A History of Childhood Trauma and Response to Treatment With Antipsychotics in First-Episode Schizophrenia Patients

Abstract

In this study, we aimed to investigate whether a history of childhood trauma (CT) can help predict early response to antipsychotic treatment in patients with first-episode schizophrenia (FES). We recruited 64 FES patients who were followed up after 12 weeks of treatment with second-generation antipsychotics. Symptomatic manifestation was examined using the Positive and Negative Syndrome Scale (PANSS). Childhood adversities were assessed using the Early Trauma Inventory Self-Report-Short Form. Nonresponders had significantly higher general trauma score, emotional abuse score, total trauma score, and baseline PANSS negative factor score. A history of CT was significantly more frequent among nonresponders. Logistic regression analysis revealed that positive history of CT, higher emotional abuse score, and higher baseline PANSS negative factor score are significant predictors of poor response to treatment. Our results indicate that a history of CT, especially emotional abuse, and higher severity of negative symptoms are independent predictors of poor response to treatment with antipsychotics.

Childhood maltreatment and treatment outcome in psychotic disorders: a systematic review and meta‐analysis

“…Two out of twelve treatment results referred to schizophrenia samples (compared to samples with mixed psychotic disorders). These results both demonstrated an association between CM and poorer treatment response related to changes in functioning and in symptoms . Of the 10 treatment results that referred to samples with mixed psychotic disorders, only one result found an association between CM and poorer treatment outcome with regard to changes in functioning.…”

“…Only two treatment results referred to the association between CM and the outcome of an exclusively pharmacological treatment. In one of those , after 12 weeks of treatment, first‐episode schizophrenia patients with CM were more often classified as non‐responders than those without CM. In the other , there was no association between CM and non‐response to 12 weeks of pharmacological treatment in first‐episode psychosis patients.…”

“…For one study , the standard deviation of the dependent variable (values on the Positive and Negative Syndrome Scale (PANSS)) was neither reported nor provided. Therefore, the standard deviation was estimated by using the mean of the standard deviations from two other included studies also using the PANSS for determining treatment outcome and also examining first‐episode psychosis patients . For one study , not enough information was available to convert the reported result into an odds ratio, so the result was converted approximatively: since the mean values of the relevant treatment outcome differed only marginally between those with and without CM at the first time of measurement (see ), the odds ratio was determined on the basis of the mean difference (and the corresponding standard deviations) at the second time of measurement.…”

Stress, Allostatic Load, and Psychosis: One Step Forward in Research But Where to Go Next?

“…There are also studies showing lower levels of peripheral blood brain-derived neurotrophic factor (BDNF) (11), elevated levels of pro-inflammatory cytokines (12), more pronounced metabolic alterations (13), and altered DNA methylation profiles (14) in patients with psychosis and a history early-life traumatic stress. Patients with psychosis and self-reported childhood adversities present with unfavorable short-and long-term treatment and functional outcomes (15,16). Finally, higher levels of stress biomarkers have been found to predict transition from ultra-high risk states to fully blown psychotic episode (17).…”

Commentary: Adverse Childhood Experiences and Risk for Suicidal Behavior in Male Iraq and Afghanistan Veterans Seeking PTSD Treatment

“…Studies have shown that a history of ACE is associated with poor response to treatment in patients with psychiatric disorders (34–36). Mental and non-mental health professionals who treat post-deployed service members should not only assess the seriousness of combat exposure but also childhood adversities to provide appropriate psychiatric treatment and to better understand psychiatric outcomes.…”