Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
Departments of Psychiatry and Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA.
Soc Psychiatry Psychiatr Epidemiol. 2022 Jul;57(7):1379-1388. doi: 10.1007/s00127-022-02239-5. Epub 2022 Feb 3.
Bullying is associated with a heightened risk for poor outcomes, including psychosis. This study aimed to replicate previous findings on bullying prevalence in clinical high-risk (CHR) individuals, to assess the longitudinal course of clinical and functional variables between bullied and non-bullied CHR and the association of bullying with premorbid functioning, clinical outcome, transition to psychosis and risk of violence.
The sample consisted of 691 CHR participants and 96 healthy controls. Participants reported whether they had experienced bullying and how long it had lasted. Assessments included DSM-5 diagnoses, attenuated psychotic symptoms, negative symptoms, social and role functioning, depression, stress, premorbid functioning, and risk of violence. The bullied and non-bullied CHR groups were compared at baseline and further longitudinally on clinical and functioning variables and transition to psychosis.
Bullying was more prevalent among CHR individuals than healthy controls. Bullied CHR had a higher prevalence of PTSD and more severe depression and stress at baseline than non-bullied CHR. There was no impact of bullying on clinical and functional variables over time. Bullying was not related to final clinical status or transition to psychosis. However, bullied participants had poorer premorbid functioning and a greater risk of violence.
While bullying may not impact the likelihood of CHR individuals to transition to psychosis, it may be a risk factor for development of the at-risk state and may be related to a greater risk of violence. Future studies should consider bullying perpetration among CHR individuals.
欺凌与较差的结果风险增加有关，包括精神病。本研究旨在复制以前关于临床高风险（CHR）个体中欺凌发生率的研究结果，评估受欺凌和未受欺凌 CHR 个体之间临床和功能变量的纵向变化，以及欺凌与发病前功能、临床结局、向精神病过渡和暴力风险的关系。
该样本包括 691 名 CHR 参与者和 96 名健康对照者。参与者报告他们是否经历过欺凌以及欺凌持续了多久。评估包括 DSM-5 诊断、精神病前驱症状、阴性症状、社会和角色功能、抑郁、压力、发病前功能和暴力风险。在基线时比较受欺凌和未受欺凌的 CHR 组，并进一步在临床和功能变量以及向精神病过渡方面进行纵向比较。
与健康对照组相比，欺凌在 CHR 个体中更为常见。与未受欺凌的 CHR 相比，受欺凌的 CHR 个体在基线时 PTSD 的患病率更高，抑郁和压力更严重。欺凌对临床和功能变量的影响在时间上没有差异。欺凌与最终的临床状态或向精神病过渡无关。然而，受欺凌的参与者发病前功能较差，暴力风险较高。
虽然欺凌可能不会影响 CHR 个体向精神病过渡的可能性，但它可能是高危状态发展的危险因素，并且可能与更高的暴力风险有关。未来的研究应考虑 CHR 个体中的欺凌行为。
