Prevalence and clinical implication of adverse childhood experiences and their association with substance use disorder among patients with schizophrenia

Abstract

Background Adverse childhood experiences (ACEs) and substance use disorder (SUD) are well-known risk factors for psychosis and dramatically affect schizophrenia. In this research, we aimed to measure the prevalence of adverse childhood experiences and substance use disorder in patients with schizophrenia and assess the effect of ACEs on the clinical presentation and overall functioning and the association between them and SUD in patients with schizophrenia. A cross-sectional study included a random sample of 165 schizophrenic patients who were examined by doing drug screen in urine, structured questionnaire to collect Socioeconomic characteristics, history of schizophrenia, structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders-fifth edition, Positive and Negative Syndrome Scale (PANSS), Adverse Childhood Experiences International Questionnaire (ACE-IQ), World Health Organization Disability Assessment Schedule 2.0, compliance rating scale, addiction severity index fifth edition (ASI) for individuals with positive urine drug screen. Results Only 14.4% of the studied patients had no adverse childhood experiences. The prevalence of positive substance abuse screening was 18.2%. There were statistically significant negative correlations between total ACE score and educational level, socioeconomic level, and the onset of schizophrenia. On the other hand, statistically significant positive correlations were found between the total ACE score and PANSS score and ASI score. The first most frequent ACE was significantly associated with female gender, lower education levels, low and middle socioeconomic classes, lifetime substance use, smokers, and positive drug screening. Emotional neglect and contact sexual abuse were significantly associated with positive drug screening. At the same time, Physical abuse was significantly associated with both lifetime substance use and positive drug screening. Conclusion The current study’s findings indicate that childhood adverse experiences and substance abuse are prevalent problems in patients with schizophrenia. Given that there is an association between both issues, they may affect the symptomatology of the disorder, the prognosis, and the therapeutic plan. It is advised that a greater emphasis on and identification of childhood trauma and drug use disorder may be a necessary step in assessing patients with schizophrenia.

Relationship between Self Stigma and Expectations in Schizophrenic Patients

“…Previous studies have shown that nutrient pan is low among self-stigmatized individuals (Clari et al, 2022;Díaz-Cutraro et al, 2022). Discussion of previous research on self-stigma which affects the quality of physical and psychological health of schizophrenic patients which is reflected in the patient's ability to maintain the body and coping abilities against perceived stressors (Cai et al, 2022;Yosep et al, 2022;Yousef et al, 2022). Schizophrenia with a negative self-stigma raises low expectations, resulting in low self-esteem and self-ability so that it is directly related to the recovery process in the form of decreased awareness or self-view of the disease which in turn greatly impacts the quality of life of schizophrenic patients.…”

Adverse childhood experiences among people with schizophrenia at comprehensive specialized hospitals in Bahir Dar, Ethiopia: a comparative study

“…These ACEs encompass occurrences involving physical, psychological, and sexual abuse, as well as physical and mental neglect, and dysfunction within the family ( 3 ). Individuals with schizophrenia as well as those with other non-psychiatric diseases with severe ACEs, displayed higher levels of comorbidity, necessitated increased medication usage, and required the involvement of a care coordinator compared to individuals with moderate or no ACEs ( 4 – 6 ).…”

“…This implies a dose-response connection, where the risk of adverse effects on physical and mental health exponentially rises with additional ACEs ( 33 , 35 ). Individuals with schizophrenia who had multiple ACEs histories exhibited more severe symptoms and unfavorable clinical results ( 4 , 36 – 38 ). Those with higher levels of ACEs tended to have lower levels of social support, which exhibited a positive correlation with suicide in individuals with schizophrenia, and decreased coping abilities ( 39 – 41 ).…”

Impacts of age and environment on postnatal microglial activity: Consequences for cognitive function following early life adversity

“…Childhood maltreatment increases the likelihood of later-life neuropsychiatric disorders, such as anxiety, schizophrenia, and substance use disorders [1][2][3]. Cognitive dysfunction is a central feature of these disorders [4][5][6][7][8][9][10]. Additionally, early life adversity (ELA) affects brain regions important for cognition, such as the prefrontal cortex (PFC) and hippocampus, which in turn influences cognitive development [11][12][13][14][15][16].…”