Childhood adversities in people at ultra-high risk (UHR) for psychosis: a systematic review and meta-analysis

Abstract

Childhood adversities have been reported to be more common among individuals at ultra-high risk (UHR) for psychosis. This paper systematically reviewed and meta-analysed (i) the severity and prevalence of childhood adversities (childhood trauma exposure, bullying victimisation and parental separation or loss) among the UHR, and (ii) the association between adversities and transition to psychosis (TTP). PsycINFO, PubMed and Embase databases were searched for studies reporting childhood adversities among UHR individuals. Only published articles were included. Risk of bias was assessed using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline (von Elm et al., 2007) and the tool developed by Hoy et al. (2012). Seventeen case–control, cross-sectional and longitudinal studies were included. UHR individuals experienced significantly more severe trauma than controls, regardless of trauma subtype. UHR were 5.5, 2.5 and 3.1 times as likely to report emotional abuse, physical abuse and bullying victimisation, respectively. There was no association with parental separation. However, childhood trauma was not significantly associated with TTP (follow-up periods: 6 months to 15 years), suggesting that trauma alone may not be a sufficient risk factor. Sexual abuse was associated with TTP but this may have been driven by a single large study. Potential confounders and low rates of TTP among UHR are limitations of this review. This is the first meta-analysis that quantitatively summarises the associations between childhood adversities and TTP among UHR, and between specific abuse subtypes and TTP. Specific recommendations have been made to increase the quality of future research. PROSPERO registration no. CRD42017054884.

Expanding the search for emerging mental ill health to safeguard student potential and vocational success in high school: A narrative review

“…Thompson et al (2009) found in an ARMS sample (n = 30), that 97% had experienced at least one form of trauma-83% reported physical abuse, 67% reported emotional abuse, and 27% sexual abuse. A systematic review and metaanalysis investigating adolescents with ARMS, also found high rates of experienced emotional abuse, physical abuse, and bullying (Peh, Rapisarda, & Lee, 2018). Studies have also investigated whether childhood trauma predicts conversion to psychosis in ARMS samples and sexual trauma was the strongest predictor of transition (Bechdolf et al, 2010;Thompson et al, 2013;Varese et al, 2012).…”

Effects of interactions between variation in dopaminergic genes, traumatic life events, and anomalous self-experiences on psychosis proneness: Results from a cross-sectional study in a nonclinical sample

“…Meta-analytic studies point to the association between traumatic life events (TLEs) and the risk of psychosis [25,26] and transition to psychosis among CHR individuals [27]. Stress has also been identified as a marker for the occurrence of subclinical psychosis in a large-scale female twin study [28].…”

Psychosis in children of separated parents: A systematic review and meta-analysis

“…The electronic search produced 2,210 references, 289 from PUBMED, 960 from EMBASE, 598 from PsychInfo, and 363 from Web of Science. Twelve reviews relevant to the topic, with a total of 1,126 references, and cited by 1,997 papers were also identified [10,11,[21][22][23][24][25][26][27][28][29][30]. The results of the search are presented in Figure 1.…”