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Childhood trauma and distress experiences associate with psychotic symptoms in patients attending primary and psychiatric outpatient care. Results of the RADEP study

Published online by Cambridge University Press:  18 April 2012

S. Luutonen ,
M. Tikka ,
H. Karlsson  and
R.K.R. Salokangas
S. Luutonen*
Affiliation:
Department of Psychiatry, University of Turku, PO Box 52, 20521 Turku, Finland Department of Psychiatry, Turku University Hospital, Turku, Finland
M. Tikka
Affiliation:
Department of Psychiatry, University of Turku, PO Box 52, 20521 Turku, Finland
H. Karlsson
Affiliation:
University of Turku, Lemminkäisenk. 1, 20014Turku, Finland
R.K.R. Salokangas
Affiliation:
Department of Psychiatry, University of Turku, PO Box 52, 20521 Turku, Finland Department of Psychiatry, Turku University Hospital, Turku, Finland Turku Psychiatric Clinic, Turku Mental Health Centre, Turku, Finland
*
⁎Corresponding author. Tel.: +358 2 3131721; fax: +358 2 3132730. E-mail address:sinluu@utu.fi (S. Luutonen).
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Abstract

Goal

We studied the prevalence of and association between psychotic symptoms and childhood trauma experiences in primary care patients compared with psychiatric care patients.

Patients and methods

We note 911 primary care and psychiatric care patients over 16 years of age filled in a questionnaire including a list of lifetime psychotic symptoms of the Composite International Diagnostic Interview (CIDI) and the childhood Trauma and Distress Scale (TADS). Prevalence of and correlations between psychotic symptoms and childhood trauma and stressful experiences were calculated. Association between the sum of CIDI symptoms and the TADS sum score was analysed by Anova.

Results

In primary care, more than half of the patients had had at least one psychotic symptom during their lifetime, and nearly 70% of patients had experienced a childhood trauma at some time or more often. In psychiatric care patients, CIDI symptoms were more prevalent and TADS scores were higher than in primary care patients. In the whole sample, CIDI symptoms correlated with TADS scores. The association remained even when the effects of age, service, and patient's functioning were taken into account. There was a dose-response between TADS scores and CIDI symptoms.

Conclusion

Childhood trauma experiences associate with psychotic symptoms. In clinical work, it is important to acknowledge that psychotic symptoms and childhood trauma experiences are common not only in psychiatric care but also in primary care patients, and thus require adequate attention.

Keywords

Psychotic symptomsChildhood distressPrimary carePsychiatric care
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 3 , March 2013 , pp. 154 - 160
Copyright
Copyright © European Psychiatric Association 2011

