Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Next article
Originalarbeit

Einfluss belastender Kindheitserfahrungen bei akuten Psychosen und ihr Zusammenhang mit Schwere und kurzfristigem Verlauf

Published Online:October 27, 2020https://doi.org/10.1026/1616-3443/a000560

Abstract

Zusammenfassung.Theoretischer Hintergrund: Misshandlung, Missbrauch und Vernachlässigung (MMV) in der Kindheit stehen mit einem erhöhten Risiko für schizophrene Spektrumsstörungen sowie einem schlechten Verlauf in Zusammenhang. Fragestellung: 1.) Wie verteilen sich die Schweregrade von MMV bei Patient_innen im Vergleich zu Gesunden? 2.) Ist MMV mit höherer Erkrankungsschwere zu Behandlungsbeginn sowie 3.) einem schlechteren Verlauf einer akuten Psychose assoziiert? Methode: MMV wurde bei Patient_innen mit schizophrenen Spektrumsstörungen (n = 101) und Gesunden (n = 50) erhoben. Die Patient_innen wurden bei der stationären Aufnahme (t1), Entlassung (t2) und sechs Monate später (t3) untersucht. Ergebnisse: 1.) Gegenüber Kontrollpersonen zeigte sich ein ansteigender Anteil von Patient_innen mit mittleren und hohen MMV-Schweregraden. MMV-Erfahrungen waren zudem 2.) mit häufigerer psychiatrischer Komorbidität sowie 3.) mit höherer Depressivität, störungsunspezifischer Symptomatik und geringerer Lebenszufriedenheit im Verlauf assoziiert. Schlussfolgerungen: MMV-Erfahrungen sind für Erkrankungschwere und akuten Verlauf von schizophrenen Spektrumsstörungen bedeutsam.


Associations of Childhood Adversities with Severity of Illness and Course of Remission from Acute Psychosis

Abstract.Background: Childhood adversities are associated with an increased risk for psychotic disorders and poor clinical outcome. Objective: We hypothesized that childhood adversities 1.) occur more frequently and aggregate particularly at medium and high levels of severity in patients compared with controls, 2.) are associated with more severe illness manifestations and 3.) modulate the course of remission from acute psychosis. Methods: Childhood adversities were assessed in 101 schizophrenia spectrum patients and 50 healthy controls. Patients were examined at hospital admission (t1), discharge (t2) and six month later (t3). Results: Childhood adversities 1.) were more frequent in patients than controls, particularly at moderate and severe levels, 2.) are associated with several indicators of illness severity, and 3.) contribute independent from psychiatric comorbidity to higher depression, overall symptom severity and lower quality of life in the course of acute treatment. Conclusion: Childhood adversities should already be considered in the treatment of acute psychosis and may warrant specialized treatment treatment of comorbid disorders.

Literatur

  • Aas, M., Andreassen, O. A., Aminoff, S. R., Færden, A., Romm, K. L., Nesvåg, R. et al. (2016). A history of childhood trauma is associated with slower improvement rates: Findings from a one-year follow-up study of patients with a first-episode psychosis. BMC Psychiatry, 16, 126, https://doi.org/10.1186/s12888-016-0827-4. First citation in articleGoogle Scholar

  • Ackenheil, M., Stotz, G., Dietz-Bauer, R., Vossen, A., Dietz, R., Vossen-Wellmann, A. et al. (1999). Mini International Neuropsychiatric Interview. German Version 5.0.0, DSM-IV. München: Psychiatrische Universitätsklinik München. First citation in articleGoogle Scholar

  • Ajnakina, O., Trotta, A., Forti, M. Di, Stilo, S. A., Kolliakou, A., Gardner-Sood, P. et al. (2018). Different types of childhood adversity and 5-year outcomes in a longitudinal cohort of first-episode psychosis patients. Psychiatry Research, 269 (8), 199 – 206. First citation in articleCrossref, Google Scholar

  • Alameda, L., Ferrari, C., Baumann, P. S., Gholam-Rezaee, M., Do, K. Q., Conus, P. et al. (2015). Childhood sexual and physical abuse: Age at exposure modulates impact on functional outcome in early psychosis patients. Schizophrenia Research, 45 (1 – 3), 2727 – 2736. First citation in articleGoogle Scholar

  • Anda, F. A., Felitti, C. J., Bremner, J. D., Walker, J. D., Whitfield, C. et al. (2006). The enduring effects of abuse and related adverse experiences in childhood. European Archives of Psychiatry and Clinical Neuroscience, 256 (3), 174 – 186. First citation in articleCrossref, Google Scholar

