Background: Childhood trauma (CT) has increasingly been tied to psychosis and schizophrenia spectrum disorders (SSDs). CT includes physical, sexual, and emotional abuse and physical and emotional neglect. Studies have pointed to more CT in psychosis compared to healthy controls, however, comparison to other patient groups has been less researched. Research on CT in relation to clinical features such as cognitive functioning and the effect of antipsychotic medication has been mixed. This knowledge is imperative to enhance trauma-informed care for patients with psychosis.
Methods: Based on data from the Bergen-Stavanger-Innsbruck-Trondheim (BeSt InTro) study, we have examined CT in relation to 1) other clinical groups, 2) cognitive performance, 3) parental mental health status, and 4) effect of antipsychotic medication. Patients (n=98) within F20-29 in the ICD-10 were assessed with the Childhood Trauma Questionnaire Short-Form and PANSS scales, in addition to a comprehensive cognitive test battery and interviews about parental mental health.
Results:
1) Patients with SSDs reported more severe CT and more types of CT compared to patients with other mental health disorders. When compared to substance abuse disorders, we found no significant differences in the number or severity of CT.
2) Physical neglect significantly predicted decreased attention and working memory abilities in SSDs
3) We found a dose-response relation between CT and psychosis, not moderated by parental mental health.
4) CT was associated with a slower effectiveness of antipsychotic medication from baseline to 52 weeks of treatment. CT subtypes were significant predictors for effect of antipsychotics; sexual abuse on positive psychosis symptoms and physical neglect for general symptoms.
Conclusions: We found CT to be frequently reported in our sample of SSDs, and CT is related to important clinical features of psychosis based on samples from our studies. Our results highlight the need for trauma-informed care for SSDs.