Age at the Time of Exposure to Trauma Modulates the Psychopathological Profile and the Level of Functioning in Early Psychosis Patients: A Prospective Study

Abstract

Introduction

Evidence suggests a relationship between exposure to trauma and higher levels of symptoms and poorer functional outcomes in early psychotic patients (EPP). However, the impact of the age at the time of exposure to trauma in this association is as yet unknown.

Objectives

To examine the potential differential impact of trauma, according to age at the time of exposure, on the level of functioning and on the psychopathological profile of EPP followed-up prospectively.

Methods

Two hundred and fifty-five EPP aged 18–35 were followed-up prospectively over 36 months. Patients who had faced at least one experience of abuse or neglect were classified according to age at the time of first exposure (early-trauma: before age 12; late-trauma: between age 12 and 16), and then compared with unexposed patients (non-trauma). The level of symptoms was assessed using the Positive and Negative Syndrome Scale. The Young Mania Rating Scale, and the Montgomery-Asberg Depression Rating Scale. The level of functioning was assessed with the global assessment of functioning.

Results

Comparisons over the 3 years of treatment with non-trauma patients revealed that:

– early-trauma patients showed consistently higher levels of positive (P = 0.006) depressive (P = 0.001), manic (P = 0.006) and negative (P = 0.029) symptoms and showed poorer functional level (P = 0.025);

– late-trauma patients only showed more negative symptoms (P = 0.029) as compared to non-trauma patients.

Conclusions

The age at the time of exposure to trauma has a modulating effect on its impact on symptoms and functional outcome in EPP and it should be systematically examined in clinical and experimental settings.

Disclosure of interest

The authors have not supplied their declaration of competing interest.