General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Institute of Psychology, Faculty of Social and Political Science, University of Lausanne, Switzerland.
General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Schizophr Res. 2023 Nov;261:18-23. doi: 10.1016/j.schres.2023.09.001. Epub 2023 Sep 7.
Childhood trauma (CT) has been shown to impact depressive symptoms measured broadly in early psychosis patients. Beyond the broad intensity of such impact, less is known about which depressive features are more impacted.
Patients of a specialized early intervention programme were evaluated after the first two and six months of treatment with the Montgomery-Asberg Depression Rating Scale (MADRS). We used the first assessment available. We estimated an Item-response model to reveal potential differential item functioning (DIF) in order to highlight depressive features that could be impacted differently than others by experiences of abuse (sexual physical and emotional) and neglect (physical and emotional).
Two hundred and sixty-two recent onset patients with psychosis were assessed. Results at the beginning of the Treatment and Early Intervention in Psychosis Program (TIPP) showed that abuse but not neglect was associated with more severe depression levels, measured at a global MADRS score. Concerning specific depressive symptoms, concentration difficulties were left largely unaffected by abuse in contrast with other aspects of depression.
The cognitive item of the depressive dimension assessed by the MADRS was not impacted by experiences of abuse, while the remaining subdomains involving anxiety, suicidality, somatic symptoms, and anhedonia were. Trials focusing on improving the impact of depression in traumatised individuals should account for the possible diluting effect of concentration when measuring the depression broadly. DIF is a promising method to better understand the impact many variables may have on various psychological dimensions at the item level.
童年创伤 (CT) 已被证明会影响早期精神病患者广泛测量的抑郁症状。除了这种影响的广泛强度之外，对于哪些抑郁特征受到的影响更大，了解得较少。
专门的早期干预计划的患者在接受治疗的前两个月和六个月后用蒙哥马利-阿斯伯格抑郁评定量表 (MADRS) 进行评估。我们使用了可用的第一个评估。我们估计了一个项目反应模型，以揭示潜在的差异项目功能 (DIF)，以便突出可能受到虐待（性、身体和情感）和忽视（身体和情感）经历的不同影响的抑郁特征。
评估了 262 名近期发病的精神病患者。在治疗和早期干预精神病计划 (TIPP) 的开始时的结果表明，虐待但不是忽视与更严重的抑郁水平相关，在全球 MADRS 评分中测量。关于特定的抑郁症状，与抑郁的其他方面相比，注意力困难受虐待的影响不大。
MADRS 评估的抑郁维度的认知项目不受虐待经历的影响，而涉及焦虑、自杀意念、躯体症状和快感缺失的其他亚域则受影响。专注于改善受创伤个体抑郁影响的试验应该考虑到在广泛测量抑郁时注意力集中的可能稀释效应。DIF 是一种更好地了解许多变量在项目水平上对各种心理维度可能产生的影响的有前途的方法。
