Childhood trauma is associated with age at onset of symptoms, functioning, and cognition in patients with schizophrenia

Abstract

Introduction Childhood trauma (CT) is known to be a vulnerability factor for schizophrenia, but the specific impacts of different trauma subtypes on the prognosis of these patients remains unclear. Objective To assess the relationships between the occurrence of overall CT and its subtypes with factors with known prognostic impact on schizophrenia, such as age at onset of symptoms, global functioning, and cognitive impairment in a sample of Brazilian patients. Methods One hundred and five stable patients diagnosed with schizophrenia according to DSM-5 criteria were evaluated using the Independent Living Skills Survey (ILSS; self-report global functioning), Schizophrenia Cognition Rating Scale (SCoRS; subjective cognitive impairment), and Childhood Trauma Questionnaire scales (CTQ; perceived overall CT, emotional neglect, physical neglect, physical abuse, and emotional and sexual abuse). Statistical analysis was performed with multivariate linear regression. Results After controlling for educational level and age, subjective cognitive impairment was directly correlated with overall perceived CT occurrence, emotional abuse, and sexual abuse. Self-report global functioning was inversely correlated with perceived overall CT occurrence, emotional abuse, and sexual abuse. Emotional abuse and physical abuse were also inversely correlated with age at onset of symptoms. Conclusions CT can be related to more severe prognoses in schizophrenia, impacting on early onset of symptoms, lower global functioning, and greater cognitive impairment. Subtypes of trauma can be associated with different prognostic risks.

Association of childhood trauma with cognitive domains in adult patients with mental disorders and in non-clinical populations: a systematic review

“…Out the 74 selected studies, 50 were conducted on patients affected by psychotic, mood and anxiety disorders (SZ, psychosis, MDD, BD, PTSD, anxiety/GAD; Supplementary Tables S1, S2). In particular, 13 studies included patients affected by SZ (Lysaker et al, 2001(Lysaker et al, , 2002Schenkel et al, 2005;Shannon et al, 2011;McCabe et al, 2012;Kelly et al, 2016;Li et al, 2017;Ruby et al, 2017;Kilian et al, 2018;Mørkved et al, 2020;Wells et al, 2020;De-Nardin et al, 2021;Kasznia et al, 2021), and 12 were conducted in patients with ultrahigh risk of psychosis (Üçok et al, 2015;Velikonja et al, 2019Velikonja et al, , 2021 or in patients with first-episode psychosis, FEP (Aas et al, 2011(Aas et al, , 2012bSideli et al, 2014;Ayesa-Arriola et al, 2020) or patients with psychosis (Garcia et al, 2016;van Os et al, 2017;Mansueto et al, 2018Mansueto et al, , 2019Schalinski et al, 2018). Four studies included patients affected by BD (Bücker et al, 2013;Jiménez et al, 2017;Martins et al, 2019;Hsieh et al, 2020), 6 studies were conducted in patients with MDD (Gould et al, 2012;Dannehl et al, 2017;Saleh et al, 2017;Kaczmarczyk et al, 2018;Chakrabarty et al, 2020;Goltermann et al, 2021), while 9 studies included subjects with PTSD…”

“…Two papers employed the CANTAB tested in psychiatric patients (Gould et al, 2012;Bücker et al, 2013), 2 the WTAR (McCabe et al, 2012;Wells et al, 2020), whereas 3 in non-clinical samples (Majer et al, 2010;Syal et al, 2014;Lewis et al, 2021). In psychiatric subjects, 2 works exploited the Word Learning Task (WLT; Mansueto et al, 2018Mansueto et al, , 2019, whereas 5 employed a specific neuropsychological battery for SZ (Garcia et al, 2016;Poletti et al, 2017;Kilian et al, 2018;Schalinski et al, 2018;De-Nardin et al, 2021). GCA in older psychiatric people was measured by the MMSE in 2 studies (Dannehl et al, 2017;Petkus et al, 2018), and one study used both the MMSE and a structured interview for the diagnosis of dementia (SIDAM; Burri et al, 2013), whereas in non-clinical populations, one study implemented both the MMSE and the MoCa (Feeney et al, 2013) or only the MMSE (Korten et al, 2014).…”

“…The association between CGA and schizophrenic and psychotic patients exposed to CT/ELS was investigated in different studies. In particular, 7 studies showed a correlation of the CT/ELS with a worse general cognitive performance, including language and IQ (Schenkel 10.3389/fpsyg.2023.1156415 Frontiers in Psychology 08 frontiersin.org Aas et al, 2011Aas et al, , 2012bMcCabe et al, 2012;Schalinski et al, 2018;De-Nardin et al, 2021;Kasznia et al, 2021). On the contrary, 9 studies did not find significant correlations with GCA (Lysaker et al, 2001(Lysaker et al, , 2002Sideli et al, 2014;Üçok et al, 2015;Garcia et al, 2016;Kelly et al, 2016;Ruby et al, 2017;van Os et al, 2017;Wells et al, 2020).…”

“…When we considered the results performed in SZ and psychotic disorders (Supplementary Table S1), 12 studies (Shannon et al, 2011;Aas et al, 2012a;Sideli et al, 2014;Üçok et al, 2015;Garcia et al, 2016;van Os et al, 2017;Mansueto et al, 2018Mansueto et al, , 2019Schalinski et al, 2018;Ayesa-Arriola et al, 2020;Mørkved et al, 2020;Kasznia et al, 2021) were carried out in European populations, whereas 6 studies (Lysaker et al, 2001(Lysaker et al, , 2002Aas et al, 2011Aas et al, , 2012bKelly et al, 2016;Velikonja et al, 2019) in mixed populations (White, Black, Afro-American, Asian or others ethnicities), with White ethnicity as the most represented. Three studies were conducted in the United States (Schenkel et al, 2005;Ruby et al, 2017;Velikonja et al, 2021), 3 in Australia (McCabe et al, 2012Quidé et al, 2018;Wells et al, 2020), one in Brazil (De-Nardin et al, 2021), one in South Africa (Kilian et al, 2018), and one in China (Li et al, 2017).…”

Subcortical structures associated with childhood trauma and perceived stress in schizophrenia

“…Individuals with a history of childhood trauma are at high risk for psychosis (Kraan et al, 2015). Childhood trauma affects the onset (De-Nardin, Muratori, Ribeiro, Huguete, & Salgado, 2022) and severity of positive and dysthymia symptoms (Ruby, Rothman, Corcoran, Goetz, & Malaspina, 2017) as well as cognitive functions (Dauvermann & Donohoe, 2019) and treatment outcomes (Kilian et al, 2020) in schizophrenia. For instance, patients with a history of childhood trauma demonstrated delayed symptom remission (Aas et al, 2016).…”