title: Childhood adversity specificity and dose-response effect in non-affective first-episode psychosis.
abstract: BACKGROUND
  Reviews conclude that childhood and adolescence sexual, physical, emotional abuse and emotional and physical neglect are all risk factors for psychosis. However, studies suggest only some adversities are associated with psychosis. Dose-response effects of several adversities on risk of psychosis have not been consistently found. The current study aimed to explore adversity specificity and dose-response effects of adversities on risk of psychosis.
  
  
  METHODS
  Participants were 101 persons with first-episode psychosis (FEP) diagnosed with ICD-10 F20 - F29 (except F21) and 101 non-clinical control persons matched by gender, age and parents' socio-economic status. Assessment included the Childhood Trauma Questionnaire and parts of the Childhood Experience of Care and Abuse Questionnaire.
  
  
  RESULTS
  Eighty-nine percent of the FEP group reported one or more adversities compared to 37% of the control group. Childhood and adolescent sexual, physical, emotional abuse, and physical and emotional neglect, separation and institutionalization were about four to 17 times higher for the FEP group (all p<0.01). The risk of psychosis increased two and a half times for each additional adversity. All associations between specific adversities and psychosis decreased when they were adjusted for other adversities.
  
  
  CONCLUSIONS
  Our findings suggest that there is a large shared effect of adversities on the risk of psychosis. Contrary to the call for further research into specific adversities, we suggest a search for mechanisms in the shared effects of traumatization. Clinical implications are thorough assessment of adversities and their possible effects.
authors: Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark; Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark. Electronic address: marietrauelsen@gmail.com.
authors: Anne Marie
authors: AM
authors: Trauelsen
authors: Centre for Youth Mental Health,The University of Melbourne, Australia; Orygen: The National Centre of Excellence in Youth Mental Health, Australia.
authors: Sarah
authors: S
authors: Bendall
authors: Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark.
authors: Jens Einar
authors: JE
authors: Jansen
authors: Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark.
authors: Hanne-Grethe Lyse
authors: HG
authors: Nielsen
authors: Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark.
authors: Marlene Buch
authors: MB
authors: Pedersen
authors: Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors: Christopher Høier
authors: CH
authors: Trier
authors: Early Psychosis Intervention Center, Region Zealand Psychiatry Roskilde, Roskilde, Denmark.
authors: Ulrik H
authors: UH
authors: Haahr
authors: Psychiatric Research Unit, Region Zealand Psychiatry Roskilde, Roskilde, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
authors: Erik
authors: E
authors: Simonsen
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002649:Child Abuse / Q000523:psychology*; D003718:Denmark; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D016015:Logistic Models; D008297:Male; D011599:Psychopathology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Abuse; Case control; Neglect; Psychological trauma; Risk