Posttraumatic stress disorder, cognitive function and quality of life in patients with schizophrenia

Schizophrenia Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Psychiatry Research (Impact Factor: 2.47). 06/2008; 159(1-2):140-6. DOI: 10.1016/j.psychres.2007.10.012
Source: PubMed


The purpose of the present study was to assess posttraumatic stress disorder (PTSD), cognitive function, and quality of life in patients with schizophrenia who had a self-reported history of trauma exposure. Outpatients diagnosed with schizophrenia or schizoaffective disorder were referred to the study. Each patient was assessed with the Positive and Negative Syndrome Scale (PANSS), the Harvard Trauma Questionnaire (HTQ), a cognitive assessment battery, Heinrich's Quality of Life Scale (QLS), and the Behavior and Symptom Identification Scale (BASIS). Eighty-seven subjects who reported experiencing at least one traumatic event were included in the study. Fifteen of 87 (17%) met the DSM-IV criteria for PTSD. The PTSD group had significantly worse overall cognitive performance than the non-PTSD group, especially in the domains of attention, working memory and executive function. In addition, the PTSD group showed significantly worse self-rated quality of life as measured by the BASIS total score. The development of PTSD is associated with poor cognitive function and subjectively, but not objectively, rated low quality of life in patients with schizophrenia. Evaluating PTSD in patients with schizophrenia could have important implications from both clinical and research perspectives.

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    • "It has been shown that cognitive performance is worse in patients with schizophrenia who also have comorbid post-traumatic stress disorder (Fan et al., 2008). In Aas et al.'s (2011) on first-episode psychosis, the correlation between trauma and cognitive impairment was significant in male patients with affective psychosis only. "
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    ABSTRACT: The aim of this study was to investigate the relationship between childhood trauma (CT) and cognitive functioning in individuals with ultra-high risk for psychosis (UHR). Fifty-three individuals at UHR for psychosis were administered a neurocognitive battery that assessed attention, processing speed, verbal learning, memory, working memory, interference inhibition, and sustained attention. The CT was assessed using the short-version Childhood Trauma Questionnaire (CTQ). We dichotomized the sample by using cut-off scores for the presence of emotional, physical and sexual trauma, and physical and emotional neglect. Those with a history of physical trauma performed worse on the Digit Span Forward test, Trail making B (time), Stroop test (difference between color and word reading times), and completed categories of the Wisconsin Card Sorting Test (WCST). Physical trauma scores were correlated with WCST-completed categories, Digit Span Forward and Stroop test scores. Physical neglect scores were negatively correlated with Digit Span Forward Test scores. Most of the significant dose-response relationships between cognitive impairment and different subtypes of CT were found only in men. There was no difference between those with and without other kinds of childhood abuse or neglect in terms of cognitive impairment.Our findings suggest that a history of physical trauma has a negative impact on cognitive function in individuals at UHR for psychosis.
    Full-text · Article · Sep 2015 · Schizophrenia Research
    • "Key Words: Trauma, posttraumatic stress, first-episode psychosis, reliability. (J Nerv Ment Dis 2011;199: 896Y898) H igh rates of trauma exposure exist among people with psychosis (Morgan and Fisher, 2007); not surprisingly, therefore, elevated rates of posttraumatic stress disorder (PTSD), ranging from 17% to 46%, have also been reported in this group (Fan et al., 2008; Gearon et al., 2003). Moreover, having a comorbid diagnosis of PTSD has been demonstrated to negatively impact the course of severe mental illness (Mueser et al., 2002), indicating that it needs to be identified and treated to improve patients' outcomes. "
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    ABSTRACT: Posttraumatic stress disorder is common among patients with psychotic disorders. The present study examined the internal reliability and comparability of the Impact of Event Scale (IES) in a sample of 38 patients with first-episode psychosis and 47 controls exposed to severe physical and/or sexual abuse. The IES total score and both subscales showed high internal consistency in both groups (Cronbach's alpha coefficients of approximately 0.9 or higher). Given their equivalent trauma reporting, the lack of differences in IES scores between patients and controls seems to indicate that patients are likely to report accurately and neither exaggerate nor minimize their posttraumatic symptoms. Overall, the findings suggest that the IES can be used to assess symptoms of posttraumatic stress in patients with psychotic disorders as in other populations.
    No preview · Article · Nov 2011 · The Journal of nervous and mental disease
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    • "While evaluating the health-related impact of natural disasters, special attention must be paid to individuals affected by psychiatric disorders, particularly autism spectrum disorders (ASD). Despite the substantial body of research linking stressful life events to the course of psychiatric diseases such as schizophrenia or affective/mood disorders (Horan et al. 2007; Fan et al. 2008), and the growing body of literature addressing the psychological sequelae of children and adolescents after natural disasters (Roussos et al. 2005; John et al. 2007), the literature completely lacks any descriptions of adaptive outcomes for people with ASD after natural disasters. This offers a special challenge to the scientific community. "
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    ABSTRACT: The literature offers no descriptions of the adaptive outcomes of people with autism spectrum disorder (ASD) after natural disasters. Aim of this study was to evaluate the adaptive behaviour of participants with ASD followed for 1year after their exposure to the 2009 earthquake in L’Aquila (Italy) compared with an unexposed peer group with ASD, by administering the Italian form of the Vineland Adaptive Behaviour Scales (VABS) at baseline, 6months and 1year after the earthquake. Exposed participants declined dramatically in their adaptive behaviour during the first months after the earthquake (p<0.01 for all VABS dimensions). However, immediate intensive post-disaster intervention allowed children and adolescents with autism showing a trend towards partial recovery of adaptive functioning. KeywordsAutism spectrum disorder–Post-traumatic stress disorder–Adaptive behaviour–Post-disaster adaptation–Intensive behavioural intervention–Resiliency
    Full-text · Article · Jun 2011 · Journal of Autism and Developmental Disorders
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