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References

Afifi, T.O.Enns, M.W.Cox, B.J.Asmundson, G.J.Stein, M.B.Sareen, J.Population attributable fractions of psychiatric disorders and suicide ideation and attempts associated with adverse childhood experiences. Am J Public Health 2008;98(5):946–952.CrossRefGoogle ScholarPubMed
Amminger, G.P.Schäfer, M.R.Papageorgiou, K.Klier, C.M.Cotton, S.M.Harrigan, S.M., et al., Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: a randomized, placebo-controlled trial. Arch Gen Psychiatry 2010;67(2):146–154.CrossRefGoogle ScholarPubMed
Amminger, G.P.Resch, F.Mutschlechner, R.Friedrich, M.H.Ernst, E.Premorbid adjustment and remission of positive symptoms in first-episode psychosis. Eur Child Adolesc Psychiatry 1997;6:212–218.CrossRefGoogle ScholarPubMed
Bailer, J.Bräuer, W.Rey, E.R.Premorbid adjustment as predictor of outcome in schizophrenia: results of a prospective study. Acta Psychiatr Scand 1996;93:368–377.CrossRefGoogle ScholarPubMed
Bak, M.Myin-Germeys, I.Hanssen, M.Bijl, R.Vollebergh, W.Delespaul, P., et al., When does experience of psychosis result in a need for care? A prospective general population study. Schizophr Bull 2003;29:349358.CrossRefGoogle Scholar
Bebbington, P.Bhugra, D.Bhugra, T.Singleton, N.Farrell, M.Jenkins, R., et al., Psychosis, victimazation and childhood disadvantage: evidence from the second British national survey of psychiatric morbidity. Br J Psychiatry 2004;185:220–226.CrossRefGoogle ScholarPubMed
Bebbington, P.Jonas, S.Kuipers, E.King, M.Cooper, C.Brugha, T., et al., Childhood sexual abuse and psychosis: data from a cross-sectional national psychiatric survey in England. Br J Psychiatry 2011;199:29–37.CrossRefGoogle ScholarPubMed
Bechdolf, A.Thompson, A.Nelson, B.Cotton, S.Simmons, M.B.Amminger, G.P., et al., Experuence of trauma and conversion to psychosis in an ultra-high-risk (prodromal) group. Acta Psychiatr Scand 2010;121:377–384.CrossRefGoogle Scholar
Bromet, E.Harrow, M.Kasl, S.Premorbid functioning and outcome in schizophrenics and nonschizophrenics. Arch Gen Psychiatry 1974;30:203–207.CrossRefGoogle ScholarPubMed
Campbell, M.L.Morrison, A.P.The relationship between bullying, psychotic-like experiences and appraisals in 14- to 16-year-olds. Behav Res Ther 2007;45:1579–1591.CrossRefGoogle ScholarPubMed
Cutajar, M.C.Mullen, P.E.Ogloff, J.R.Thomas, S.D.Wells, D.L.Spataro, J.Schizophrenia and other psychotic disorders in a cohort of sexually abused children. Arch Gen Psychiatry 2010;67(11):1114–1119.CrossRefGoogle Scholar
Darves-Bornoz, J.M.Lemperiere, T.Degiovanni, A.Gaillard, P.Sexual victimization in women with schizophrenia and bipolar disorder. Soc Psychiatry Psychiatr Epidemiol 1995;30:78–84.CrossRefGoogle ScholarPubMed
Duran, B.Malcoe, L.H.Sanders, M.Waitzkin, H.Skiper, B.Yager, J.Child maltreatment prevance and mental disorders outcomes among American Indian women in primary care. Child Abuse Negl 2004;28:131–145.CrossRefGoogle Scholar
Fisher, H.L.Jones, P.B.Fearon, P.Craig, T.K.Dazzan, P.Morgan, K., et al., The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder. Psychol Med 2010;40:1967–1978.CrossRefGoogle ScholarPubMed
Gittelman-Klein, R.Klein, D.F.Premorbid asocial adjustment and prognosis in schizophrenia. J Psychiatr Res 1969;7:35–53.CrossRefGoogle Scholar
Horneland, M.Vaglum, P.Larsen, T.K.The prevalence of DSM-III-R “prodromal” symptoms of schizophrenia in non-psychotic psychiatric outpatients. Nord J Psychiatry 2002;56:247–251.CrossRefGoogle ScholarPubMed
Kelleher, I.Harley, M.Lynch, F.Arseneault, L.Fitzpatrick, C.Cannon, M.Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample. Br J Psychiatry 2008;193:378–382.CrossRefGoogle ScholarPubMed
Kirkbride, J.B.Jones, P.B.The prevention of schizophrenia – what can we learn from eco-epidemiology?. Schizophr Bull 2010;24:1739–1746.Google Scholar
Larkin, W.Read, J.Childhood trauma and psychosis: evidence, pathways, and implications. J Postgrad Med 2008;54:287–293.Google ScholarPubMed
Lataster, T.van Os, J.Drukker, M.Henquet, C.Feron, F.Gunther, N., et al., Childhood victimisation and developmental expression of non-clinical delusional ideation and hallucinatory experiences: victimisation and non-clinical psychotic experiences. Soc Psychiatry Psychiatr Epidemiol 2006;41:423–428.CrossRefGoogle ScholarPubMed
McGlashan, T.H.Zipursky, R.B.Perkins, D.Addington, J.Miller, T.Woods, S.W., et al., Randomized, double-blind trial of olanzapine versus placebo in patients prodromally symptomatic for psychosis. Am J Psychiatry 2006;163(5):790–799.CrossRefGoogle Scholar
