Impact of childhood trauma on positive and negative symptom remission in first episode psychosis

Marita Pruessner; Suzanne King; Franz Veru; Inga Schalinski; Nadia Vracotas; Sherezad Abadi; Gerald Jordan; Martin Lepage; Srividya Iyer; Ashok K. Malla; Jai Shah; Ridha Joober

doi:10.1016/j.schres.2021.02.023

Impact of childhood trauma on positive and negative symptom remission in first episode psychosis

Marita Pruessner^*, Suzanne King, Franz Veru, Inga Schalinski, Nadia Vracotas, Sherezad Abadi, Gerald Jordan, Martin Lepage, Srividya Iyer, Ashok K. Malla, Jai Shah, Ridha Joober

^*Corresponding author for this work

Psychology

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

Objective: Early life adversity is suspected to play an important role for onset and course of psychosis, but its relationship with longer-term clinical outcome is not entirely clear. In this longitudinal study, we investigated the impact of childhood trauma (CT) on positive and negative symptom remission in first episode psychosis (FEP) patients over two years.

Methods: A total of 210 FEP patients were assessed with the Childhood Trauma Questionnaire. Patients reporting moderate to severe trauma (CT; N = 114; 54.3%) were compared to those without trauma (N-CT; N = 96; 45.7%). Positive (PSR) and negative symptom remission (NSR) were determined monthly over 24 months following established criteria using the Scale for Assessment of Positive Symptoms and the Scale for Assessment of Negative Symptoms. Global Functioning was evaluated at baseline and 24 months of follow-up.

Results: Compared to N-CT patients, CT patients had achieved significantly lower rates of PSR at 12 months and significantly lower rates of NSR at 24 months. A dose-response relationship was observed between the number of trauma categories fulfilled and the number of patients not achieving PSR and NSR at these time points. Higher trauma scores were significantly associated with poor functioning and higher positive and negative symptom severity at 24 months, but not at baseline and 12 months of follow-up.

Conclusion: Differential effects of CT on clinical outcome may not be apparent at psychosis onset, but only become evident through poor symptomatic remission and general functioning over time. Targeted diagnostic and therapeutic efforts after illness onset might limit these detrimental consequences.

Original language	English
Pages (from-to)	82-89
Number of pages	8
Journal	Schizophrenia Research
Volume	231
Early online date	31 Mar 2021
DOIs	https://doi.org/10.1016/j.schres.2021.02.023
Publication status	Published - May 2021

Bibliographical note

Funding Information:
This research was supported by a NARSAD Young Investigator Award and funding from the Golden Family Foundation to MP, funding from the joint program of the Fonds de Rechereche du Québec Santé (FRQS) and the Ministère de la Santé et des Services Sociaux (MSSS) to SK and RJ (# 24501-2041 ) J, and a grant by the Canadian Institutes of Health Research (CIHR) to ML and AM (# 68961 ). JS reports research funding from FRQS, and ML and RJ report salary support from FRQS. We would like to thank Ms. Nicole Pawliuk for help with data management for the study and the PEPP clinical and research teams for their help with patient recruitment.

Publisher Copyright:
© 2021 Elsevier B.V.

Keywords

Childhood trauma
Early life adversity
First episode psychosis
Schizophrenia
Symptom remission

ASJC Scopus subject areas

Psychiatry and Mental health
Biological Psychiatry

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

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title = "Impact of childhood trauma on positive and negative symptom remission in first episode psychosis",

abstract = "Objective: Early life adversity is suspected to play an important role for onset and course of psychosis, but its relationship with longer-term clinical outcome is not entirely clear. In this longitudinal study, we investigated the impact of childhood trauma (CT) on positive and negative symptom remission in first episode psychosis (FEP) patients over two years. Methods: A total of 210 FEP patients were assessed with the Childhood Trauma Questionnaire. Patients reporting moderate to severe trauma (CT; N = 114; 54.3%) were compared to those without trauma (N-CT; N = 96; 45.7%). Positive (PSR) and negative symptom remission (NSR) were determined monthly over 24 months following established criteria using the Scale for Assessment of Positive Symptoms and the Scale for Assessment of Negative Symptoms. Global Functioning was evaluated at baseline and 24 months of follow-up. Results: Compared to N-CT patients, CT patients had achieved significantly lower rates of PSR at 12 months and significantly lower rates of NSR at 24 months. A dose-response relationship was observed between the number of trauma categories fulfilled and the number of patients not achieving PSR and NSR at these time points. Higher trauma scores were significantly associated with poor functioning and higher positive and negative symptom severity at 24 months, but not at baseline and 12 months of follow-up. Conclusion: Differential effects of CT on clinical outcome may not be apparent at psychosis onset, but only become evident through poor symptomatic remission and general functioning over time. Targeted diagnostic and therapeutic efforts after illness onset might limit these detrimental consequences.",

keywords = "Childhood trauma, Early life adversity, First episode psychosis, Schizophrenia, Symptom remission",

author = "Marita Pruessner and Suzanne King and Franz Veru and Inga Schalinski and Nadia Vracotas and Sherezad Abadi and Gerald Jordan and Martin Lepage and Srividya Iyer and Malla, {Ashok K.} and Jai Shah and Ridha Joober",

