title: Life events and psychosis: a review and meta-analysis.
abstract: BACKGROUND
  Recent models of psychosis implicate stressful events in its etiology. However, while evidence has accumulated for childhood trauma, the role of adult life events has received less attention. Therefore, a review of the existing literature on the relationship between life events and onset of psychotic disorder/experiences is timely.
  
  
  METHODS
  A search was conducted using PsychInfo, Medline, Embase, and Web of Science to identify studies of life events and the onset of psychosis or psychotic experiences within the general population. Given previous methodological concerns, this review included a novel quality assessment tool and focused on findings from the most robust studies. A meta-analysis was performed on a subgroup of 13 studies.
  
  
  RESULTS
  Sixteen studies published between 1968 and 2012 were included. Of these, 14 reported positive associations between exposure to adult life events and subsequent onset of psychotic disorder/experiences. The meta-analysis yielded an overall weighted OR of 3.19 (95% CI 2.15-4.75). However, many studies were limited by small sample sizes and the use of checklist measures of life events, with no consideration of contextual influences on the meaning and interpretation of events.
  
  
  CONCLUSIONS
  Few studies have assessed the role of adult life events in the onset of psychosis. There was some evidence that reported exposure to adult life events was associated with increased risk of psychotic disorder and subclinical psychotic experiences. However, the methodological quality of the majority of studies was low, which urges caution in interpreting the results and points toward a need for more methodologically robust studies.
authors.affiliation: Health Service and Population Research Department, Section of Social Psychiatry, Institute of Psychiatry, King's College London, London, UK. stephanie.beards@kcl.ac.uk
authors.forename: Stephanie
authors.initials: S
authors.lastname: Beards
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gayer-Anderson
authors.forename: Susana
authors.initials: S
authors.lastname: Borges
authors.forename: Michael E
authors.initials: ME
authors.lastname: Dewey
authors.forename: Helen L
authors.initials: HL
authors.lastname: Fisher
authors.forename: Craig
authors.initials: C
authors.lastname: Morgan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D006801:Humans; D008016:Life Change Events; D011618:Psychotic Disorders / Q000209:etiology*; D012307:Risk Factors; D012559:Schizophrenia / Q000209:etiology*; D013997:Time Factors
keywords: etiology; life events; psychosis; review; stress