Stress load during childhood affects psychopathology in psychiatric patients

Katja Weber,Jens Borgelt,Klaus Hoffmann,Klaus Schonauer,Brigitte Rockstroh,Hans Watzl,Karl Pröpster,Tzvetan Popov,Barbara Awiszus

doi:10.1186/1471-244x-8-63

Abstract

BackgroundChildhood stress and trauma have been related to adult psychopathology in different psychiatric disorders. The present study aimed at verifying this relationship for stressful experiences during developmental periods by screening stress load across life in adult psychiatric inpatients with different diagnoses compared to healthy subjects. In addition, a relationship between the amount of adverse experiences and the severity of pathology, which has been described as a 'building block' effect in posttraumatic stress disorder (PTSD), was explored for non-traumatic events in psychiatric disorders other than PTSD.Methods96 patients with diagnoses of Major Depressive Disorder (MDD), schizophrenia, drug addiction, or personality disorders (PD) and 31 subjects without psychiatric diagnosis were screened for adverse experiences in childhood (before the age of six years), before onset of puberty, and in adulthood using the Early Trauma Inventory and the Posttraumatic Stress Diagnostic Scale. Effects of stress load on psychopathology were examined for affective symptoms, PTSD, and severity of illness by regression analyses and comparison of subgroups with high and low stress load.ResultsHigh stress load in childhood and before puberty, but not in adulthood, was related to negative affect in all participants. In patients, high stress load was related to depressive and posttraumatic symptoms, severity of disorder, and the diagnoses of MDD and PD.ConclusionResults support the hypothesis of stress-sensitive periods during development, which may interact with genetic and other vulnerability factors in their influence on the progress of psychiatric disorders. A 'dose' effect of stress load on the severity of psychopathology is not restricted to the relationship between traumata and PTSD.

Highlights

Childhood stress and trauma have been related to adult psychopathology in different psychiatric disorders
The present study explored whether a relationship between early life stress and adult psychopathology can be found irrespective of the specific disorder, whether a subgroup of individuals with high early life stress load can be described across diagnoses, or whether stress load and its relationship with psychopathology varies between diagnostic groups, which would point to a more complex interaction between vulnerability factors
Stress measures correlated with each other, suggesting accumulating or interacting effects of stress: In both groups, prenatal stress correlated with stress load across life periods, and in the patient group, traumatic experiences (PDS) correlated with stress load across life

Summary

Introduction

Childhood stress and trauma have been related to adult psychopathology in different psychiatric disorders. A burgeoning number of studies point to the influence of adverse or traumatic experiences during childhood on adult psychopathology [1,2,3,4,5,6,7]. Studies comparing childhood trauma effects between disorders [16,17] found disorder-specific relationships, and relationships between abuse and specific symptoms like hallucinations across diagnostic boundaries [37,38]. The present study explored whether a relationship between early life stress and adult psychopathology can be found irrespective of the specific disorder, whether a subgroup of individuals with high early life stress load can be described across diagnoses, or whether stress load and its relationship with psychopathology varies between diagnostic groups, which would point to a more complex interaction between vulnerability factors

Methods

Results

Discussion

Conclusion