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04-11-2010 | Mental health | Article

Specific types of childhood adversity linked to psychosis risk

Abstract

Free abstract

MedWire News: Results from a UK study suggest that only certain adverse childhood experiences are associated with an increased risk for psychotic disorders in later life.

"Childhood adversity has been associated with onset of psychosis in adulthood, but these studies have used only general definitions of this environmental risk indicator," explain Helen Fisher (King's College London) and team in the journal Psychological Medicine.

To investigate the risk for psychosis associated with specific adverse childhood experiences, the researchers studied 182 individuals, aged 16-65 years, who presented to psychiatric services for the first time with a psychotic disorder between 1997 and 2000, and 246 geographically-matched mentally healthy controls.

Of the participants with a psychotic disorder, 61.0% had a non-affective psychotic diagnosis, such as schizophrenia, while 20.3% had depressive and 18.7% manic psychoses.

All of the participants completed the Childhood Experience of Care and Abuse Questionnaire, which was used to gather data on exposure to different types of childhood adversity, such as neglect, antipathy, physical and sexual abuse, disrupted living arrangements, and lack of a supportive figure.

After adjustment for gender, age, ethnicity, study centre, and parental social class, the team found that maternal physical abuse, maternal antipathy, and maternal neglect were significantly associated with an increased risk for psychotic disorders in later life, at odds ratios (ORs) of 2.35, 2.07, and 1.24, respectively.

Paternal maltreatment, paternal physical abuse, sexual abuse, disrupted living arrangements, and other forms of childhood adversity were not significantly associated with the later development of psychotic disorders, after adjustment.

Fisher and team conclude: "Specific characteristics of childhood adversity appear to be important in relation to clinical psychosis."

They add: "If replicated, these findings have potentially important implications for future research into the aetiological mechanisms operating between childhood adversity and later psychosis.

"Moreover, the elevated frequency of childhood abuse amongst psychosis patients in this sample supports recent guidance for mental health services in the UK that requires clinicians to routinely assess all patients for early abusive experiences and provide suitable interventions."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen

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