Childhood maltreatment contributes to clinical and subclinical symptoms of psychosis in patients and healthy volunteers.
The intensity of symptoms was greater among patients, and the self-reported psychotic symptoms of the volunteers were considered to be subclinical. However, the strength of association between maltreatment and self-reported symptoms was found to be comparable in both groups, Pamela DeRosse, Ph.D., and her colleagues reported online April 7 in Schizophrenia Research.
The findings "provide strong support for the continuity of the relation between childhood maltreatment and severity of subclinical psychotic symptoms observed in the general population and the severity of psychotic symptoms observed in patients with schizophrenia and schizoaffective disorder," wrote Dr. DeRosse of the Feinstein Institute for Medical Research, Manhasset, N.Y., and her coauthors. "Elucidating the mechanisms that underlie this relationship may provide insight into the pathophysiology of risk and resilience to psychotic disorders," they said (Schizophr. Res. 2014 April 7 [doi: 10.1016/j.schres.2014.03.009]).
She and her coauthors examined the relationships between self-reported psychotic symptoms and several forms of childhood maltreatment (emotional, physical, and sexual abuse; and emotional and physical neglect). The study cohort included 447 healthy adults and 184 stable patients with schizophrenia or schizoaffective disorder. Controls were assessed by using several tools, including the Childhood Trauma Questionnaire. Participants in both groups were assessed with that tool and also with others typically used to identify clinically apparent symptoms.
All forms of childhood abuse were significantly more common among the patients than the controls. Among patients, severity of their clinical symptoms (positive, negative, and depressive) significantly correlated with the severity of abuse. The controls experienced that same significant association between abuse and subclinical symptoms.
For both groups, the associations were particularly strong between all categories of symptoms and childhood emotional abuse, the authors said. In fact, the strongest and most consistent relationships were among the CAPE (Community Assessment of Psychic Experiences) subscale scores and severity of childhood emotional abuse. All P values in that category were less than .001 among participants in both groups. All of the associations remained unchanged when the groups were broken down by gender and by race/ethnicity.
Because the associations affected all symptom categories, it’s tough to tease out specifics, they noted. "This overlap makes it difficult to draw conclusions regarding the relationship between specific forms of childhood maltreatment and specific types of subclinical/clinical psychotic symptoms."
The study was sponsored by the National Institute of Mental Health and several research centers. Dr. DeRosse had no financial declarations. One of her coauthors reported associations with numerous pharmaceutical companies.