McGorry, P.D.Yung, A.R.Phillips, L.J.Yuen, H.P.Francey, S.Cosgrave, E.M., et al., Randomized controlled trial of interventions designed to reduce the risk of progression to first-episode psychosis in a clinical sample with subthreshold symptoms. Arch Gen Psychiatry 2002;59:921–928.CrossRefGoogle Scholar
Morrison, A.P.French, P.Walford, L.Lewis, S.W.Kilcommons, A.Green, J., et al., Cognitive therapy for the prevention of psychosis in people at ultra-high risk: randomised controlled trial. Br J Psychiatry 2004;185:291–297.CrossRefGoogle ScholarPubMed
Nordentoft, M.Bjarking, L.Hemmingsen, R.Psychiatric emergency outreach: a report on the first 2 years of functioning in Copenhagen. Nord J Psychiatry 2002;56:399–405.CrossRefGoogle ScholarPubMed
Olfson, M.Lewis-Fernandez, R.Weissman, M.M.Feder, A.Gameroff, M.J.Pilowsky, D., et al., Psychotic symptoms in an urban general medicine practice. Am J Psychiatry 2002;159:14121419.CrossRefGoogle Scholar
Olin, S.C.Mednick, S.A.Cannon, T.Jacobsen, B.Parnas, J.Schulsinger, F., et al., School teacher ratings predictive of psychiatric outcome 25 years later. Br J Psychiatry Suppl 1998;172:7–13.CrossRefGoogle ScholarPubMed
Patterson, P.Skeate, A.Birchwood, M., et al., TADS-EPOS 1.2. Birmingham: University of Birmingham; 2002.Google Scholar
Phillips, L.Case history data and prognosis in schizophrenia. J Nerv Ment Dis 1953;117:515–525.CrossRefGoogle Scholar
Porcerelli, J.H.Cogan, R.Markova, T.Murdoch, W.Porcerelli, M.Abuse, outpatient charges and utilisation, and psychiatric symptoms among urban women on Medicaid. J Am Board Family Med 2010;23:363–370.CrossRefGoogle Scholar
Ramiro, L.S.Madrid, B.J.Brown, D.W.Adverse childhood experiences (ACE) and health-risk behaviors among adults in a developing country setting. Child Abuse Negl 2010;34:842–855.CrossRefGoogle Scholar
Read, J.van, O.S.J.Morrison, A.P.Ross, C.A.Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr Scand 2005;112:330–350.CrossRefGoogle ScholarPubMed
Salokangas, R.K.R.Psychosocial prognosis in schizophrenia. Formation of the prognosis for schizophrenic patients: a multivariate analysis. Turku: Annales Universitatis Turkuensis. Ser. D. University of Turku; 1978.Google Scholar
Salokangas, R.K.R.Precursors and markers of psychosis – scientific basis for examinations and intervention. Neurol Psychiat Brain Res 2001;9:105–126.Google Scholar
Salokangas, R.K.R.Luutonen, S.Nieminen, M.Karlsson, H.Vulnerability to psychosis in patients attending primary care. Results of the RADEP study. Nord J Psychiatry 2005;59:239–245.CrossRefGoogle ScholarPubMed
Salokangas, R.K.R.Luutonen, S.Nieminen, M.Huttunen, J.Karlsson, H.Vulnerability to psychosis increases the risk of depression. Results of the RADEP study. Nord J Psychiatry 2007;61(5):393–402.CrossRefGoogle ScholarPubMed
Schreier, A.Wolke, D.Thomas, K.Horwood, J.Hollis, C.Gunnell, D., et al., Prospective study of peer victimization in childhood and psychotic symptoms in a non-clinical population at age 12 years. Arch Gen Psychiatry 2009;66:527–536.CrossRefGoogle Scholar
Spauwen, J.Krabbendam, L.Lieb, R.Wittchen, H.U.Van Os, J.Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness. Br J Psychiatry 2006;188:527–533.CrossRefGoogle ScholarPubMed
Van Os, J.Hanssen, M.Bijl, R.V.Ravelli, A.Strauss (1969) revisited: a psychosis continuum in the general population?. Schizophr Res 2000;45:1120.CrossRefGoogle ScholarPubMed
Van Os, J.Hanssen, M.Bijl, R.V.Vollebergh, W.Prevalence of psychotic disorder and community level of psychotic symptoms: an urban-rural comparison. Arch Gen Psychiatry 2001;58:663668.CrossRefGoogle Scholar
Verdoux, H.van Os, J.Psychotic symptoms in non-clinical populations and the continuum of psychosis. Schizophr Res 2002;54:59–65.CrossRefGoogle ScholarPubMed
Weinreb, L.Savageau, J.A.Candib, L.M.Reed, G.W.Fletcher, K.E.Hargraves, L.Screening for childhood trauma in adult primary care patients: a cross-sectional survey. Prim Care Companion J Clin Psychiatry 2010;12(216):e1–e10.Google ScholarPubMed
Whitfield, C.L.Dube, S.R.FElitti, V.C.Anda, R.F.Adverse childhood experiences and hallucinations. Child Abuse Negl 2005;29:797–810.CrossRefGoogle ScholarPubMed
World Health Organisation. Composite international diagnostic interview (CIDI). Version 1.0. Geneva: World Health Organisation; 1990.Google Scholar
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