Childhood trauma and psychotic disorders: a systematic, critical review of the evidence.
ABSTRACT There is controversy over whether childhood trauma (CT) is a causal factor in the development of psychosis. This review aims to identify and critically analyze the association between CT and psychotic disorders. Studies investigating CT and psychotic disorder were identified by searches of electronic databases and manual searches of references lists, and 46 studies were identified. Forty studies had no control group, only psychiatric control groups, or unmatched, nonpopulation control groups and thus had methodologies that were inadequate to determine the relationship between CT and psychosis. Six studies used appropriate control groups. Three studies found an association between CT and psychosis, 2 found potentially real associations that failed to reach statistical significance, and 1 found no association, tentatively suggesting a relationship between CT and psychotic disorders. Several methodological problems were found in the studies in the review, including the highest quality studies, which limit the strength of the conclusions that can be drawn from them. These were lack of statistical power, lack of attention to moderating or mediating variables, the way in which CT was measured, and the use of cross-sectional research designs. These problems, some of which may be unavoidable in CT research, suggest the need for new and innovative methodologies in the investigation of CT and psychosis. Directions for further research are explored.
Full-textDOI: · Available from: Henry Jackson, May 26, 2015
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ABSTRACT: Gender identity disorder (GID), recently renamed gender dysphoria (GD), is a rare condition characterized by an incongruity between gender identity and biological sex. Clinical evidence suggests that schizophrenia occurs in patients with GID at rates higher than in the general population and that patients with GID may have schizophrenia-like personality traits. Conversely, patients with schizophrenia may experience alterations in gender identity and gender role perception. Neurobiological research, including brain imaging and studies of finger length ratio and handedness, suggests that both these disorders are associated with altered cerebral sexual dimorphism and changes in cerebral lateralization. Various mechanisms, such as Toxoplasma infection, reduced levels of brain-derived neurotrophic factor (BDNF), early childhood adversity, and links with autism spectrum disorders, may account for some of this overlap. The implications of this association for further research are discussed.12/2014; 2014:463757. DOI:10.1155/2014/463757
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ABSTRACT: To describe the prevalence and demographic, clinical and functional correlates of childhood trauma in patients attending early psychosis clinics. Participants were recruited from outpatients attending four early psychosis services. Exposure to childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Psychopathology was measured using the Positive and Negative Syndrome Scale and the Depression, Anxiety and Stress Scale. Social and vocational functioning and substance use were also assessed. Over three-quarters of the 100 patients reported exposure to any childhood trauma. Emotional, physical and sexual abuse were reported by 54%, 23% and 28% of patients, respectively, while 49% and 42% of patients reported emotional and physical neglect, respectively. Female participants were significantly more likely to be exposed to emotional and sexual abuse. Exposure to childhood trauma was correlated with positive psychotic symptoms and higher levels of depressive, anxiety and stress symptoms; however, it had no impact on social or vocational functioning or recent substance use. Exposure to childhood trauma was common in patients with early psychosis, and associated with increased symptomatology. Existing recommendations that standard clinical assessment of patients with early psychosis should include inquiry into exposure to childhood trauma are supported. © The Royal Australian and New Zealand College of Psychiatrists 2015.Australian and New Zealand Journal of Psychiatry 02/2015; DOI:10.1177/0004867415575379 · 3.77 Impact Factor
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ABSTRACT: Estudios previos han destacado el papel de las experiencias traumáticas tempranas como un factor predisponente importante de gran variedad de alte-raciones psicopatológicas. Sin embargo, el papel del trauma en el desarrollo de la psicosis es un área poco estudiada a día de hoy, especialmente en nues-tro país. En este sentido, el objetivo de esta investigación fue analizar la pre-valencia de diferentes experiencias traumáticas tempranas en una muestra clínica de 48 pacientes psicóticos (31 varones y 17 mujeres) y estudiar el po-sible efecto que dichas experiencias tienen en el curso y en la evolución de los trastornos psicóticos. Los resultados mostraron que el 75% de los pacientes estudiados refirieron historia previa de trauma, no existiendo entre varones y mujeres importantes diferencias en la prevalencia de dichas experiencias. Sí se encontraron diferencias en la presencia de sintomatología positiva, siendo más frecuente en los pacientes con historia previa de experiencias traumáticas. Estos resultados ponen de manifiesto la relación existente entre experiencias * Agradecimientos: La presente investigación ha sido posible gracias al apoyo recibido del Ministerio de Ciencia e Innovación (PSI2008-06220, PSI2011-23818). Correspondencia: Nuria Ordóñez Camblor. Servicio de Psiquiatría, Hospital Divino Vallés, Av. Islas Baleares, 1 09006, Burgos. Correo electrónico: firstname.lastname@example.org.Anuario de Psicologia 01/2014; 44(3):283-294.