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The association of adverse childhood experiences with long-term outcomes of psychosis: a 21-year prospective cohort study after a first episode of psychosis.
Peralta, Victor; García de Jalón, Elena; Moreno-Izco, Lucía; Peralta, David; Janda, Lucía; Sánchez-Torres, Ana M; Cuesta, Manuel J.
Afiliación
  • Peralta V; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain.
  • García de Jalón E; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
  • Moreno-Izco L; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain.
  • Peralta D; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
  • Janda L; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
  • Sánchez-Torres AM; Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.
  • Cuesta MJ; Mental Health Department, Servicio Navarro de Salud, Pamplona, Spain.
Psychol Med ; : 1-10, 2024 May 30.
Article en En | MEDLINE | ID: mdl-38813601
ABSTRACT

BACKGROUND:

Evidence suggests a possible relationship between exposure to childhood adversity (CA) and functional impairment in psychosis. However, the impact of CA on long-term outcomes of psychotic disorders remains poorly understood.

METHODS:

Two hundred and forty-three patients were assessed at their first episode of psychosis for CA and re-assessed after a mean of 21 years of follow-up for several outcome domains, including symptoms, functioning, quality of life, cognitive performance, neurological dysfunction, and comorbidity. The unique predictive ability of CA exposure for outcomes was examined using linear regression analysis controlling for relevant confounders, including socioeconomic status, family risk of schizophrenia, and obstetric complications.

RESULTS:

There were 54% of the patients with a documented history of CA at mild or higher levels. CA experiences were more prevalent and severe in schizophrenia than in other psychotic disorders (p < 0.001). Large to very large effect sizes were observed for CA predicting most role functioning variables and negative symptoms (ΔR2 between 0.105 and 0.181). Moderate effect sizes were observed for positive symptoms, personal functioning, impaired social cognition, impaired immediate verbal learning, poor global cognition, internalized stigma, poor personal recovery, and drug abuse severity (ΔR2 between 0.040 and 0.066). A dose-response relationship was observed between levels of CA and severity of outcome domains.

CONCLUSION:

Our results suggest a strong and widespread link between early adversity exposure and outcomes of psychotic disorders. Awareness of the serious long-term consequences of CA should encourage better identification of those at risk and the development of effective interventions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Psychol Med Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Psychol Med Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido