The influence of life events on the subsequent course of psychotic illness: A prospective follow-up of the Camberwell Collaborative Psychosis Study

Abstract

SynopsisFifty-nine psychotic patients with acute onset of illness, who had been interviewed about their experience of stressful life events before the episode, were followed up for an average of 42 months. Thirty patients (51%) had experienced a stressful life event in the 3 months immediately before onset (EV +), 29 had not (EV −).In patients with an RDC diagnosis of affective disorder or unspecified functional psychosis, the presence of stressful life events was associated subsequently with milder symptom severity, less time spent in hospital, more treatment for depressive symptoms and less for psychotic symptoms. In schizophrenia, differences were less apparent, but patients with event associated episodes had less need of anti-psychotic maintenance medication over the follow-up period and tended to have spent more time in complete remission. EV + schizophrenic subjects also had higher morbid risk for schizophrenia in their first degree relatives, and tended to be female and to have less typical symptoms than EV − schizophrenic patients.

Structural brain abnormalities in male schizophrenics reflect fronto-temporal dissociation

“…Patients were recruited from the Camberwell Psychosis Follow-up Study (van Os et al 1994). All right-handed males with 1 left-handed item on the Annett scale (Annett, 1970) and who fulfilled DSM-III-R (APA, 1987) criteria for schizophrenia were contacted, of whom 42 consented to undergo MRI scanning and interview.…”

Conversion disorder: a problematic diagnosis

“…Psychological stress is universal and is known to be associated with exacerbation or the precipitation of not only psychiatric illness, such as depression27 and schizophrenia,28 but also physical illnesses such as acute coronary syndromes29 or multiple sclerosis 30. But these associations do not prove causation.…”

Shame amplifies the association between stressful life events and paranoia amongst young adults using mental health services: Implications for understanding risk and psychological resilience

“…Several studies have implicated a role for stressful events in the aetiology of general psychotic symptoms (e.g., Bebbington et al, 1993;Freeman et al, 2011) but results have been inconsistent (Chung et al, 1986;Van Os et al, 1994). It is possible that these varying results have been caused by the presence of unrecognised moderating factors, which may 'amplify' or 'buffer' the association between an input and an outcome variable.…”