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Childhood trauma is associated with a specific admixture of affective, anxiety, and psychosis symptoms cutting across traditional diagnostic boundaries

Published online by Cambridge University Press:  02 October 2014

M. van Nierop ,
W. Viechtbauer ,
N. Gunther ,
C. van Zelst ,
R. de Graaf ,
M. ten Have ,
S. van Dorsselaer ,
M. Bak ,
R. van Winkel  and
Genetic Risk and OUtcome of Psychosis (GROUP) investigators
M. van Nierop*
Affiliation:
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
W. Viechtbauer
Affiliation:
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
N. Gunther
Affiliation:
Faculty of Psychology and Educational Sciences, Open University, The Netherlands
C. van Zelst
Affiliation:
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
R. de Graaf
Affiliation:
Netherlands Institute of Mental Health and Addiction, Da Costakade, Utrecht, The Netherlands
M. ten Have
Affiliation:
Netherlands Institute of Mental Health and Addiction, Da Costakade, Utrecht, The Netherlands
S. van Dorsselaer
Affiliation:
Netherlands Institute of Mental Health and Addiction, Da Costakade, Utrecht, The Netherlands
M. Bak
Affiliation:
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
R. van Winkel
Affiliation:
Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands University Psychiatric Center Katholieke Universiteit Leuven, Campus Kortenberg, Leuvensesteenweg, Kortenberg, Belgium
*
*Address for correspondence: M. van Nierop, MSc, School of Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Vijverdalseweg 1, Concorde Building (SN2), 6200 MD Maastricht, The Netherlands. (Email: m.vannierop@maastrichtuniversity.nl)
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Abstract

Background.

Meta-analyses link childhood trauma to depression, mania, anxiety disorders, and psychosis. It is unclear, however, whether these outcomes truly represent distinct disorders following childhood trauma, or that childhood trauma is associated with admixtures of affective, psychotic, anxiety and manic psychopathology throughout life.

Method.

We used data from a representative general population sample (NEMESIS-2, n = 6646), of whom respectively 1577 and 1120 had a lifetime diagnosis of mood or anxiety disorder, as well as from a sample of patients with a diagnosis of schizophrenia (GROUP, n = 825). Multinomial logistic regression was used to assess whether childhood trauma was more strongly associated with isolated affective/psychotic/anxiety/manic symptoms than with their admixture.

Results.

In NEMESIS-2, largely comparable associations were found between childhood trauma and depression, mania, anxiety and psychosis. However, childhood trauma was considerably more strongly associated with their lifetime admixture. These results were confirmed in the patient samples, in which it was consistently found that patients with a history of childhood trauma were more likely to have a combination of multiple symptom domains compared to their non-traumatized counterparts. This pattern was also found in exposed individuals who did not meet criteria for a psychotic, affective or anxiety disorder and who did not seek help for subclinical psychopathology.

Conclusions.

Childhood trauma increases the likelihood of a specific admixture of affective, anxiety and psychotic symptoms cutting across traditional diagnostic boundaries, and this admixture may already be present in the earliest stages of psychopathology. These findings may have significant aetiological, pathophysiological, diagnostic and clinical repercussions.

Keywords

Anxietychildhood traumadepressionmaniapsychosisstratified medicine
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 6 , April 2015 , pp. 1277 - 1288
Copyright
Copyright © Cambridge University Press 2014 

