Childhood trauma and cardiometabolic risk in severe mental disorders: The mediating role of cognitive control

Abstract

Background Cardiometabolic risk is increased in severe mental disorders (SMDs), and there appears to be a relationship between childhood trauma and cardiometabolic risk, possibly related to adverse health behavior. The current study examined the association between childhood trauma and serum lipids and adiposity in SMDs and the potential mediating role of cognitive and personality characteristics. Methods Participants with schizophrenia and bipolar spectrum disorders (N = 819) were included, cardiometabolic risk factors (serum lipids, body mass index, and waist circumference) were measured, and history of childhood trauma was assessed by the Childhood Trauma Questionnaire. Cognitive and personality characteristics were available in subsamples, with assessments of cognitive control, impulsiveness, self-esteem, and affective lability. Linear regressions and mediation analyses with Hayes’ PROCESS were performed, adjusting for age, sex, antipsychotic agent propensity of metabolic side-effect, and diagnostic group. Results Experience of three or more subtypes of childhood trauma was positively associated with waist circumference in patients with SMDs (p = 0.014). There were no other significant associations between trauma variables and lipid or adiposity measures in the total sample. Cognitive control was a significant mediator between experience of one or two subtypes of childhood trauma and waist circumference. Conclusions The results indicate childhood trauma as a predisposing factor for increased waist circumference in individuals with SMDs. Poorer cognitive control, suggestive of adverse health behavior, might be a mediating factor of the association, and the findings indicate the potential importance of increased focus on these factors in prevention and treatment regimens targeting cardiometabolic health.

The association between adverse childhood experiences and metabolic syndrome in severe mental illness: A literature review

“…14,17,18,[22][23][24][25]29 . Twelve studies 11,12,13,[15][16][17][19][20][21]25,26,29 showed a significant association between ACE and obesity, with four studies 13,17,25,29 reporting an association between parental loss or separation and obesity, while other studies reported that SA 17,19,22,8,9,23 and PA 15 were associated with obesity.…”

“…846 were excluded at the title and abstract level and 62 studies that met the inclusion criteria were retrieved and assessed at full text level. Twenty articles 1,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] (Figure 1) published between 2011 and 2021 met the criteria for our final review. The majority of these studies (n = 12) were cross-sectional, 14,[17][18][21][22][23][24][25][26][27][28][29] while seven were case-control studies, 1,11,13,15,16,19,20 and one study was prospective, monitoring the weight gain in the participants for a year.…”

“…Twenty articles 1,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] (Figure 1) published between 2011 and 2021 met the criteria for our final review. The majority of these studies (n = 12) were cross-sectional, 14,[17][18][21][22][23][24][25][26][27][28][29] while seven were case-control studies, 1,11,13,15,16,19,20 and one study was prospective, monitoring the weight gain in the participants for a year. 12 Nineteen studies described the sample and together they included 13,976 participants (including 5656 healthy controls).…”

“…Among the physical health outcomes, obesity (body mass index or waist circumference) was the most commonly studied (n = 14), 11,[13][14][15][16][17][18][19][20][21][22][23]25 followed by diabetes mellitus (n = 13), 1,13,14,17,18,20,[22][23][24][26][27][28][29] dyslipidaemia (n = 9), 1,14,16,18,[21][22][23]26,29 and hypertension (n = 8). 14,17,18,[22][23][24][25]29 .…”

Crosstalk between Schizophrenia and Metabolic Syndrome: The Role of Oxytocinergic Dysfunction

“…Chronic stress, particularly childhood trauma, has detrimental consequences that lead to metabolic syndrome [320] and schizophrenia [321], which has been proven in the genetic changes of persons with metabolic syndrome [322] and persons with schizophrenia [203]. These interactions are also illustrated through the association between childhood trauma and metabolic syndrome in persons with schizophrenia [137,323]. Recent findings postulate that schizophrenia risk loci can influence stochastic variation in gene expression through epigenetic processes, highlighting the intricate interaction between the genetic and epigenetic control of neurodevelopmental trajectories, leaving molecular scars that influence brain functions [324].…”