title: Adversity and psychosis: a 10-year prospective study investigating synergism between early and recent adversity in psychosis.
abstract: OBJECTIVE
  Recent studies have suggested that early adverse events, such as childhood trauma, may promote enduring liability for psychosis whereas more recent adverse events may act as precipitants. Examination of these environmental dynamics, however, requires prospective studies in large samples. This study examines whether the association between recent adverse events and psychosis is moderated by exposure to early adversity.
  
  
  METHODS
  A random regional representative population sample of 3021 adolescents and young adults in Munich, Germany, was assessed three times over a period of up to 10 years, collecting information on sociodemographic factors, environmental exposures, and measures of psychopathology and associated clinical relevance. Evidence of statistical non-additivity between early adversity (two levels) and more recent adversity (four levels) was assessed in models of psychotic symptoms. Analyses were a priori corrected for age, gender, cannabis use, and urbanicity.
  
  
  RESULTS
  Early and recent adversity were associated with each other (RR = 1.32, 95% CI 1.06-1.66; P = 0.014) and displayed statistical non-additivity at the highest level of exposure to recent adversity (χ(2) = 4.59; P = 0.032).
  
  
  CONCLUSIONS
  The findings suggest that early adversity may impact on later expression of psychosis either by increasing exposure to later adversity and/or by rendering individuals more sensitive to later adversity if it is severe.
authors: Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Center, The Netherlands.
authors: J
authors: J
authors: Lataster
authors: I
authors: I
authors: Myin-Germeys
authors: R
authors: R
authors: Lieb
authors: H-U
authors: HU
authors: Wittchen
authors: J
authors: J
authors: van Os
mesh_terms: D000293:Adolescent; D002649:Child Abuse / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D012931:Social Environment; D013315:Stress, Psychological / Q000453:epidemiology*; D055815:Young Adult