能的变化。
纳入了来自 7 项研究的 12 项治疗结果（636 名患者，平均治疗时间：59.2 周）。CM 与精神障碍治疗结果较差相关（OR=1.51，95%CI=[1.08, 2.10]）。有证据表明，这种关联可能随着疾病持续时间和年龄的增加而增加，并且在精神分裂症样本中可能更强。
在精神障碍的治疗结果方面，CM 研究严重不足。本荟萃分析表明，CM 患者的治疗反应较差，这一事实强调了开展更多研究的必要性。如果这种关联得到证实，那么识别患有 CM 的患者并考虑相关的临床和生物学条件可能有助于改善精神障碍的治疗结果。
