title: Impact of Different Childhood Adversities on 1-Year Outcomes of Psychotic Disorder in the Genetics and Psychosis Study.
abstract: While the role of childhood adversity in increasing the risk of psychosis has been extensively investigated, it is not clear what the impact of early adverse experiences is on the outcomes of psychotic disorders. Therefore, we investigated associations between childhood adversity and 1-year outcomes in 285 first-presentation psychosis patients. Exposure to childhood adversity prior to 17 years of age was assessed using the Childhood Experience of Care and Abuse Questionnaire. Data on illness course, symptom remission, length of psychiatric hospitalization, compliance with medication, employment, and relationship status were extracted from clinical records for the year following first contact with mental health services for psychosis. Seventy-one percent of patients reported exposure to at least 1 type of childhood adversity (physical abuse, sexual abuse, parental separation, parental death, disrupted family arrangements, or being taken into care). No robust associations were found between childhood adversity and illness course or remission. However, childhood physical abuse was associated with almost 3-fold increased odds of not being in a relationship at 1-year follow-up compared to patients who did not report such adverse experiences. There was also evidence of a significant association between parental separation in childhood and longer admissions to psychiatric wards during 1-year follow-up and 2-fold increased odds of noncompliance with medication compared to those not separated from their parents. Therefore, our findings suggest that there may be some specificity in the impact of childhood adversity on service use and social functioning among psychosis patients over the first year following presentation to mental health services.
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK;
authors.forename: Antonella
authors.initials: A
authors.lastname: Trotta
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK;
authors.forename: Robin M
authors.initials: RM
authors.lastname: Murray
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK;
authors.forename: Anthony S
authors.initials: AS
authors.lastname: David
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK;
authors.forename: Anna
authors.initials: A
authors.lastname: Kolliakou
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK;
authors.forename: Jennifer
authors.initials: J
authors.lastname: O'Connor
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK;
authors.forename: Marta
authors.initials: M
authors.lastname: Di Forti
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK;
authors.forename: Paola
authors.initials: P
authors.lastname: Dazzan
authors.affiliation: Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK;
authors.forename: Valeria
authors.initials: V
authors.lastname: Mondelli
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Craig
authors.initials: C
authors.lastname: Morgan
authors.affiliation: MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; helen.2.fisher@kcl.ac.uk.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Fisher
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000706:statistics & numerical data*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000453:epidemiology*; D012720:Severity of Illness Index
keywords: first episode; illness course; psychosis; psychotic symptoms; service use; trauma