Environmental factors during adolescence associated with later development of psychotic disorders – A nested case-control study

Bratlien, Unni; Øie, Merete Glenne; Haug, Elisabeth; Møller, Paul; Andreassen, Ole A.; Lien, Lars; Melle, Ingrid

doi:10.1016/j.psychres.2013.12.048

Cited by 21 publications

(13 citation statements)

References 36 publications

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“…During 2008 and 2009 a total of 44 patients with schizophrenia spectrum disorders were coming to their first adequate treatment (i.e., not having previously received adequate antipsychotic medication in adequate doses for 12 weeks, or until remission); some had not initiated treatment at first evaluation. To enhance statistical power we additionally included 11 patients enrolled in a related study of young patients with psychosis born in 1985/86 (Bratlien et al, 2014, 2015). They were in the early phases of treatment, with an even shorter DUP than the strict first treatment patients, and met the same inclusion and exclusion criteria, except for the strict definition of first treatment.…”

Section: Methodsmentioning

confidence: 99%

The Association between Anomalous Self-experiences, Self-esteem and Depressive Symptoms in First Episode Schizophrenia

Haug

Øie

Andreassen

et al. 2016

Front. Hum. Neurosci.

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Background: Anomalous self-experiences (ASEs) aggregate in schizophrenia spectrum disorders, but the relationship between ASEs, and depression has been studied to a limited extent. Lower self-esteem has been shown to be associated with depression in early psychosis. Our hypothesis is that ASEs in early phases of schizophrenia are linked to lower levels of self-esteem, which in turn is associated with depression.Aim: The aim is to examine the relationship between ASEs, self-esteem and depression in first-episode schizophrenia spectrum disorders.Method: ASEs were assessed in 55 patients with first-episode schizophrenia by means of the Examination of anomalous Self-Experience (EASE) instrument. Assessment of depression was based on the Calgary Depression Scale for Schizophrenia (CDSS). Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES). Symptom severity was assessed using the Structured Clinical Interview for the Positive and Negative Syndrome Scale (SCI-PANSS). Substance misuse was measured with the Drug Use Disorder Identification Test (DUDIT), and alcohol use was measured with the Alcohol Use Disorder Identification Test (AUDIT). Data on childhood adjustment were collected using the Premorbid Adjustment Scale (PAS). Data on childhood trauma were collected using the Norwegian version of the Childhood Trauma Questionnaire, short form (CTQ-SF).Results: Analyses detected a significant association between current depression and ASEs as measured by the EASE in women, but not in men. The effect of ASEs on depression appeared to be mediated by self-esteem. No other characteristics associated with depression influenced the relationship between depression, self-esteem and ASEs.Conclusion: Evaluating ASEs can assist clinicians in understanding patients' experience of self-esteem and depressive symptoms. The complex interaction between ASEs, self-esteem, depression and suicidality could be a clinical target for the prevention of suicidality in this patient group.

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Section: Methodsmentioning

confidence: 99%

The Association between Anomalous Self-experiences, Self-esteem and Depressive Symptoms in First Episode Schizophrenia

Haug

Øie

Andreassen

et al. 2016

Front. Hum. Neurosci.

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“…In the short time since the publication of that review, over twenty additional studies have been published, most of which provide further evidence that childhood adversities are more common among those with psychosis, again across the spectrum. Perhaps most notably, in a prospective study of 1,112 adolescents, Kelleher et al found that cessation of trauma was associated with subsequent cessation of psychotic experiences.…”

