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<p>Adverse childhood experiences (ACEs) are common in people at clinical high-risk for psychosis (CHR), however, the relationship between ACEs and long-term clinical outcomes is still unclear. This study examined associations between ACEs and clinical outcomes in CHR individuals. 344 CHR individuals and 67 healthy controls (HC) were assessed using the Childhood Trauma Questionnaire (CTQ), the Bullying Questionnaire and the Childhood Experience of Care and Abuse (CECA). CHR were followed up for up to 5 years. Remission from the CHR state, transition to psychosis (both defined with the Comprehensive Assessment of an At Risk Mental State), and level of functioning (assessed with the Global Assessment of Functioning) were assessed. Stepwise and multilevel logistic regression models were used to investigate the relationship between ACEs and outcomes. ACEs were significantly more prevalent in CHR individuals than in HC. Within the CHR cohort, physical abuse was associated with a reduced likelihood of remission (OR = 3.64, <i>p</i> = 0.025). Separation from a parent was linked to an increased likelihood of both remission (OR = 0.32, <i>p</i> = 0.011) and higher level of functioning (OR = 1.77, <i>p</i> = 0.040). Death of a parent (OR = 1.87, <i>p</i> = 0.037) was associated with an increased risk of transitioning to psychosis. Physical abuse and death of a parent are related to adverse long-term outcomes in CHR. The counter-intuitive association between separation from a parent and outcomes may reflect the removal of a child from an adverse environment. Future studies should investigate whether interventions targeting the effect of specific ACEs might help to improve outcomes in this population.</p>

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Association between Adverse Childhood Experiences and long-term outcomes in people at Clinical High-Risk for Psychosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月20日

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  • Stefania Tognin,
  • Ana Catalan,
  • Claudia Aymerich,
  • Anja Richter,
  • Matthew J. Kempton,
  • Gemma Modinos,
  • Ryan Hammoud,
  • Iñigo Gorostiza,
  • Evangelos Vassos,
  • Mark van der Gaag,
  • Lieuwe de Haan,
  • Barnaby Nelson,
  • Anita Riecher-Rössler,
  • Rodrigo Bressan,
  • Neus Barrantes-Vidal,
  • Marie-Odile Krebs,
  • Merete Nordentoft,
  • Stephan Ruhrmann,
  • Gabriele Sachs,
  • Bart P. F. Rutten,
  • Philip McGuire,
  • Lucia R. Valmaggia,
  • Matthew J. Kempton,
  • Maria Calem,
  • Gemma Modinos,
  • Lieuwe de Haan,
  • Mark van der Gaag,
  • Eva Velthorst,
  • Tamar C. Kraan,
  • Daniella S. van Dam,
  • Nadine Burger,
  • Barnaby Nelson,
  • Patrick McGorry,
  • G. Paul Amminger,
  • Christos Pantelis,
  • Athena Politis,
  • Joanne Goodall,
  • Anita Riecher-Rössler,
  • Stefan Borgwardt,
  • Erich Studerus,
  • Rodrigo Bressan,
  • Ary Gadelha,
  • Elisa Brietzke,
  • Graccielle Asevedo,
  • Elson Asevedo,
  • Andre Zugman,
  • Neus Barrantes-Vidal,
  • Tecelli Domínguez-Martínez,
  • Anna Racciopi,
  • Thomas R. Kwapil,
  • Manel Monsonet,
  • Lídia Hinojosa,
  • Mathilde Kazes,
  • Claire Daban,
  • Julie Bourgin,
  • Olivier Gay,
  • Célia Mam-Lam-Fook,
  • Marie-Odile Krebs,
  • Dorte Nordholm,
  • Lasse Randers,
  • Kristine Krakauer,
  • Louise Glenthøj,
  • Birte Glenthøj,
  • Merete Nordentoft,
  • Stephan Ruhrmann,
  • Dominika Gebhard,
  • Julia Arnhold,
  • Joachim Klosterkötter,
  • Gabriele Sachs,
  • Iris Lasser,
  • Bernadette Winklbaur,
  • Philippe A. Delespaul,
  • Bart P. Rutten,
  • Jim van Os,
  • Lucia Valmaggia,
  • Philip McGuire

摘要

Adverse childhood experiences (ACEs) are common in people at clinical high-risk for psychosis (CHR), however, the relationship between ACEs and long-term clinical outcomes is still unclear. This study examined associations between ACEs and clinical outcomes in CHR individuals. 344 CHR individuals and 67 healthy controls (HC) were assessed using the Childhood Trauma Questionnaire (CTQ), the Bullying Questionnaire and the Childhood Experience of Care and Abuse (CECA). CHR were followed up for up to 5 years. Remission from the CHR state, transition to psychosis (both defined with the Comprehensive Assessment of an At Risk Mental State), and level of functioning (assessed with the Global Assessment of Functioning) were assessed. Stepwise and multilevel logistic regression models were used to investigate the relationship between ACEs and outcomes. ACEs were significantly more prevalent in CHR individuals than in HC. Within the CHR cohort, physical abuse was associated with a reduced likelihood of remission (OR = 3.64, p = 0.025). Separation from a parent was linked to an increased likelihood of both remission (OR = 0.32, p = 0.011) and higher level of functioning (OR = 1.77, p = 0.040). Death of a parent (OR = 1.87, p = 0.037) was associated with an increased risk of transitioning to psychosis. Physical abuse and death of a parent are related to adverse long-term outcomes in CHR. The counter-intuitive association between separation from a parent and outcomes may reflect the removal of a child from an adverse environment. Future studies should investigate whether interventions targeting the effect of specific ACEs might help to improve outcomes in this population.