title: Trauma and recent life events in individuals at ultra high risk for psychosis: review and meta-analysis.
abstract: BACKGROUND
  Childhood trauma and recent life-events have been related to psychotic disorders. The aim of the present study was to examine whether childhood trauma and recent life-events are significantly more prevalent in patients at Ultra High Risk (UHR) of developing a psychotic disorder compared to healthy controls.
  
  
  METHODS
  A search of PsychInfo and Embase was conducted, relevant papers were reviewed, and three random-effects meta-analyses were performed. One meta-analysis assessed the prevalence rate of childhood trauma in UHR subjects and two meta-analyses were conducted to compare UHR subjects and healthy control subjects on the experience of childhood trauma and recent life-events.
  
  
  RESULTS
  We found 12 studies on the prevalence of (childhood) trauma in UHR populations and 4 studies on recent life-events in UHR populations. We performed a meta-analysis on 6 studies (of which trauma prevalence rates were available) on childhood trauma in UHR populations, yielding a mean prevalence rate of 86.8% (95% CI 77%-93%). Childhood trauma was significantly more prevalent in UHR subjects compared to healthy control groups (Random effects Hedges' g=1.09; Z=4.60, p<.001). In contrast to our hypothesis, life-event rates were significantly lower in UHR subjects compared to healthy controls (Random effects Hedges' g=-0.53; Z=-2.36, p<.02).
  
  
  CONCLUSIONS
  Our meta-analytic results illustrate that childhood trauma is highly prevalent among UHR subjects and that childhood trauma is related to UHR status. These results are in line with studies on childhood trauma in psychotic populations. In contrast to studies on recent life-events in psychotic populations, our results show that recent life-events are not associated with UHR status.
authors.affiliation: Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, The Netherlands. Electronic address: t.kraan@parnassiagroep.nl.
authors.forename: Tamar
authors.initials: T
authors.lastname: Kraan
authors.affiliation: Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, The Netherlands; Departments of Psychiatry and Preventive Medicine, Icahn School of Medicine, Mount Sinai, New York, USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Velthorst
authors.affiliation: Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands; Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.
authors.forename: Filip
authors.initials: F
authors.lastname: Smit
authors.affiliation: Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, The Netherlands.
authors.forename: Lieuwe
authors.initials: L
authors.lastname: de Haan
authors.affiliation: Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; Parnassia Psychiatric Institute, The Hague, The Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: van der Gaag
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D008016:Life Change Events; D011618:Psychotic Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D012307:Risk Factors; D014947:Wounds and Injuries / Q000150:complications / Q000453:epidemiology / Q000523:psychology
keywords: Childhood trauma; Life events; Psychosis; Ultra high risk