Risk for Psychosis Linked With Childhood Trauma, Life Events, and Isolation

High risk for psychosis is associated with less social support, more life events, and greater childhood trauma, according to a study recently published in Psychiatry Research. These may be risk factors for psychosis and merit further research into interventional approaches.

This study included 200 participants aged 15 to 45 years, 83 of whom were at high risk for psychosis, 56 of whom had first-episode psychosis with schizophrenia, and 61 of whom were healthy controls. Psychological assessments and interviews were conducted to examine characteristics and clinical symptoms. The Perceived Social Support Scale, Life Events Scale, and Childhood Trauma Questionnaire were utilized. Pearson χ ² tests, independent samples t-tests, logistic regression analyses, and a one-way analysis of variance were used to compare psychological, clinical, and demographic features among high-risk, first episode psychosis with schizophrenia, and control groups. Adjusted analysis of covariance was used for repeated comparisons.

Compared with healthy controls, being at high risk for psychosis was associated with more childhood trauma (P <.001), total life events (P =.004), and social support deficit (P =.01), according to univariate analysis. Analysis of covariance supported these results, with the exception of social support deficit factoring in adjustments for education, age, employment, and marital status. The first-episode psychosis with schizophrenia group also received lower scores on the Perceived Social Support Scale than did healthy controls (P =.03). The high-risk and first-episode psychosis with schizophrenia groups both showed strong correlations with being unmarried, increased childhood trauma, and worse general function compared with controls.

Limitations to this study include a cross-sectional design, a small sample size, and the generation of recall bias through the use of exclusively retrospective psychological scales.

The study researchers conclude that “in comparison to healthy controls, high-risk individuals experienced [more severe] childhood trauma and significantly more life events meanwhile perceived poorer social support, which may be the risk factors of conversion to psychosis and may possibly bring about deterioration in overall function. Thus, this study greatly called for attention to further exploration to develop optimal psychosocial interventions, which may be beneficial in improving symptoms of high-risk individuals and may therefore help to delay and reduce conversion to psychosis.”

This study received funding from the Guangdong Provincial Department of Science and Technology and the Guangdong Provincial Administration of traditional Chinese Medicine.

Reference

Huang ZH, Hou CL, Huang YH, et al. Individuals at high risk for psychosis experience more childhood trauma, life events and social support deficit in comparison to healthy controls [published online January 15, 2019]. Psychiatry Res. doi: 10.1016/j.psychres.2019.01.060