Early life stress and PTSD symptoms in patients with comorbid schizophrenia and substance abuse.
OBJECTIVE
The comorbidity of schizophrenia and substance abuse is well documented and is remarkable for its prevalence and poor prognosis. While the etiology for this association is unknown, one possible mechanism relates to traumatic early life experiences, which have been shown to predispose individuals to both psychosis and substance abuse.


METHODS
Participants (N=122) who were outpatients in an inner city public mental health clinic and who were diagnosed with schizophrenia, were administered a battery of structured clinical assessments including the Childhood Traumatic Events Scale (CTES), Davidson PTSD rating scale, Hamilton Depression Rating Scale (HDRS), Positive and Negative Symptom Scale (PANSS), and assessments of medication satisfaction and side effects. Patients with schizophrenia and a history of substance abuse (N=70) were compared to patients with schizophrenia who did not have a history of substance abuse (N=52).


RESULTS
Patients with schizophrenia and a history of substance abuse had significantly higher frequency and severity of childhood traumatic events, greater PTSD symptomatology, significantly higher depression scores, and higher scores on the general subscale of the PANSS.


CONCLUSIONS
Our findings lend support to the notion that sensitization to stress from early life experiences may be a factor contributing to the high rate of substance abuse comorbidity in patients with schizophrenia.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Emory at Grady-Florida Hall, 60 Coca Cola Pl., Atlanta, GA 30335, USA. gschell@emory.edu
Geraldine
G
Scheller-Gilkey
Kelly
K
Moynes
Ilene
I
Cooper
Carole
C
Kant
Andrew H
AH
Miller
D000328:Adult; D015897:Comorbidity; D003710:Demography; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000453:epidemiology / Q000209:etiology*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000150:complications*; D013315:Stress, Psychological / Q000150:complications*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology*