Previous research show that a history of childhood trauma is more prevalent in people suffering from psychosis compared with the general population. Childhood trauma has also been linked to cognitive abnormalities in adulthood, and cognitive abnormalities, in turn, are one of the key clinical features of psychosis. Therefore, the aim of this study is to test whether there is a relationship between childhood trauma and cognitive function in patients with first episode psychosis.
We recruited 50 patients with first episode psychosis (mean±age:28.6±8.1; gender 62% males) and 60 controls (age: 26.5±5.5 yrs; gender: 58.3% males) as part of the large Genetic and Psychosis (GAP) study, carried out in South London. 6 of the patients were drug naive or medication free, 39 were on atypical antipsychotics, and 5 were on typical antipsychotic. Information about a history of childhood physical abuse, sexual abuse, separation and loss (up to and including age 11) were obtained by the Childhood Experience of Care and Abuse Questionnaire (CECA.Q). Furthermore, patients and controls underwent neuropsychological assessments from the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III), several working memory and executive tasks, together with the Wechsler Memory Scale-Third Edition (WMS-III), and the National Adult Reading Test (NART). Chi-square test was used to compare categorical variables (e.g. childhood trauma) between patients and controls. Pearson's correlation was used to investigate the relationship between childhood trauma and cognitive function. Furthermore, a one way ANOVA was performed to covariate for possible confounders, such as education, ethnicity, Premorbid IQ, medication, and diagnosis in the patients (schizophreniform versus “other psychosis”).
As expected, patients scored significantly worse on all the cognitive tasks presented compared to controls (p < 0.05), and showed a significantly higher incidence of childhood trauma than controls (p = 0.008). Particularly, two types of childhood trauma, physical and sexual abuse were related to worse cognitive performance in a dose dependent manner for specific task from the WAIS-III (Block design, r = -0.26, p = 0.077), and working memory tasks/executive function (trail B; r = 0.30, p = 0.054; trail B-A; r = 0.36, p = 0.020, Spatial Working Memory strategy; r = 0.33, p = 0.028, and Stockings of Cambridge mean subsequent thinking time; r = 0.30, P = 0.048). Also in controls, a negative correlation was observed between particular types of childhood trauma and cognitive function.
Our data suggest that patients with first episode psychosis with a history of childhood trauma of physical or sexual abuse show greater cognitive impairment on several cognitive domains, particularly working memory, compared to patients without childhood trauma. The data presented above could be part of a possible understanding of the aetiology of cognitive dysfunction in psychosis.
Acknowledgment: This research is funded by the British Academy and the South London and Maudsley NHS Foundation Trust & Institute of Psychiatry NIHR Biomedical Research Centre for Mental Health.
1. Perez, C. M., Widom, C. S., 1994. Childhood victimization and long-term intellectual and academic outcomes. Child Abuse Negl. 18, 617–633.
2. Read, J., van, O. J., Morrison, A. P., Ross, C. A., 2005. Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr. Scand. 112, 330–350.
3. Reichenberg, A., Harvey, P. D., 2007. Neuropsychological impairments in schizophrenia: Integration of performance-based and brain imaging findings. Psychol. Bull. 133, 833–858.
|Secondary author(s): |
|Mondelli, V., Reichenberg, A., Di Forti, M., Wiffen, B., Handley, R., Taylor, H., Murray, R., Dazzan, P., Pariante, C.|
|Aas, M., Mondelli, V., Reichenberg, A., Di Forti, M., Wiffen, B., Handley, R., . . . Pariante, C. (2009). Is there a link between a history of childhood trauma and cognitive impairment in first-episode psychosis? European Neuropsychopharmacology, 19(Suppl. 3), S682-S682.|