Section: Evidencementioning

confidence: 99%

Childhood adversities and psychosis: evidence, challenges, implications

2016

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There is a substantial body of research reporting evidence of associations between various forms of childhood adversity and psychosis, across the spectrum from experiences to disorder. This has been extended, more recently, to include studies of cumulative effects, of interactions with other factors, of specific effects, and of putative biological and psychological mechanisms. In this paper we evaluate this research and highlight the remaining methodological issues and gaps that temper, but do not dismiss, conclusions about the causal role of childhood adversity. We also consider the emerging work on cumulative, synergistic, and specific effects and on mechanisms; and discuss the broader implications of this line of research for our understanding of psychosis. We conclude that the current balance of evidence is that childhood adversities -particularly exposure to multiple adversities involving hostility and threat -do, in some people, contribute to the onset of psychotic experiences and psychotic disorders. There has been a flurry of research on the relationship between childhood adversity and psychosis over the past ten years. This has extended, more recently, to studies that have sought to elaborate on the nature of the relationship, by examining cumulative effects, interactions with other risk factors (e.g., genes), specificity of effects, and putative mechanisms.For some authors, the accumulated evidence unequivocally establishes that difficult and unpleasant experiences in childhood contribute to the development of psychoses 1 . For others, the evidence is not so clear cut 2 . At issue, in part at least, are fundamental questions about the nature and aetiology of psychosis. Much, then, is at stake and a further appraisal of the evidence is warranted. In this paper, we first summarize and critically evaluate research on the association between childhood adversities and psychosis (including low-level experiences, at risk states, and disorders). In doing this, we focus particularly on remaining methodological issues and gaps in the literature, and on research that has further investigated the nature of the association. We then reflect on the broader implications of this work for our understanding of psychosis. CHILDHOOD ADVERSITYChildhood adversity is a broad term that denotes exposure to a range of difficult or unpleasant situations or experiences, usually before the age of 16. The adversities typically considered in studies of psychoses include household poverty, separation from a parent (i.e., family breakdown), death of a parent, neglect, abuse (including emotional, psychological, physical, and sexual), and peer bullying.Estimates suggest that large numbers of children are exposed to such situations and experiences. In the UK, for example, according to estimates, over 3 million children (28%) live in poverty (defined as less than 60% of the average household income) 3 , over 3 million children (23% of those living in families) live in lone parent households 4 , around 6% of those aged 0-10 years and around...

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“…Moreover, loneliness is associated with poorer quality of life [17] and personal recovery [18], and with more severe mental health symptoms [19]. Similarly, a number of negative health outcomes have been found to be associated with objective social isolation, for example, increased all-cause mortality rate [20], poor physical health outcomes [21,22], worse psychotic symptoms [23,24], depressive symptoms [24], and higher risk of dementia [25]. Conversely, social support that is perceived as sufficient is associated with less severe psychiatric symptoms, higher functioning, better personal recovery, greater self-esteem and empowerment, and improved quality of life [26].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: a systematic review

Mann

Wang

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

130

122

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Purpose Subjective and objective social isolation are important factors contributing to both physical and mental health problems, including premature mortality and depression. This systematic review evaluated the current evidence for the effectiveness of interventions to improve subjective and/or objective social isolation for people with mental health problems. Primary outcomes of interest included loneliness, perceived social support, and objective social isolation. Methods Three databases were searched for relevant randomised controlled trials (RCTs). Studies were included if they evaluated interventions for people with mental health problems and had objective and/or subjective social isolation (including loneliness) as their primary outcome, or as one of a number of outcomes with none identified as primary. Results In total, 30 RCTs met the review's inclusion criteria: 15 included subjective social isolation as an outcome and 11 included objective social isolation. The remaining four evaluated both outcomes. There was considerable variability between trials in types of intervention and participants' characteristics. Significant results were reported in a minority of trials, but methodological limitations, such as small sample size, restricted conclusions from many studies. Conclusion The evidence is not yet strong enough to make specific recommendations for practice. Preliminary evidence suggests that promising interventions may include cognitive modification for subjective social isolation, and interventions with mixed strategies and supported socialisation for objective social isolation. We highlight the need for more thorough, theory-driven intervention development and for well-designed and adequately powered RCTs.

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Environmental factors during adolescence associated with later development of psychotic disorders – A nested case-control study

Cited by 21 publications

References 36 publications

The Association between Anomalous Self-experiences, Self-esteem and Depressive Symptoms in First Episode Schizophrenia

The Association between Anomalous Self-experiences, Self-esteem and Depressive Symptoms in First Episode Schizophrenia

Childhood adversities and psychosis: evidence, challenges, implications

The effectiveness of interventions for reducing subjective and objective social isolation among people with mental health problems: a systematic review

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