title: The effect of childhood adversity on 4-year outcome in individuals at ultra high risk for psychosis in the Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial.
abstract: Childhood adversity is associated with a range of mental disorders, functional impairment and higher health care costs in adulthood. In this study we evaluated if childhood adversity was predictive of adverse clinical and functional outcomes and health care costs in a sample of patients at ultra-high risk (UHR) for developing a psychosis. Structural Equation Modeling was used to examine the effect of childhood adversity on depression, anxiety, transition to psychosis and overall functioning at 4-year follow-up. In addition, we evaluated economic costs of childhood adversity in terms of health care use and productivity loss. Data pertain to 105 UHR participants of the Dutch Early Detection and Intervention Evaluation (EDIE-NL). Physical abuse was associated with higher depression rates (b=0.381, p=0.012) and lower social functional outcome (b=-0.219, p=0.017) at 4-year follow-up. In addition, emotional neglect was negatively associated with social functioning (b=-0.313, p=0.018). We did not find evidence that childhood adversity was associated with transition to psychosis, but the experience of childhood adversity was associated with excess health care costs at follow-up. The data indicate long-term negative effects of childhood adversity on depression, social functioning and health care costs at follow-up in a sample of UHR patients.
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands; Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands.
authors.forename: Tamar C
authors.initials: TC
authors.lastname: Kraan
authors.affiliation: Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands.
authors.forename: Helga K
authors.initials: HK
authors.lastname: Ising
authors.affiliation: Department of Methods & Statistics, Faculty of Social Sciences, Leiden University, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Fokkema
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands; Departments of Psychiatry and Preventive Medicine, Icahn School of Medicine, Mount Sinai, New York, US.
authors.forename: Eva
authors.initials: E
authors.lastname: Velthorst
authors.affiliation: Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands.
authors.forename: David P G
authors.initials: DPG
authors.lastname: van den Berg
authors.affiliation: Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands.
authors.forename: Margot
authors.initials: M
authors.lastname: Kerkhoven
authors.affiliation: Department of Psychiatry, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Veling
authors.affiliation: Department of Clinical Psychology, VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; Department of Public Mental Health, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Filip
authors.initials: F
authors.lastname: Smit
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: Don H
authors.initials: DH
authors.lastname: Linszen
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 Research and Education, Friesland Mental Health Services, Leeuwarden, The Netherlands; Universitair Centrum Psychiatrie, UMCG, The Netherlands.
authors.forename: Lex
authors.initials: L
authors.lastname: Wunderink
authors.affiliation: Department of Research and Education, Friesland Mental Health Services, Leeuwarden, The Netherlands.
authors.forename: Nynke
authors.initials: N
authors.lastname: Boonstra
authors.affiliation: Bascule, Child and Adolescent Psychiatry, Amsterdam, The Netherlands.
authors.forename: Rianne M C
authors.initials: RMC
authors.lastname: Klaassen
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: Sara
authors.initials: S
authors.lastname: Dragt
authors.affiliation: Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands; Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.
authors.forename: Judith
authors.initials: J
authors.lastname: Rietdijk
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: Lieuwe
authors.initials: L
authors.lastname: de Haan
authors.affiliation: Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands; Department of Clinical Psychology, VU University, Amsterdam, The Netherlands. Electronic address: m.vander.gaag@vu.nl.
authors.forename: Mark
authors.initials: M
authors.lastname: van der Gaag
mesh_terms: D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology*; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D012307:Risk Factors; D012917:Social Adjustment