title: Childhood trauma and clinical outcome in patients at ultra-high risk of transition to psychosis.
abstract: BACKGROUND
  Although transition rates in 'ultra-high risk' (UHR) for psychosis samples are declining, many young individuals at UHR still experience attenuated positive symptoms and impaired functioning at follow-up. The present study examined the association between a history of childhood trauma and transition to psychosis, and symptomatic and functional outcome, in UHR patients.
  
  
  METHODS
  Data on childhood trauma were available for 125 UHR individuals. Cox regression and linear regression analyses were used to determine the association between childhood trauma, and clinical and functional outcome, during the 24-month follow-up.
  
  
  RESULTS
  Of the 125 UHR subjects 26 individuals (20.8%) transitioned to psychosis within 24 months. Childhood trauma did not predict transition to psychosis. However, at 24-month follow-up, UHR patients with higher levels of childhood trauma had higher levels of attenuated positive symptoms (b = 0.34, t = 2.925, p < 0.01), general symptoms (b = 0.29, t = 2.707, p < 0.01) and depression (b = 0.32, t = 2.929, p < 0.01) and lower levels of global functioning (b = − 0.33, t = − 2.853, p = 0.01). Childhood trauma was not significantly associated with a differential course of symptoms over time, although in those with higher levels of childhood trauma, attenuated positive symptoms were more persistent at a trend level.
  
  
  CONCLUSIONS
  Our results suggest that childhood trauma may contribute to a shared vulnerability for several psychopathological domains.
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands. Electronic address: t.kraan@parnassia.nl.
authors.forename: Tamar
authors.initials: T
authors.lastname: Kraan
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: Daniella S
authors.initials: DS
authors.lastname: van Dam
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands; Department of Psychiatry, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands; Departments of Psychiatry and Preventive Medicine, Icahn School of Medicine, Mount Sinai, New York, NY, USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Velthorst
authors.affiliation: Department of Psychiatry, VU University Medical Center Amsterdam, the Netherlands.
authors.forename: Esther L
authors.initials: EL
authors.lastname: de Ruigh
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: Dorien H
authors.initials: DH
authors.lastname: Nieman
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Sarah
authors.initials: S
authors.lastname: Durston
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Patricia
authors.initials: P
authors.lastname: Schothorst
authors.affiliation: Department of Clinical Psychology, VU University, Amsterdam, the Netherlands; Department of Psychiatry, Parnassia Psychiatric Institute, The Hague, the Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: van der Gaag
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands.
authors.forename: Lieuwe
authors.initials: L
authors.lastname: de Haan
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000209:etiology*; D012307:Risk Factors; D055815:Young Adult
keywords: Childhood trauma; Outcome; Psychosis; Ultra-high risk