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References

Andreasen, NC, Flaum, M, Arndt, S (1992). The comprehensive assessment of symptoms and history (CASH). An instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615–623.CrossRefGoogle ScholarPubMed
Andrew, G, Peters, L (1998). The psychometric properties of the Composite International Diagnostic Interview. Social Psychiatry and Psychiatric Epidemiology 33, 80–88.CrossRefGoogle Scholar
Arseneault, L, Cannon, M, Fisher, H, Polanczyk, G, Moffitt, TE, Caspi, A (2011). Childhood trauma and children's emerging psychotic symptoms: a genetically sensitive longitudinal cohort study. American Journal of Psychiatry 168, 65–72.CrossRefGoogle ScholarPubMed
Bernstein, DP, Stein, JA, Newcomb, MD, Walker, E, Pogge, D, Ahluvalia, T, Stokes, J, Handelsman, L, Medrano, M, Desmond, D (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse & Neglect 27, 169–190.CrossRefGoogle ScholarPubMed
Bijl, RV, van Zessen, G, Ravelli, A, de Rijk, C, Langendoen, Y (1998). The Netherlands Mental Health Survey and Incidence Study (NEMESIS): objectives and design. Social Psychiatry and Psychiatric Epidemiology 33, 581–586.CrossRefGoogle ScholarPubMed
De Bont, PA, van den Berg, DP, van der Vleugel, BM, De Roos, C, Mulder, CL, Becker, ES, de Jongh, A, van der Gaag, M, van Minnen, A (2013). A multi-site single blind clinical study to compare the effects of prolonged exposure, eye movement desensitization and reprocessing and waiting list on patients with a current diagnosis of psychosis and co morbid post traumatic stress disorder: study protocol for the randomized controlled trial Treating Trauma in Psychosis. Trials 14, Published online: 23 May 2013. doi:10.1186/1745-6215-14-151.CrossRefGoogle ScholarPubMed
De Graaf, R, Ormel, J, Ten Have, M, Burger, H, Buist-Bouwman, M (2008). Mental disorders and service use in the Netherlands. Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD). In The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders (ed. R. C. Kessler and T. Bedirhan Ustun), pp. 388–405. Cambridge University Press: Geneva, Switzerland. Google Scholar
De Graaf, R, ten Have, M, van Dorsselaer, S (2010). The Netherlands Mental Health Survey and Incidence study-2 (NEMESIS-2): design and methods. International Journal of Methods in Psychiatric Research 19, 125–141.CrossRefGoogle ScholarPubMed
Elzinga, BM, Spinhoven, P, Berretty, E, de Jong, P, Roelofs, K (2010). The role of childhood abuse in HPA-axis reactivity in social anxiety disorder: a pilot study. Biological Psychiatry 83, 1–6.CrossRefGoogle ScholarPubMed
Etain, B, Henry, R, Bellivier, F, Mathieu, F, Leboyer, M (2008). Beyond genetics: childhood affective trauma in bipolar disorder. Bipolar Disorders 10, 867–876.CrossRefGoogle ScholarPubMed
Fisher, H, McGuffin, P, Boydell, J, Fearon, P, Craig, TK, Dazzan, P, Morgan, K, Doody, GA, Jones, PB, Leff, J, Murray, RM, Morgan, C (2014). Interplay between childhood physical abuse and familial risk in the onset of psychotic disorders. Schizophrenia Bulletin. Published online: 7 January 2014. doi:10.1093/schbul/sbt201.CrossRefGoogle ScholarPubMed
Fisher, H, Morgan, C, Dazzan, P, Craig, TK, Morgan, K, Hutchinson, G, Jones, PB, Doody, GA, Pariante, C, McGuffin, P, Murray, RM, Leff, J, Fearon, P (2009). Gender differences in the association between childhood abuse and psychosis. British Journal of Psychiatry 194, 319–325.CrossRefGoogle ScholarPubMed