note = "Funding Information: This research was supported by a NARSAD Young Investigator Award and funding from the Golden Family Foundation to MP, funding from the joint program of the Fonds de Rechereche du Qu{\'e}bec Sant{\'e} (FRQS) and the Minist{\`e}re de la Sant{\'e} et des Services Sociaux (MSSS) to SK and RJ (# 24501-2041 ) J, and a grant by the Canadian Institutes of Health Research (CIHR) to ML and AM (# 68961 ). JS reports research funding from FRQS, and ML and RJ report salary support from FRQS. We would like to thank Ms. Nicole Pawliuk for help with data management for the study and the PEPP clinical and research teams for their help with patient recruitment. Publisher Copyright: {\textcopyright} 2021 Elsevier B.V.",

year = "2021",

month = may,

doi = "10.1016/j.schres.2021.02.023",

language = "English",

volume = "231",

pages = "82--89",

journal = "Schizophrenia Research",

issn = "0920-9964",

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T1 - Impact of childhood trauma on positive and negative symptom remission in first episode psychosis

AU - Pruessner, Marita

AU - King, Suzanne

AU - Veru, Franz

AU - Schalinski, Inga

AU - Vracotas, Nadia

AU - Abadi, Sherezad

AU - Jordan, Gerald

AU - Lepage, Martin

AU - Iyer, Srividya

AU - Malla, Ashok K.

AU - Shah, Jai

AU - Joober, Ridha

N1 - Funding Information: This research was supported by a NARSAD Young Investigator Award and funding from the Golden Family Foundation to MP, funding from the joint program of the Fonds de Rechereche du Québec Santé (FRQS) and the Ministère de la Santé et des Services Sociaux (MSSS) to SK and RJ (# 24501-2041 ) J, and a grant by the Canadian Institutes of Health Research (CIHR) to ML and AM (# 68961 ). JS reports research funding from FRQS, and ML and RJ report salary support from FRQS. We would like to thank Ms. Nicole Pawliuk for help with data management for the study and the PEPP clinical and research teams for their help with patient recruitment. Publisher Copyright: © 2021 Elsevier B.V.

PY - 2021/5

Y1 - 2021/5

N2 - Objective: Early life adversity is suspected to play an important role for onset and course of psychosis, but its relationship with longer-term clinical outcome is not entirely clear. In this longitudinal study, we investigated the impact of childhood trauma (CT) on positive and negative symptom remission in first episode psychosis (FEP) patients over two years. Methods: A total of 210 FEP patients were assessed with the Childhood Trauma Questionnaire. Patients reporting moderate to severe trauma (CT; N = 114; 54.3%) were compared to those without trauma (N-CT; N = 96; 45.7%). Positive (PSR) and negative symptom remission (NSR) were determined monthly over 24 months following established criteria using the Scale for Assessment of Positive Symptoms and the Scale for Assessment of Negative Symptoms. Global Functioning was evaluated at baseline and 24 months of follow-up. Results: Compared to N-CT patients, CT patients had achieved significantly lower rates of PSR at 12 months and significantly lower rates of NSR at 24 months. A dose-response relationship was observed between the number of trauma categories fulfilled and the number of patients not achieving PSR and NSR at these time points. Higher trauma scores were significantly associated with poor functioning and higher positive and negative symptom severity at 24 months, but not at baseline and 12 months of follow-up. Conclusion: Differential effects of CT on clinical outcome may not be apparent at psychosis onset, but only become evident through poor symptomatic remission and general functioning over time. Targeted diagnostic and therapeutic efforts after illness onset might limit these detrimental consequences.

AB - Objective: Early life adversity is suspected to play an important role for onset and course of psychosis, but its relationship with longer-term clinical outcome is not entirely clear. In this longitudinal study, we investigated the impact of childhood trauma (CT) on positive and negative symptom remission in first episode psychosis (FEP) patients over two years. Methods: A total of 210 FEP patients were assessed with the Childhood Trauma Questionnaire. Patients reporting moderate to severe trauma (CT; N = 114; 54.3%) were compared to those without trauma (N-CT; N = 96; 45.7%). Positive (PSR) and negative symptom remission (NSR) were determined monthly over 24 months following established criteria using the Scale for Assessment of Positive Symptoms and the Scale for Assessment of Negative Symptoms. Global Functioning was evaluated at baseline and 24 months of follow-up. Results: Compared to N-CT patients, CT patients had achieved significantly lower rates of PSR at 12 months and significantly lower rates of NSR at 24 months. A dose-response relationship was observed between the number of trauma categories fulfilled and the number of patients not achieving PSR and NSR at these time points. Higher trauma scores were significantly associated with poor functioning and higher positive and negative symptom severity at 24 months, but not at baseline and 12 months of follow-up. Conclusion: Differential effects of CT on clinical outcome may not be apparent at psychosis onset, but only become evident through poor symptomatic remission and general functioning over time. Targeted diagnostic and therapeutic efforts after illness onset might limit these detrimental consequences.

KW - Childhood trauma

KW - Early life adversity

KW - First episode psychosis

KW - Schizophrenia

KW - Symptom remission

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JF - Schizophrenia Research

ER -

Impact of childhood trauma on positive and negative symptom remission in first episode psychosis

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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