Department of Psychiatry & Behavioral Sciences, University of California-Davis, Sacramento, California.
Department of Psychology, University of California-Los Angeles, Westwood, California.
Early Interv Psychiatry. 2020 Dec;14(6):755-761. doi: 10.1111/eip.12931. Epub 2020 Feb 10.
The trauma-psychosis cycle proposes an interactive relationship between impaired developmental and cognitive trajectory, childhood trauma exposure, and increased risk for psychosis. This study explored how childhood trauma (CT) and atypical development (AD) impact clinical course in an early psychosis cohort.
A retrospective chart review of behavioural and clinical research data was conducted with individuals ages 12 to 40 (N = 508; 72.4% males) evaluated by an early psychosis program.
CT exposure was associated with earlier onset of full threshold psychosis, more hospitalizations, higher ratings of negative symptoms, and increased likelihood of engaging in suicidal behaviour. AD alone was associated with earlier onset of psychosis symptoms, higher ratings of negative symptoms and greater likelihood of engaging in non-suicidal self-injury. The combination of CT and AD was associated with the earliest symptom onset and poorest psychosocial functioning.
The findings contribute to our understanding of heterogeneity in the early psychosis population and highlight the specific risk factors that could be targets in treatment.
创伤-精神病循环提出了发育和认知轨迹受损、儿童期创伤暴露和精神病风险增加之间的相互关系。本研究探讨了儿童期创伤 (CT) 和非典型发育 (AD) 如何影响早期精神病队列的临床病程。
对一个早期精神病项目评估的年龄在 12 至 40 岁的个体（N=508；72.4%为男性）进行了行为和临床研究数据的回顾性图表审查。
CT 暴露与全阈值精神病的发病较早、住院次数增加、负性症状评分较高以及自杀行为的可能性增加有关。单独的 AD 与精神病症状的发病较早、负性症状评分较高以及非自杀性自我伤害的可能性增加有关。CT 和 AD 的组合与最早的症状发作和最差的社会心理功能有关。
这些发现有助于我们理解早期精神病患者人群的异质性，并强调了可能成为治疗目标的特定风险因素。
