Exploring the association between lifetime traumatic experiences and positive psychotic symptoms in a group of long-stay patients with schizophrenia: the mediating effect of depression, anxiety, and distress

Abstract

Background Positive psychotic symptoms of schizophrenia are generally characterized by hallucinations and delusions. We propose to assess the relationship between total composite trauma and positive psychotic symptoms, along with the mediation effect of cognition, fear of COVID-19, insomnia, anxiety, distress, and depression of Lebanese patients with schizophrenia. Methods A cross-sectional study was carried out, between June and July 2021, by deriving data from 155 long-stay in-patients diagnosed with schizophrenia. Results Depression, anxiety, and distress but not cognitive impairment, insomnia, and fear of COVID-19) mediated the association between lifetime traumatic experiences and positive psychotic symptoms. Higher traumatic experiences were associated with greater depression, anxiety, and distress, indicating a significant positive total effect on positive psychotic scores. Moreover, higher depression, anxiety, and distress were significantly associated with higher positive psychotic symptoms. Conclusion Our results contribute to the existing knowledge by suggesting other possible intervention paths through mediating factors. Interventions that improve anxiety, depression, and distress severity may be effective in reducing positive psychotic symptoms among patients with schizophrenia having experienced lifetime trauma.

Validation and optimal cut-off score of the World Health Organization Well-being Index (WHO-5) as a screening tool for depression among patients with schizophrenia

“…This cross-sectional study has been conducted during August and October 2023 using convenience sampling. The target sample was set as inpatients of the Psychiatric Hospital of the Cross, Jal Eddib (suburbs of the capital Beirut), Lebanon, with the following inclusion criteria: (1) age of 18 years and over, (2) with a schizophrenia or a schizoaffective disorder diagnosis following the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria; (3) at chronic stage of the disease, defined as with more than 1 year of illness duration [ 41 ]; and institutionalized in the above-mentioned long-stay hospital for more than one year (The detailed description of the study population can be found elsewhere [ 32 , 42 ]); (4) experiencing either partial or total recovery, this choice has been made as personal recovery represents a longitudinal process occurring in stages [ 43 ]; and (5) able to give their free and informed consent to participate after study objectives and general instructions were thoroughly explained to them (in case of inability to consent a family member did). This target population was chosen so that potential confounding effects of some factors, such as severity of psychotic symptoms, treatment adherence and substance use, are reduced or eliminated.…”

Validation and Optimal Cut-Off Score of the World Health Organization Well- being Index (WHO-5) as a Screening Tool for Depression among Patients with Schizophrenia

“…This cross-sectional study has been conducted during August and October 2023. The target sample was set as inpatients of the Psychiatric Hospital of the Cross, Jal Eddib (suburbs of the capital Beirut), Lebanon, with the following inclusion criteria: (1) age of 18 years and over, (2) with a schizophrenia or a schizoaffective disorder diagnosis following the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria [35]; (3) at chronic stage of the disease, de ned as with more than 1 year of illness duration [52]; and institutionalized in the above-mentioned long-stay hospital for more than one year (The detailed description of the study population can be found elsewhere [47,53]); (4) experiencing either partial or total recovery, this choice has been made as personal recovery represents a longitudinal process occurring in stages [54,55]; and (5) able to give their free and informed consent to participate after study objectives and general instructions were thoroughly explained to them (in case of inability to consent a family member did). The Ethics and Research Committee of the Psychiatric Hospital of the Cross approved this study protocol.…”

Arabic translation and validation of the Clinician Administered Staden Schizophrenia Anxiety Rating Scale (S-SARS)

“…This cross-sectional study has been conducted during August and October 2023. The target sample was set as inpatients of the Psychiatric Hospital of the Cross, Jal Eddib (suburbs of the capital Beirut), Lebanon, with the following inclusion criteria: (1) age of 18 years and over, (2) with a schizophrenia or a schizoaffective disorder diagnosis following the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria [35], (3) at chronic stage of the disease, de ned as with more than 1 year of illness duration [42], and institutionalized in the above-mentioned long-stay hospital for more than one year (The detailed description of the study population can be found elsewhere [40,43]), (4) remitted and clinically stable, as de ned by Fleischhacker et al [44]: patients "were required to be symptomatically stable, as judged by the treating physician, be receiving a stable dose of an antipsychotic drug for at least 4 weeks before the survey and be in good general physical health", and (5) able to give their free and informed consent to participate after study objectives and general instructions were thoroughly explained to them (in case of inability to consent a family member did).…”