Fisher, HL, Craig, TK, Fearon, P, Morgan, K, Dazzan, P, Lappin, J, Hutchinson, G, Doody, GA, Jones, PB, McGuffin, P, Murray, RM, Leff, J, Morgan, C (2011). Reliability and comparability of psychosis patients’ retrospective reports of childhood abuse. Schizophrenia Bulletin 37, 546–553.CrossRefGoogle ScholarPubMed
Fusar-Poli, P, Yung, AR, McGorry, P, van Os, J (2014). Lessons learned from the psychosis high-risk state: towards a general staging model of prodromal intervention. Psychological Medicine 44, 17–24.CrossRefGoogle ScholarPubMed
Harley, M, Kelleher, I, Clarke, M, Lynch, F, Arseneault, L, Connor, D, Fitzpatrick, C, Cannon, M (2010). Cannabis use and childhood trauma interact additively to increase the risk of psychotic symptoms in adolescence. Psychological Medicine 40, 1627–1634.CrossRefGoogle ScholarPubMed
Heins, M, Simons, C, Lataster, T, Pfeifer, S, Versmissen, D, Lardinois, M, Marcelis, M, Delespaul, P, Krabbendam, L, van Os, J, Myin-Germeys, I (2011). Childhood trauma and psychosis: a case-control and case-sibling comparison across different levels of genetic liability, psychopathology, and type of trauma. American Journal of Psychiatry 168, 1286–1294.CrossRefGoogle ScholarPubMed
Helzer, JE, Robins, LN, McEvoy, LT, Spitznagel, EL, Stoltzman, RK, Farmer, A, Brockington, IF (1985). Physician reexamination of lay-interviewed cases in the general population. Archives of General Psychiatry 42, 657–666.CrossRefGoogle ScholarPubMed
Kapur, S, Phillips, AG, Insel, TR (2012). Why has it taken so long for biological psychiatry to develop clinical tests and what to do about it? Molecular Psychiatry 17, 1174–1179.CrossRefGoogle Scholar
Kay, SR, Fiszbein, A, Opler, LA (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–276.CrossRefGoogle ScholarPubMed
Korver, N, Quee, PJ, Boos, HB, Simons, C, de Haan, L (2012). Genetic Risk and Outcome of Psychosis (GROUP), a multi site longitudinal cohort study focused on gene-environment interaction: objectives, sample characteristics, recruitment and assessment methods. International Journal of Methods in Psychiatric Research 21, 205–221.CrossRefGoogle Scholar
Kuo, JR, Goldin, PR, Werner, K, Heimberg, RG, Gross, JJ (2011). Childhood trauma and current psychological functioning in adults with social anxiety disorder. Journal of Anxiety Disorders 25, 467–473.CrossRefGoogle ScholarPubMed
Matheson, SL, Shepherd, AM, Pinchbeck, RM, Laurens, KR, Carr, VJ (2012). Childhood adversity in schizophrenia: a systematic meta-analysis. Psychological Medicine 43, 225–238.CrossRefGoogle ScholarPubMed
Moore, THM, Zammit, S, Lingford-Hughes, A, Barnes, TRE, Jones, PB, Burke, M, Lewis, G (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 370, 319–328.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, van Os, J (2007). Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clinical Psychology Review 27, 409–424.CrossRefGoogle ScholarPubMed
Nanni, V, Uher, R, Danese, A (2012). Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis. American Journal of Psychiatry 169, 141–151.CrossRefGoogle ScholarPubMed
Read, J, Fosse, R, Moskowitz, A, Perry, B (2014). The traumagenic neurodevelopmental model of psychosis revisited. Neuropsychiatry 4, 65–79.CrossRefGoogle Scholar
Read, J, Hammersley, P, Rudegeair, T (2007). Why, when and how to ask about childhood abuse. Advances in Psychiatric Treatment 13, 101–110.CrossRefGoogle Scholar
Read, J, van Os, J, Morrison, AP, Ross, CA (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavia 112, 330–350.CrossRefGoogle ScholarPubMed
