Experience of trauma and conversion to psychosis in an ultra‐high‐risk (prodromal) group

Abstract

Bechdolf A, Thompson A, Nelson B, Cotton S, Simmons MB, Amminger GP, Leicester S, Francey SM, McNab C, Krstev H, Sidis A, McGorry PD, Yung AR. Experience of trauma and conversion to psychosis in an ultra‐high‐risk (prodromal) group. Objective: We aimed to replicate a recent finding of high prevalence of trauma history in patients at ‘ultra‐high risk’ (UHR) of psychotic disorder and to investigate whether trauma predicts conversion to psychosis in this population. Method: A consecutive sample of UHR patients was assessed. History of trauma was accessed with the General Trauma Questionnaire. Cox regression models were used to explore relationship between conversion to psychosis and trauma. Results: Of 92 UHR patients nearly 70% had experienced a traumatic event and 21.7% developed psychosis during follow‐up (mean 615 days). Patients who had experienced a sexual trauma (36%) were significantly more likely to convert to first‐episode psychosis (OR 2.96) after controlling for meeting multiple UHR intake groups. Conclusion: UHR patients have a high prevalence of history of trauma. Previous sexual trauma may be a predictor of onset of psychotic disorder in this population.

Bullying victimisation and paranoid ideation in people at ultra high risk for psychosis

“…Our findings are consistent with a previous report of an increased prevalence of bullying victimisation in UHR individuals , and, more generally, with evidence of increased rates of adverse life events in this group , Bechdolf et al, 2010, Falukozi and Addington, 2012, Tikka et al, 2013, Thompson et al, 2014. These observations support the concept of a causal, dose-response relationship between victimisation and the risk and severity of psychotic symptoms (Bebbington et al, 2013, Lataster et al, 2013, although in the present study prolonged bullying was not associated with an increased level of paranoid ideation.…”

Childhood abuse in the etiological continuum underlying psychosis from first-episode psychosis to psychotic experiences

“…The fact that individuals at psychometric risk for psychosis (High CAPE group) also presented a high prevalence of childhood abuse is in accordance with previous research, although others have found even higher prevalences (35).…”

Social defeat predicts paranoid appraisals in people at high risk for psychosis

“…Although previous studies have reported high rates of adverse life events in UHR individuals (Addington et al, 2013;Bechdolf et al, 2010;Falukozi and Addington, 2012;Thompson et al, 2009;Tikka et al, 2013) and abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis, the main bodily response to stress (Aiello et al, 2012;Day et al, 2014;Walker et al, 2008), this study is the first to have shown that social defeat is more evident in UHR subjects than controls. The study also provided the first evidence that the level of social defeat predicted the extent to which UHR subjects made paranoid appraisals in a social setting.…”