Trauma and Psychosis: is There a Link?

Abstract

Introduction: During the last decade there has been a resurgence of interest in the relationship between early adversity and the development of psychiatric symptoms later in life. There is accumulating evidence for a link between childhood trauma and the development of most psychiatric disorders, including mood and anxiety disorders, eating disorders, personality disorders and substance abuse. Recently, a substantial number of studies have suggested that childhood trauma is also an important risk factor for psychosis. Indeed, a significant proportion of people with psychotic disorders report traumatic experiences during childhood and an increasing number of population-based studies have provided data that suggest that childhood trauma (and to a lesser extent adult abuse or experience of a traumatic event) is of aetiological importance in psychosis. Aims and Methods: This work has as main goal, starting from a review of the literature on this subject, to reflect on the possible mechanisms that may mediate the relationship between maltreatment in childhood and greater predisposition for the development of psychotic symptoms in adolescence and adulthood. Results and Conclusions: There is increasing evidence that neurobiological mechanisms such as dysregulation of the hypothalamic-pituitary-adrenal axis and sensitization of the dopaminergic system may mediate the interaction between the experience of traumatic events at early stages of brain development and increased risk for psychotic symptoms later in life. Preliminary evidence also suggests that polymorphisms within the cathecol-O-methyltransferase and brain-derived neurotrophic factor genes may interact with psychosocial stress in the development of psychosis.