  • Bailey, T., Alvarez-Jimenez, M., Garcia-Sanchez, A. M., Hulbert, C., Barlow, E. & Bendall, S. (2018). Childhood trauma is associated with severity of hallucinations and delusions in psychotic disorders: a systematic review and meta-analysis. Schizophrenia Bulletin, 44 (5), 1111 – 1122. First citation in articleCrossref, Google Scholar

  • Benjamini, Y. & Hochberg, Y. (1995). Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing. Journal of the Royal Statistical Society. Series B (Methodological), 57 (1), 289 – 300. First citation in articleCrossref, Google Scholar

  • Bonoldi, I., Simeone, E., Rocchetti, M., Codjoe, L., Rossi, G., Gambi, F. et al. (2013). Prevalence of self-reported childhood abuse in psychosis: A meta-analysis of retrospective studies. Psychiatry Research, 210 (1), 8 – 15. First citation in articleCrossref, Google Scholar

  • Caldecott-Hazard, S. & Hall, R. C. W. (1995). Global assessment of functioning: A modified scale. Psychosomatics, 36 (2), 267 – 275. First citation in articleGoogle Scholar

  • Bentall, R. P., De Sousa, P., Varese, F., Wickham, S., Sitko, K., Haarmans, M. et al. (2014). From adversity to psychosis: Pathways and mechanisms from specific adversities to specific symptoms. Social Psychiatry and Psychiatric Epidemiology, 49 (7), 1011 – 1022. First citation in articleCrossref, Google Scholar

  • Ciompi, L. (2011). Soteria Bern: Konzeptuelle und empirische Grundlagen, Wirkhypothesen. In L. CiompiH. HoffmannM. Broccard (Hrsg.), Wie wirkt Soteria? S. 43 – 68. Heidelberg: Carl-Auer. First citation in articleGoogle Scholar

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. (2nd ed.). Hillsdale, N.Y.: Lawrence Erlbaum Associates. First citation in articleGoogle Scholar

  • Conus, P., Cotton, S., Schimmelmann, B. G., McGorry, P. D. & Lambert, M. (2010). Pretreatment and outcome correlates of sexual and physical trauma in an epidemiological cohort of first-episode psychosis patients. Schizophrenia Bulletin, 36 (6), 1105 – 1114. First citation in articleCrossref, Google Scholar

  • Daig, I., Spangenberg, L., Henrich, G., Herschbach, P., Kienast, T. & Brähler, E. (2011). Alters- und geschlechtspezifische Neunormierung der Fragen zur Lebenszufriedenheit (FLZM) für die Altersspanne von 14 bis 64 Jahre. Zeitschrift Für Klinische Psychologie und Psychotherapie, 40, 172 – 178. First citation in articleLink, Google Scholar

  • Dilling, H., Moumbour, W., Schmidt, M. H. & Schulte-Markwort, E. (1994). Internationale Klassifikation psychischer Störungen : ICD-10 Kapitel V (F); diagnostische Kritierien für Forschung und Praxis. Bern: Huber. First citation in articleGoogle Scholar

  • Fisher, H. L., Craig, T. K., Fearon, P., Morgan, K., Dazzan, P., Lappin, J. et al. (2011). Reliability and comparability of psychosis patients’ retrospective Reports of childhood abuse. Schizophrenia Bulletin, 37 (3), 546 – 553. First citation in articleCrossref, Google Scholar

  • Franke, G. H. (2000). BSI: Brief Symptom Inventory von LR Derogatis (Kurzform der SCL-90-R), deutsche Version. Göttingen: Beltz. First citation in articleGoogle Scholar

  • Haahr, U. H., Larsen, T. K., Simonsen, E., Rund, B. R., Joa, I., Rossberg, J. et al. (2016). Relation between premorbid adjustment, duration of untreated psychosis and close interpersonal trauma in first-episode psychosis. Early Intervention in Psychiatry, 12 (3), https://doi.org/10.1111/eip.12315 First citation in articleCrossref, Google Scholar

  • Hautzinger, M., Keller, F. & Kühler, C. (2006). Das Beck Depressionsinventar II. Deutsche Bearbeitung und Handbuch zum BDI II. Frankfurt am Main: Harcourt Test Services. First citation in articleGoogle Scholar

  • Henrich, G. & Herschbach, P. (2000). Questions on Life Satisfaction (FLZ-M) – a short questionnaire for assessing subjective quality of life. European Journal of Psychological Assessment, 16 (3), 150 – 159. First citation in articleLink, Google Scholar

