Centre for Studies on Justice and Society, Institute of Sociology, Pontificia Universidad Católica de Chile, Santiago, Chile.
Early Intervention Program, Instituto Psiquiátrico Dr J. Horwitz Barak, Santiago, Chile; Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile.
Psychiatry Res. 2022 Oct;316:114733. doi: 10.1016/j.psychres.2022.114733. Epub 2022 Jul 17.
Adverse childhood experiences (ACEs) increase the risk of psychotic experiences (PE), but little is known about heterogeneities of this association in different developmental stages, dimensions, or whether they are affected by substance use disorder (SUD). This study examines the association between different types of ACEs at various developmental stages and lifetime PE in patients with SUD in Chile.
We included 399 consenting adults in outpatient or residential SUD treatment programs. Sociodemographic data and information about PE and ACEs were obtained by trained clinical psychologists.
Patients reporting PE experienced more ACEs compared to patients without PE (4.2 versus 3.4). They also experienced more complex adversities (41.8% versus 25.1%), had more psychiatric comorbidities (85% versus 70.4%), and reported using more substances (mean 4.5 versus 3.9). Adjusted association between ACEs and PE showed the highest OR for arrests (1.88), sexual abuse (1.81), alcohol abuse by parents (1.48), school exclusion (1.39), foster or residential care (18.3).
Early exposure to ACEs is a risk factor for later PE among patients with SUD. Type of ACE and the period when they occurred is important, suggesting the existence of critical periods where the individual is more susceptible to adverse environmental stimuli.
不良的童年经历（ACEs）会增加出现精神病性体验（PE）的风险，但人们对不同发育阶段、不同维度的这种关联的异质性，以及它们是否受到物质使用障碍（SUD）的影响知之甚少。本研究在智利的 SUD 患者中，考察了不同类型的 ACEs 在不同发育阶段与终生 PE 之间的关系。
我们纳入了 399 名同意参加的门诊或住院 SUD 治疗项目的成年人。通过训练有素的临床心理学家获得社会人口统计学数据以及关于 PE 和 ACE 的信息。
与没有 PE 的患者相比，报告有 PE 的患者经历了更多的 ACEs（4.2 比 3.4）。他们还经历了更复杂的逆境（41.8%比 25.1%），有更多的精神共病（85%比 70.4%），并报告使用了更多的物质（平均 4.5 比 3.9）。对 ACEs 和 PE 之间的调整关联表明，被捕（1.88）、性虐待（1.81）、父母酗酒（1.48）、学校开除（1.39）、寄养或住宿照顾（18.3）的比值比最高。
早期接触 ACEs 是 SUD 患者后期出现 PE 的一个风险因素。ACE 的类型和发生的时期很重要，这表明存在个体更容易受到不良环境刺激的关键时期。
