title: Exposure to Political Violence in Northern Ireland and Outcome of First Episode Psychosis.
abstract: The impact of political violence on individuals presenting with an episode of first episode psychosis has not been examined. Individuals were assessed for exposure to political violence in Northern Ireland (the "Troubles") by asking for a response to 2 questions: one asked about the impact of violence "on your area"; the second about the impact of violence "on you or your family's life." The participants were separated into 2 groups (highandlowimpact) for each question. Symptom profiles and rates of substance misuse were compared across the groups at baseline and at 3-year follow up. Of the 178 individuals included in the study 66 (37.1%) reported ahighimpact of the "Troubles" on their life and 81 (45.5%) ahighimpact of the "Troubles" on their area. There were no significant differences in symptom profile or rates of substance misuse betweenhighandlowgroups at presentation. At 3-year follow-uphighimpact of the "Troubles" on life was associated with higher Positive and Negative Symptom Scale (PANSS) Total (P= .01), PANSS-Positive (P< .05), and PANSS-General (P< .01) scores and lower global assessment of functioning disability (P< .05) scores, after adjusting for confounding factors. Impact of the "Troubles" on area was not associated with differences in symptom outcomes. This finding adds to the evidence that outcomes in psychosis are significantly impacted by environmental factors and suggests that greater attention should be paid to therapeutic strategies designed to address the impact of trauma.
authors.affiliation: Belfast Health and Social Care Trust, Belfast, UK;
authors.forename: Aidan
authors.initials: A
authors.lastname: Turkington
authors.affiliation: School of Sociology, Social Policy and Social Work, Queen's University of Belfast, Belfast, UK;
authors.forename: Michael
authors.initials: M
authors.lastname: Duffy
authors.affiliation: Department of Psychiatry, Queen's University of Belfast, Belfast, UK;
authors.forename: Suzanne
authors.initials: S
authors.lastname: Barrett
authors.affiliation: Northern Health and Social Care Trust, Antrim, UK;
authors.forename: Rosalind
authors.initials: R
authors.lastname: McCaul
authors.affiliation: Northern Health and Social Care Trust, Antrim, UK;
authors.forename: Richard
authors.initials: R
authors.lastname: Anderson
authors.affiliation: Department of Psychiatry, Queen's University of Belfast, Belfast, UK;
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Cooper
authors.affiliation: School of Psychology, Queen's University of Belfast, Belfast, UK.
authors.forename: Teresa
authors.initials: T
authors.lastname: Rushe
authors.affiliation: Department of Psychiatry, Queen's University of Belfast, Belfast, UK; c.c.mulholland@qub.ac.uk.
authors.forename: Ciaran
authors.initials: C
authors.lastname: Mulholland
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009660:Northern Ireland; D017063:Outcome Assessment, Health Care; D011057:Politics; D000067073:Psychological Trauma / Q000150:complications / Q000523:psychology* / Q000628:therapy; D011618:Psychotic Disorders / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D014754:Violence / Q000523:psychology*
keywords: Northern Ireland; political violence; psychosis; symptoms; trauma