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Background: There is recent increasing interest in the relationship between early childhood trauma and the risk of developing psychotic experiences later in life (2,3). Although a large number of studies of psychiatric patients, a majority of whom have a psychotic disorder, indicate that the prevalence of childhood trauma in this group is high, whether childhood trauma is of etiological importance in psychosis remains controversial (1, 2, 4).
Objectives: In the present study, we aimed to investigate the possibility of a link between psychotic disorders and childhood traumatic experiences by comparing trauma exposure in a group of female patients with a diagnosis of psychotic disorders to a group diagnosed with severe non-psychotic disorders. The secondary purpose of this study was to examine the clinical correlations between trauma exposure, dissociative phenomena, and psychiatric symptomatology and psychosocial functioning for these two groups.
Methods: Patients with psychotic disorders, mostly schizophrenic (n=54), and with a non-psychotic diagnosis (n=24), were recruited at the Women's Clinic of the Istanbul Erenköy Mental Health Hospital. The data were collected through a semi-structured interview for demographic, psychiatric, and trauma histories. Psychotic symptoms were measured by using the Positive and Negative Symptom Scale (PANSS). At the main interview, the Childhood Traumatic Questionnaire (CTQ), Dissociative Experiences Scale (DES), Traumatic Experiences Checklist (TEC), and SCL-90-R were administered to all participants by psychiatrists, who were blind to trauma history.
Results: In this preliminary study, high prevalence rates of childhood traumatic experiences and dissociative phenomenon were found in a sample of consecutively admitted moderately ill psychotic inpatients. Another finding of the present study was that emotional abuse during childhood was most strongly correlated with the experience of dissociative symptoms in adult schizophrenia patients. Additionally, in this group a history of trauma was significantly related to somatization, poor communication skills, and depressive symptoms.
Conclusions: The results of this study are consistent with previous studies raising the possibility that such trauma is of etiological importance in schizophrenia and other related disorders (4-6).
References:
1. Schafer I, Harfst T, Aderhold V, Briken P, Lehmann M, Moritz S, Read J, Naber D. Childhood trauma and dissociation in female patients with schizophrenia spectrum disorders an exploratory study. J Nerv Ment Dis 2006; 194: 135- 138.
2. Spence W, Mulholland C, Lynch G, Mchugh S, Dempster M, Shannon C. Rates of childhood trauma in a sample of patients with schizophrenia as compared with a sample of patients with non-psychotic diagnosis. Journal of Trauma & Dissociation 2006; 7(3): 7- 22.
3. Lysaker PH, LaRocco VA. The prevalence and correlates of trauma-related symptoms in schizophrenia spectrum disorder. Comprehensive Psychiatry 2008; 49: 330- 334.
4. Larkin W, Read J. Childhood trauma and psychosis: Evidence, pathways, and implications. J Postgrad Med 2008; 54(4): 287- 293.
5. Bendall S, Jackson HJ, Hulbert CA, McGorry PD. Childhood trauma and psychotic disorders: a systematic, critical review of the evidence. Schizophrenia Bulletin 2008; 34(3): 568- 579. 6. Morgan C, Fisher H. Environmental factors in schizophrenia: childhood trauma- a critical review. Schizophrenia Bulletin 2007; 33(1): 3- 10. Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S192