Zhang Lei, Zhao Nan, Zhu Minghuan, Tang Minyi, Liu Weiqing, Hong Wenjuan
Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China.
Front Psychiatry. 2023 Aug 28;14:1247063. doi: 10.3389/fpsyt.2023.1247063. eCollection 2023.
The relationship between adverse childhood experiences (ACEs) and the development of psychotic symptoms is not well understood. Therefore, this study aimed to investigate the frequency and distribution of ACEs among patients with schizophrenia and their potential correlation with symptomatology and personality pathology. We conducted a cross-sectional study involving 571 patients with schizophrenia in Shanghai, China. Symptomatology was assessed using the Positive and Negative Symptoms Scale (PANSS) and personality pathology was assessed using the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+). ACEs were assessed using the Child Trauma Questionnaire-Short Form (CTQ-SF). ACEs were highly prevalent, with 80.8% of the patients with schizophrenia reporting at least one ACE. The three most common types of ACE were physical neglect (69.8%), emotional neglect (28.2%), and emotional abuse (22.9%). For specific ACE, emotional abuse was significantly associated with PD traits, whereas emotional and physical neglect types of ACE was significantly associated with negative symptoms. A higher level of physical abuse was more commonly reported by men, younger individuals, and those with a higher level of antisocial PD traits. Higher levels of physical neglect were associated with more severe negative symptoms. ACEs are commonly observed in patients with schizophrenia. Therefore, it is strongly recommended that this clinical population be provided with a comprehensive assessment and individualized intervention for those exposed to specific ACEs.
童年不良经历（ACEs）与精神病性症状发展之间的关系尚未得到充分理解。因此，本研究旨在调查精神分裂症患者中ACEs的发生频率和分布情况，以及它们与症状学和人格病理学之间的潜在关联。我们在中国上海对571例精神分裂症患者进行了一项横断面研究。使用阳性和阴性症状量表（PANSS）评估症状学，使用人格诊断问卷第四版升级版（PDQ-4+）评估人格病理学。使用儿童创伤问卷简表（CTQ-SF）评估ACEs。ACEs的发生率很高，80.8%的精神分裂症患者报告至少有一次ACE。三种最常见的ACE类型是身体忽视（69.8%）、情感忽视（28.2%）和情感虐待（22.9%）。对于特定的ACE，情感虐待与人格障碍特质显著相关，而情感和身体忽视类型的ACE与阴性症状显著相关。男性、较年轻个体以及具有较高反社会人格障碍特质水平的人更常报告较高程度的身体虐待。较高程度的身体忽视与更严重的阴性症状相关。ACEs在精神分裂症患者中很常见。因此，强烈建议对这一临床群体针对那些暴露于特定ACEs的情况进行全面评估和个体化干预。