Smeets, F, Lataster, T, Dominguez, MG, Hommes, J, Lieb, R, Wittchen, HU, van Os, J (2012). Evidence that onset of psychosis in the population reflects early hallucinatory experiences that through environmental risks and affective dysregulation become complicated by delusions. Schizophrenia Bulletin 38, 531–542.CrossRefGoogle ScholarPubMed
Spitzer, RL, Williams, JB, Gibbon, M, First, MB (1992). The Structured Clinical Interview for DSM-III-R (SCID). I: history, rationale, and description. Archives of General Psychiatry 49, 624–629.CrossRefGoogle ScholarPubMed
Statacorp (2011). Stata Statistical Software: Release 12. StataCorp LP: College Station, TX.Google Scholar
Valiengo, LL, Soeiro-de-Souza, MG, Marques, AH, Moreno, DH, Juruena, MF, Andreazza, AC, Gattaz, WF, Machado-Vieira, R (2012). Plasma cortisol in first episode drug-naive mania: differential levels in euphoric verus irritable mood. Journal of Affective Disorders 138, 149–152.CrossRefGoogle Scholar
van Nierop, M, Lataster, T, Smeets, F, Gunther, N, van Zelst, C, de Graaf, R, ten Have, M, van Dorsselaer, S, Bak, M, Myin-Germeys, I, Viechtbauer, W, van Os, J, van Winkel, R (2014 a). Psychopathological mechanisms linking childhood traumatic experiences to risk of psychotic symptoms. Analysis of a large, representative population-based sample. Schizophrenia Bulletin 40, S123–S130.CrossRefGoogle ScholarPubMed
van Nierop, M, van Dam, D, Viechtbauer, W, Velthorst, E, van Winkel, R, GROUP Investigators (2014 b). Childhood abuse and neglect in relation to presence and persistence of psychotic and depressive symptomatology. Psychological Medicine (in press).Google Scholar
van Nierop, M, van Os, J, Gunther, N, van Zelst, C, de Graaf, R, ten Have, M, van Dorsselaer, S, Bak, M, Myin-Germeys, I, van Winkel, R (2014 c). Does Social Defeat mediate the association between childhood trauma and psychosis? Evidence from the Nemesis-2 study. Acta Psychiatrica Scandinavia 129, 467–476.CrossRefGoogle ScholarPubMed
van Os, J (2013). The dynamics of subthreshold psychopathology: implications for diagnosis and treatment. American Journal of Psychiatry 170, 695–698.CrossRefGoogle ScholarPubMed
van Winkel, R, Esquivel, G, Kenis, G, Wichers, M, Collip, D, Peerbooms, O, Rutten, BPF, Myin-Germeys, I, van Os, J (2010). Genome-wide findings in schizophrenia and the role of gene-environment interplay. CNS Neuroscience & Therapeutics 16, 5–e192.CrossRefGoogle ScholarPubMed
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, J, Van Os, J, Bentall, R (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661–671.CrossRefGoogle ScholarPubMed
Vreeburg, SA, Hoogendijk, WJG, van Pelt, J, DeRijk, RH, Verhagen, JCM, van Dyck, R, Smit, JH, Zitman, FG, Penninx, BWJH (2009). Major depressive disorder and hypothalamic-pituitary-adrenal axis activity. Results from a large cohort study. Archives of General Psychiatry 66, 617–626.CrossRefGoogle ScholarPubMed
Wigman, JTW, van Os, J, Thiery, E, Derom, C, Collip, D, Jacobs, N, Wichers, M (2013). Psychiatric diagnosis revisited: towards a system of staging and profiling combining nomothetic and idiographic parameters of momentary mental states. PLoS ONE 8, e59559.CrossRefGoogle ScholarPubMed
Wigman, JTW, Van Winkel, R, Ormel, J, Verhulst, FC, Van Os, J, Vollebergh, WAM (2012). Early trauma and familial risk in the development of the extended psychosis phenotype in adolescence. Acta Psychiatrica Scandinavia 126, 266–273.CrossRefGoogle ScholarPubMed
Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, Jablenski, A, Regier, D, Sartorius, N (1990). SCAN. Schedules for clinical assessment in neuropsychiatry. Archives of General Psychiatry 47, 589–593.CrossRefGoogle ScholarPubMed
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