Similar Rates of Childhood Trauma in Schizophrenia and Substance Use Disorders

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Increased prevalence of adversity and trauma experienced during childhood has been noted in adults with substance use disorder and schizophrenia spectrum disorders.
Increased prevalence of adversity and trauma experienced during childhood has been noted in adults with substance use disorder and schizophrenia spectrum disorders.

Patients with schizophrenia spectrum disorders have similar rates of childhood trauma (both in severity and frequency) as patients with substance use disorders, according to a recent study published in Psychiatry Research.

Although the link between substance use in schizophrenia spectrum disorders has been well documented, few studies have compared the experience of childhood trauma among patients with schizophrenia spectrum disorders and those with substance use disorders. Study investigators therefore set out to examine the frequency, types, and severity of childhood trauma in schizophrenia spectrum disorders vs substance use disorders, with childhood trauma being understood to include both active forms of abuse (sexual, physical, and emotional abuse) and passive abuse (physical and emotional neglect). 

Participants were matched by age and gender, with childhood trauma measured by the Childhood Trauma Questionnaire Short-Form (CTQ-SF), a 28-item, self-report questionnaire that screens for passive and active forms of abuse.

For this study, both the psychosis group (patients with schizophrenia spectrum disorders) and the substance abuse group (patients with substance use disorders) included a sample group of 57 patients, each with 22 female participants and 35 male participants, with similar levels of education, marital status, and living situations. The study found no statistically significant differences between the CTQ-SF results of the psychosis group and those of the substance abuse group. Childhood trauma experiences were determined to be similarly represented in the 5 subtypes (sexual, physical, and emotional abuse, and emotional and physical neglect) and similar in frequency and severity.

Previous studies have established the link between childhood trauma and psychosis, with proposed mechanisms being primarily related to stress response. Similar high stress and low coping mechanisms are proposed to explain the established link between childhood trauma and substance use disorders, as well. Comorbidity of substance use disorders and schizophrenia spectrum disorders is also frequently reported in the literature (20% to 30%).

Considering the similarities in frequency and severity of childhood trauma between schizophrenia spectrum disorders and substance use disorders demonstrated by the present study, the investigators conclude, “Future research should address the issue of causality and aim at investigating how and why individuals exposed to [childhood trauma] develop a primary [schizophrenia spectrum disorder] or [substance use disorder].”

Reference

Mørkved N, Winje D, Dovran A, et al. Childhood trauma in schizophrenia spectrum disorders as compared to substance abuse disorders [published March 2018]. J Psych Res. doi:10.1016/j.psychres.2018.01.011

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