Early Psychosis and Trauma

EARLY PSYCHOSIS AND TRAUMA

Background

Schizophrenia and related psychosis causes severe disability affecting approximately 1/100 people aged 15 to 25 years. These illnesses are often life-long and are associated with high levels of morbidity and mortality. The understanding of the aetiology of these conditions is embryonic and the management remains suboptimal with many patients continuing to experience high levels of adverse physical and mental health outcomes.

Large community studies have shown that childhood trauma (CT) including abuse, neglect and bullying is associated with increased risk of psychotic symptoms and psychotic disorder. Research has previously shown that CT increases risk of psychotic symptoms in Australian clinical and community samples. Up to 65% of hospitalized patients with schizophrenia have been exposed to abuse during childhood. Research is now examining if CT is a direct causative factor of psychosis.

Another consideration is that exposure to childhood trauma adversely affects the course of psychosis. There are a number of plausible explanations for this. CT results in higher levels of anxiety which in turn exacerbates psychotic symptoms. Alternatively, CT may result in increased use of substances which is a known risk factor for poor prognosis of psychosis.

Research

We are proposing a longitudinal study early in the individual’s course of illness to examine if CT is a risk factor for poorer treatment outcomes and to seek explanations for this poorer illness course. This in turn may result in recommendations for psychological or pharmacological therapies for patients with first episode psychosis who have experienced childhood trauma.

This project aims (i) to identify the prevalence of exposure to childhood trauma such as abuse, neglect or bullying in patients with first episode psychosis (ii) to compare symptomatology of patients with and without exposure to childhood trauma (iii) to compare patient outcomes at three and six months.