The role of childhood trauma in cognitive performance in schizophrenia and bipolar disorder – A systematic review

Abstract

Childhood trauma (CT) has repeatedly been associated with cognitive deficits in patients with psychosis but many inconsistencies have been reported so that the nature of the relationship remains unclear. The purpose of this review was to better characterize the contribution of CT to cognitive deficits by considering the type, severity and frequency of childhood traumatic events and their relationships with psychosis at all stages.Relevant studies were identified via electronic and manual literature searches and included original studies that investigated the relationship between CT and higher cognitive performance or social cognitive performance in patients with schizophrenia, bipolar disorder and psychosis at all stages of the illness stages (i.e. ultra-high risk, first episode or chronic phase).Overall, a majority of studies reported that patients who experienced CT displayed deficits in general cognitive ability compared to patients with psychosis without such a history. Associations between CT and other cognitive function were more mixed. When comparing patient groups, the association between CT and cognitive function was more inconsistent in patients with chronic schizophrenia than in healthy participants, ultra-high risk individuals, first-episode patients and patients with chronic bipolar disorder.In understanding the variability in the reported relationships between CT and cognition across study populations, we highlight the variety of questionnaires used and discuss the likelihood of there being differences in cognitive function based on specific stressors, severity and frequency. Finally, we consider future research steps that may shed light on psychobiological mechanisms underlying CT and cognitive performance in patients with psychosis.

Childhood Trauma Associated With Abnormal Resting-State Brain Network Connectivity in First-Episode Schizophrenia Patients

“…These results consistent with previous research [40,41], and a network-based study implemented by Isvoranu et al also suggested that different types of traumatic experiences were related to positive and negative symptoms through general psychotic symptoms [42]. Previous studies reported that cognitive de cits of psychiatric patients who experienced CT are more obvious than those had no history of CT [43], and abnormal results related to CT had been found in both general cognition [44] and social cognition [45], this article also found sexual abuse was negatively associated with speed of processing and social cognition, but we didn't conduct a strati ed analysis of the two types of patients because of insu cient sample size. It was worth mentioning that we found that family functions are signi cantly associated with CT, the family cohesion or adaptability were negatively related to most types of CT, and results are consistent with a previous study which concentrated on dissociative symptoms in adolescents, mentioned the possibility of coexistence between family dysfunction and early trauma frequency [46].…”

Sexual abuse and physical neglect in childhood are associated with affective theory of mind in adults with schizophrenia

“…Other research indicates that childhood trauma can have a negative effect on cognition also in adults, both healthy individuals and persons with psychosis ( Misiak et al, 2017 ). Two recent systematic reviews of the relevant literature concluded that childhood trauma is associated with reduced cognitive function in psychosis ( Vargas et al, 2019 ; Dauvermann and Donohoe, 2019 ). Although three social cognitive studies were included in one of the reviews ( Dauvermann and Donohoe, 2019 ), they were not interpreted because they were few with inconsistent results.…”

“…Two recent systematic reviews of the relevant literature concluded that childhood trauma is associated with reduced cognitive function in psychosis ( Vargas et al, 2019 ; Dauvermann and Donohoe, 2019 ). Although three social cognitive studies were included in one of the reviews ( Dauvermann and Donohoe, 2019 ), they were not interpreted because they were few with inconsistent results. However, a systematic literature review across major psychiatric disorders concluded that early negative social experiences, including childhood trauma, seems to be associated with poorer social cognition ( Rokita et al, 2018 ).…”

Childhood maltreatment and treatment outcome in psychotic disorders: a systematic review and meta‐analysis

“…Patients with a psychotic disorder and CM also show a higher concentration of inflammatory markers compared to psychotic patients without CM , which is again predictive of non‐response to antipsychotics . In psychotic disorders, CM is further related to cognitive impairments, including general cognitive ability, working memory, attention, verbal skills and visual perceptual organization , which is associated with non‐response to treatments aimed at improving social and occupational functioning as well as to treatments aimed at reducing symptoms . Besides these neurobiological and cognitive alterations, CM has been suggested to be a crucial source of increased stress sensitivity in patients with a psychotic disorder , which can favour the occurrence of psychotic symptoms in response to potentially stressful events .…”