Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Victoria, Australia.
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Victoria, Australia.
Schizophr Res. 2020 Oct;224:116-125. doi: 10.1016/j.schres.2020.09.017. Epub 2020 Oct 15.
Childhood trauma, particularly sexual abuse, has been associated with transition to psychosis in individuals at "ultra-high risk" (UHR). This study investigated whether the effects of various forms of childhood trauma on transition to psychosis are mediated by cortical thickness and surface area abnormalities.
This prospective study used data from 62 UHR individuals from a previous (PACE 400) cohort study. At follow-up, 24 individuals had transitioned to psychosis (UHR-T) and 38 individuals had not transitioned (UHR-NT). Student-t/Mann-Whitney-U tests were performed to assess morphological differences in childhood trauma (low/high) and transition. Mediation analyses were conducted using regression and bootstrapping techniques.
UHR individuals with high sexual trauma histories presented with decreased cortical thickness in bilateral middle temporal gyri and the left superior frontal gyrus compared to those with low sexual trauma. Participants with high physical abuse had increased cortical thickness in the right middle frontal gyrus compared to those with low physical abuse. No differences were found for emotional abuse or physical/emotional neglect. Reduced cortical thickness in the right middle temporal gyrus and increased surface area in the right cingulate were found in UHR-T compared to UHR-NT individuals. Sexual abuse had an indirect effect on transition to psychosis, where decreased cortical thickness in the right middle temporal gyrus was a mediator.
Results suggest that childhood sexual abuse negatively impacted on cortical development of the right temporal gyrus, and this heightened the risk of transition to psychosis in our sample. Further longitudinal studies are needed to precisely understand this link.
童年创伤，尤其是性虐待，与“超高风险”（UHR）个体向精神病的转变有关。本研究调查了各种形式的童年创伤对向精神病转变的影响是否通过皮质厚度和表面积异常来介导。
这项前瞻性研究使用了来自先前（PACE 400）队列研究的 62 名 UHR 个体的数据。在随访中，24 名个体向精神病转变（UHR-T），38 名个体未向精神病转变（UHR-NT）。学生 t/曼-惠特尼 U 检验用于评估童年创伤（低/高）和转变之间的形态差异。使用回归和自举技术进行中介分析。
与低性创伤史的 UHR 个体相比，有高性创伤史的 UHR 个体双侧颞中回和左额上回的皮质厚度减少。与低身体虐待相比，有高身体虐待史的参与者右额中回的皮质厚度增加。在情绪虐待或身体/情感忽视方面没有差异。与 UHR-NT 个体相比，UHR-T 个体右颞中回皮质厚度减少，右扣带回表面积增加。性虐待对向精神病转变有间接影响，右颞中回皮质厚度减少是其中介。
结果表明，童年性虐待对右侧颞叶皮质发育产生负面影响，这增加了我们样本向精神病转变的风险。需要进一步的纵向研究来准确理解这种联系。
