Gender differences in childhood trauma in first episode psychosis: Association with symptom severity over two years
Gender differences in childhood trauma in first episode psychosis: Association with symptom severity over two years
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DOI：
10.1016/j.schres.2018.06.043
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发表时间：
2019-03-01
影响因子：
4.5
通讯作者：
Joober, Ridha
中科院分区：
文献类型：
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作者：
Pruessner, Marita;King, Suzanne;Joober, Ridha
早期生活逆境与精神病发病风险增加和临床预后差有关。男性患者往往比女性患者表现出更严重的精神病病程。本研究的目的是探讨儿童创伤（CT）的性别差异及其对精神病发病后症状和功能结局的影响。该研究包括210名诊断为首发精神病（FEP）的患者（144名男性，66名女性）。用童年创伤问卷对早期逆境进行评估。在建立的早期干预服务中，在基线、12个月和24个月的随访中，用简短精神病学评定量表和整体功能评估量表对精神病症状和一般功能进行评分。男性患者遭受身体或情感忽视的比例更高，而女性患者遭受情感虐待的比例明显更高。更严重的CT与女性更高的抑郁水平和男性的阴性症状有关。在男性患者24个月时观察到阳性和阴性症状严重程度和整体功能的明显CT效果。无论男女，情感虐待都是抑郁症的最强预测因子。仅在男性患者中，情绪虐待预示着阳性症状的严重程度和整体功能受损，而情绪忽视预示着更严重的阴性症状。我们的研究结果表明，男性和女性FEP患者的CT经历存在差异，对男性患者的长期预后影响更明显。研究结果支持了这样一种观点，即男性精神病患者相对较差的病程是由于压力易感性的性别差异造成的。(C) 2018 Elsevier B.V.版权所有
Early life adversity is associated with increased risk for psychosis onset and poor clinical outcome. Male compared to female patients often show a more severe course of psychotic illness. The aim of the present study was to investigate gender differences in childhood trauma (CT) and their impact on symptomatic and functional outcome following psychosis onset.The study included 210 patients (144 men, 66 women) diagnosed with a first-episode of psychosis (FEP). Early adversity was assessed with the Childhood Trauma Questionnaire. Psychotic symptoms and general functioning were rated with the Brief Psychiatric Rating Scale and Global Assessment of Functioning scale at baseline, 12 and 24 months of follow-up in an established early intervention service.Male patients reported higher rates of physical or emotional neglect, whereas female patients indicated significantly higher rates of emotional abuse. More severe CT was related to higher levels of depression in women and to negative symptoms in men. Distinct CT effects were observed on positive and negative symptom severity and global functioning in male patients at 24 months. Emotional abuse was the strongest predictor of depression in both genders. In male patients only, emotional abuse predicted positive symptom severity and impaired global functioning whereas emotional neglect predicted more severe negative symptoms.Our results suggest differences in CT experiences in male and female FEP patients, with a more pronounced impact on longer-term outcome in male patients. The findings support the notion that sex differences in stress vulnerability account for the relatively poor illness course in male psychosis patients. (C) 2018 Elsevier B.V. All rights reserved.