Childhood adversity predicts psychosis onset

Children who have been exposed to early adversities are at increased odds of developing psychosis, suggests a study. 

This meta-analysis utilized the databases of PubMed, Embase, PsycINFO, Web of Science, Wanfang, and CNKI. The investigators searched for case-control, cross-sectional, and cohort studies examining the association between adversity and psychotic symptoms/illness. Prediction intervals calculation and sensitivity analyses were also performed. 

The study included a pooled total of 349,265 patients from 119 case-control studies (15,186 cases and 14,879 controls), 51 cross-sectional studies (n=299,659), and 13 cohort studies (n=19,541). 

Adversity was found to be significantly associated with psychosis across all study designs (overall odds ratio [OR], 2.80, 95 percent confidence interval [CI], 2.18–3.60). 

In secondary analyses, exposure to each adversity subtype resulted in a higher likelihood of psychosis, with the highest odds for emotional abuse (OR, 3.54, 95 percent CI, 3.04–4.13) and the lowest odds for parental antipathy (OR, 1.58, 95 percent CI, 1.48–1.68). No significant differences by sex were noted, but the odds for sexual abuse was greater for women. 

Additionally, an earlier psychosis onset was observed in adversity-exposed individuals (mean difference, –0.70 years, 95 percent CI, –1.47 to –0.12). 

"The results have broad clinical implications, as they highlight the need for selective prevention of exposure to early adversities and the implementation of trauma-informed therapies in the treatment of psychosis,” the investigators said.