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首发精神分裂症谱系障碍中病前适应与儿童期创伤类型和时间的关联。

Associations of premorbid adjustment with type and timing of childhood trauma in first-episode schizophrenia spectrum disorders.

作者信息

Smit Anna M, Kilian Sanja, Emsley Robin A, Luckhoff Hilmar K, Swartz Leslie, Seedat Soraya, Asmal Laila

机构信息

Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Department of Psychology, Faculty of Arts and Social Sciences, Stellenbosch University, Cape Town, South Africa.

出版信息

S Afr J Psychiatr. 2021 Jun 22;27:1639. doi: 10.4102/sajpsychiatry.v27i0.1639. eCollection 2021.

Abstract

BACKGROUND

Childhood trauma may contribute to poorer premorbid social and academic adjustment which may be a risk factor for schizophrenia.

AIM

We explored the relationship between premorbid adjustment and childhood trauma, timing of childhood trauma's moderating role as well as the association of clinical and treatment-related confounders with premorbid adjustment.

SETTING

We conducted a secondary analysis in 111 patients with first-episode schizophrenia (FES) disorders that formed part of two parent studies, EONKCS study ( =73) and the Shared Roots study ( =38).

METHODS

Type of childhood trauma was assessed with the Childhood Trauma Questionnaire, short-form and premorbid adjustment using the Premorbid Adjustment Scale. Timing of childhood trauma was assessed using the Life Events Checklist and life events timeline. Linear regression analyses were used to assess the moderating effect of timing of childhood trauma. Clinical and treatment-related confounders were entered into sequential hierarchical regression models to identify independent predictors of premorbid adjustment across key life stages.

RESULTS

Childhood physical neglect was associated with poorer premorbid academic functioning during childhood and early adolescence, and poorer premorbid social functioning during early and late adolescence. By hierarchical regression modelling ( = 0.13), higher physical neglect subscale scores ( = 0.011) independently predicted poorer premorbid social adjustment during early adolescence. Timing of childhood trauma did not moderate the relationship between childhood trauma and premorbid functioning.

CONCLUSION

In patients with FES, childhood physical neglect may contribute to poorer premorbid social functioning during early adolescence. This may provide us with an opportunity to identify and treat at-risk individuals earlier.

摘要

背景

童年创伤可能导致病前社会和学业适应能力较差,这可能是精神分裂症的一个危险因素。

目的

我们探讨了病前适应与童年创伤之间的关系、童年创伤调节作用的时间以及临床和治疗相关混杂因素与病前适应的关联。

背景

我们对111例首发精神分裂症(FES)患者进行了二次分析,这些患者是两项母研究EONKCS研究(n = 73)和共同根源研究(n = 38)的一部分。

方法

使用儿童创伤问卷简表评估童年创伤类型,使用病前适应量表评估病前适应情况。使用生活事件清单和生活事件时间线评估童年创伤的时间。采用线性回归分析评估童年创伤时间的调节作用。将临床和治疗相关混杂因素纳入逐步分层回归模型,以确定关键生命阶段病前适应的独立预测因素。

结果

童年期身体忽视与童年期和青春期早期较差的病前学业功能以及青春期早期和晚期较差的病前社交功能相关。通过分层回归建模(R² = 0.13),较高的身体忽视分量表得分(β = 0.011)独立预测青春期早期较差的病前社会适应。童年创伤的时间并未调节童年创伤与病前功能之间的关系。

结论

在首发精神分裂症患者中,童年期身体忽视可能导致青春期早期病前社交功能较差。这可能为我们提供一个更早识别和治疗高危个体的机会。

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