  • Isele, D., Teicher, M. H., Ruf-Leuschner, M., Elbert, T., Kolassa, et al. (2014). KERF–Ein Instrument zur umfassenden Ermittlung belastender Kindheitserfahrungen. Zeitschrift Für Klinische Psychologie und Psychotherapie, 43, 121 – 130. First citation in articleLink, Google Scholar

  • Kay, S. R., Fiszbein, A. & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13 (2), 261 – 276. First citation in articleCrossref, Google Scholar

  • Kraan, T. C., Ising, H. K., Fokkema, M., Velthorst, E., Berg, D. P. G. Van Den, Kerkhoven, M. et al. (2017). The effect of childhood adversity on 4-year outcome in individuals at ultra high risk for psychosis in the Dutch Early Detection Intervention Evaluation (EDIE-NL) Trial. Psychiatry Research, 247, 55 – 62. First citation in articleCrossref, Google Scholar

  • Sass, H., Wittchen, H.-U. & Zaudig, M. (1996). Diagnostisches und statistisches Manual psychischer Störungen – DSM-IV. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Schenkel, L. S., Spaulding, W. D., DiLillo, D. & Silverstein, S. M. (2005). Histories of childhood maltreatment in schizophrenia: Relationship with premorbid functioning, symptomatology, and cognitive deficits. Schizophrenia Research, 76 (2 – 3), 273 – 286. First citation in articleCrossref, Google Scholar

  • Schalinski, I., Fischer, Y. & Rockstroh, B. (2015). Impact of childhood adversities on the short-term course of illness in psychotic spectrum disorders. Psychiatry Research, 228 (3), 633 – 640. First citation in articleCrossref, Google Scholar

  • Schalinski, I., Teicher, M. H., Nischk, D., Hinderer, E., Müller, O. & Rockstroh, B. (2016). Type and timing of adverse childhood experiences differentially affect severity of PTSD, dissociative and depressive symptoms in adult inpatients. BMC Psychiatry, 16 (1), https://doi.org/10.1186/s12888-016-1004-5. First citation in articleCrossref, Google Scholar

  • Stain, H. J., Brønnick, K., Hegelstad, W. T. V, Joa, I., Johannessen, J. O., Langeveld, J. et al. (2014). Impact of interpersonal trauma on the social functioning of adults with first-episode psychosis. Schizophrenia Bulletin, 40 (6), 1491 – 1498. First citation in articleCrossref, Google Scholar

  • Teicher, M.H. & Parigger, A. (2015). The ‘Maltreatment and Abuse Chronology of Exposure’ (MACE) Scale for the retrospective assessment of abuse and neglect during development. PLoS ONE, 10(2): e0117423 https://doi.org/10.1371/journal.pone.0117423 First citation in articleCrossref, Google Scholar

  • Trauelsen, A. M., Bendall, S., Jansen, J. E., Nielsen, H. G. L., Pedersen, M. B., Trier, C. H. et al. (2015). Childhood adversity specificity and dose-response effect in non-affective first-episode psychosis. Schizophrenia Research, 165 (1), 52 – 59. First citation in articleCrossref, Google Scholar

  • Trotta, A., Murray, R. M., David, A. S., Kolliakou, A., O’Connor, J., Di Forti, M. et al. (2016). Impact of different childhood adversities on 1-year outcomes of psychotic disorder in the Genetics and Psychosis Study. Schizophrenia Bulletin, 42 (2), 464 – 475. First citation in articleCrossref, Google Scholar

  • Ucok, A. & Bikmaz, S. (2007). The effects of childhood trauma in patients with first-episode schizophrenia. Acta Psychiatrica Scandinavica, 116 (5), 371 – 377. First citation in articleCrossref, Google Scholar

  • Van Nierop, M., Viechtbauer, W., Gunther, N., van Zelst, C., de Graaf, R., Ten Have, M. et al. (2015). Childhood trauma is associated with a specific admixture of affective, anxiety, and psychosis symptoms cutting across traditional diagnostic boundaries. Psychological Medicine, 45 (2015), 1277 – 1288. First citation in articleCrossref, Google Scholar

  • Varese, F., Smeets, F., Drukker, M., Lieverse, R., Lataster, T., Viechtbauer, W. et al. (2012). Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective-and cross-sectional cohort studies. Schizophrenia Bulletin, 38 (4), 661 – 671. First citation in articleCrossref, Google Scholar

  • West, B., Welch, K. & Gałecki, A. (2014). Linear Mixed Models. (2nd ed.). New York, NY: Chapman and Hall/ CRC. First citation in articleCrossref, Google Scholar