Abstract
Childhood trauma is a recognised risk factor for schizophrenia. It has been proposed that childhood trauma interferes with normal neurodevelopment, thereby establishing a biological vulnerability to schizophrenia. Poor premorbid adjustment is frequently a precursor to schizophrenia, and may be a manifestation of neurodevelopmental compromise. We investigated the relationship between childhood trauma and premorbid adjustment in 77 patients with first-episode schizophrenia spectrum disorders. We also investigated possible mediating roles for other selected risk factors in the relationship. We found several significant correlations between different trauma types and both social and academic premorbid adjustment from childhood to late adolescence. There were no significant moderating effects for family history of schizophrenia or family history of psychiatric disorder. History of obstetric complications, substance abuse and poor motor coordination weakened some of the associations between childhood trauma and premorbid adjustment, while poor sequencing of motor acts strengthened the association. Our results confirm previous studies indicating an association between childhood trauma and premorbid adjustment. Results indicate a general rather than specific association, apparent with different types of trauma, and affecting both social and academic components of premorbid adjustment across childhood, early and late adolescence. Further, our results suggest a complex interplay of various risk factors, supporting the notion of different pathways to psychosis.
Highlights
Schizophrenia is widely regarded as a neurodevelopmental disorder, with genetic and environmental risk factors interacting to contribute to altered brain development and later manifestation of the illness [1]
In this study we investigated the relationship between childhood trauma and premorbid adjustment in patients diagnosed with a first episode of schizophrenia-spectrum disorders
Our results confirm previous studies indicating an association between childhood trauma and premorbid adjustment, and suggest that this association is apparent for different types of trauma, and for both social and academic components of premorbid adjustment across childhood, early and late adolescence
Summary
Schizophrenia is widely regarded as a neurodevelopmental disorder, with genetic and environmental risk factors interacting to contribute to altered brain development and later manifestation of the illness [1]. Premorbid adjustment (i.e. an individual’s functioning across social and academic domains from childhood through to early adulthood prior to the onset of psychosis) has long been a focus of interest in schizophrenia research [2]. Childhood Trauma and Premorbid Adjustment in First-Episode Schizophrenia. Technology of South Africa, the Medical Research Council of South Africa and an unrestricted grant from Lundbeck International
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