Childhood trauma, antipsychotic medication, and symptom remission in first-episode psychosis
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Background To what extent psychotic symptoms in first-episode psychosis (FEP) with a history of childhood interpersonal trauma (CIT) are less responsive to antipsychotic medication is not known. In this longitudinal study, we compare symptom trajectories and remission over the first 2 years of treatment in FEP with and without CIT and examine if differences are linked to the use of antipsychotics. Methods FEP (N = 191) were recruited from in- and outpatient services 1997-2000, and assessed at baseline, 3 months, 1 and 2 years. Inclusion criteria were 15-65 years, actively psychotic with a DSM-IV diagnosis of psychotic disorder and no previous adequate treatment for psychosis. Antipsychotic medication is reported as defined daily dosage (DDD). CIT (<18) was assessed with the Brief Betrayal Trauma Survey, and symptomatic remission based on scores from the Positive and Negative Syndrome Scale. Results CIT (n = 63, 33%) was not associated with symptomatic remission at 2 years follow-up (71% in remission, 14% in relapse), or time to first remission (CIT 12/ no-CIT 9 weeks, p = 0.51). Those with CIT had significantly more severe positive, depressive, and excited symptoms. FEP with physical (N = 39, 20%) or emotional abuse (N = 22, 14, 7%) had higher DDD at 1 year (p < 0.05). Mean DDD did not excerpt a significant between-group effect on symptom trajectories of positive symptoms. Conclusion Results indicate that antipsychotic medication is equally beneficial in the achievement of symptomatic remission in FEP after 2 years independent of CIT. Still, FEP patients with CIT had more severe positive, depressive, and excited symptoms throughout.
Originalsprog | Engelsk |
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Tidsskrift | Psychological Medicine |
Vol/bind | 53 |
Udgave nummer | 6 |
Sider (fra-til) | 2399–2408 |
Antal sider | 10 |
ISSN | 0033-2917 |
DOI | |
Status | Udgivet - 2021 |
Bibliografisk note
Funding Information:
This work was supported by the Norwegian National Research Council #133897/320 and #154642/320, the Norwegian Department of Health and Social Affairs, and the National Council for Mental Health, Health and Rehabilitation #1997/41 and #2002/306, Rogaland County and Oslo County. This work was also funded by the Theodore and Vada Stanley Foundation and the Regional Health Research Foundation for Eastern Region, Denmark; Roskilde County, Helsefonden, Lundbeck Pharma, Eli Lily, and Janssen Cilag Pharmaceuticals Denmark; the National Alliance for Research on Schizophrenia and Depression (NARSAD) distinguished investigator award young investigator award, and NIM grant MH-01654.
Publisher Copyright:
© The Author(s), 2021. Published by Cambridge University Press.
ID: 286313974