title: Mild Depressive Symptoms Mediate the Impact of Childhood Trauma on Long-Term Functional Outcome in Early Psychosis Patients.
abstract: The mechanism linking childhood trauma (CT) to the functional deficits observed in early psychosis (EP) patients is as yet unknown. We aim to examine the potential mediating effect of depressive symptoms in this well-established association.
  
  
  
  Two hundred nine EP subjects aged 18-35 were assessed for functioning and psychopathology after 2, 6, 12, 18, 24, 30, and 36 months of treatment. Patients were classified into early trauma if they had faced at least one experience of abuse (physical, sexual, or emotional) or neglect (physical or emotional) before age 12, and late trauma if the exposure had occurred between ages 12 and 16. Diagnosis was based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Psychopathology was assessed with the Positive and Negative Syndrome Scale and the Montgomery-Asberg Depression Rating Scale. Functioning was measured with the Global Assessment of Functioning (GAF) and the Social and Occupational Functioning Assessment Scale (SOFAS). Mediation analyses were performed in order to study whether the relationship between CT and functioning was mediated by depressive symptoms.
  
  
  
  When compared with nonexposed patients, early but not late trauma patients showed lower levels of GAF and SOFAS scores over all the time points, excepting after the first assessment. After 30 and 36 months, the effect of early trauma on functioning was completely mediated by depressive symptoms. No mediating effect of positive or negative symptoms was highlighted at those time points.
  
  
  
  Mild depressive symptoms mediated the impact of early trauma on long-term functional outcome. Intensifying pharmacologic and/or psychotherapeutic treatment, focused on the depressive dimension, may help traumatized EP patients to improve their functioning.
authors.affiliation: Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.|Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland.|Psychiatric Liaison Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
authors.forename: Luis
authors.initials: L
authors.lastname: Alameda
authors.affiliation: Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Golay
authors.affiliation: Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.|Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Baumann
authors.affiliation: Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.|Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Progin
authors.affiliation: Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
authors.forename: Nadir
authors.initials: N
authors.lastname: Mebdouhi
authors.affiliation: Mobile Psychiatry Unit, Department of Psychiatry, Prangins Psychiatric Hospital (CHUV), Prangins, Switzerland.
authors.forename: Julien
authors.initials: J
authors.lastname: Elowe
authors.affiliation: Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
authors.forename: Carina
authors.initials: C
authors.lastname: Ferrari
authors.affiliation: Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.|Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
authors.forename: Kim Q
authors.initials: KQ
authors.lastname: Do
authors.affiliation: Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Conus
mesh_terms: D000293:Adolescent; D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000706:statistics & numerical data*; D000367:Age Factors; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011618:Psychotic Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D055815:Young Adult
keywords: childhood trauma; depression; first episode psychosis; functional outcome; mediation; prospective; psychopathology