Childhood trauma and psychosis: New perspectives on aetiology and treatment

摘要

Over the last 10 years, it has become increasingly apparent from well-conducted research studies that childhood trauma is a risk factor for psychosis. A recent meta-analysis of the role of childhood adversity on the risk of developing psychosis found that the odds of developing psychosis were significantly increased as a result of sexual abuse (odds ratio?=?2.38), physical abuse (odds ratio?=?2.95), emotional abuse (odds ratio?=?3.40), bullying (odds ratio?=?2.39), neglect (odds ratio?=?2.90), but not parental death.[1] Furthermore, in the studies that had controlled for potential confounders such as cannabis use, genetic liability (i.e. family history of psychosis), co-morbid psychopathology, ethnicity and education level, the effect of childhood trauma remained significant. This suggests that the effect of childhood trauma on psychosis is at least partially independent of these factors. A review of 46 studies found that between 28% and 73% of people with psychosis have experienced trauma such as sexual, physical or emotional abuse in childhood.[2] A study by Wang et?al., published in this issue of Early Intervention in Psychiatry, shows that in a large Chinese sample both people with first-episode psychosis (FEP) (n?=?128) and chronic psychosis (n?=?571) had an equally high prevalence of childhood trauma, 71% and 69%, respectively.[3]