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Psychological trauma as a transdiagnostic risk factor for mental disorder: an umbrella meta‐analysis

Published online by Cambridge University Press:  19 July 2023

B. M. Hogg ,
I. Gardoki-Souto ,
A. Valiente-Gómez ,
A. Ribeiro Rosa ,
L. Fortea ,
J. Radua ,
B. L. Amann  and
A. Moreno-Alcázar
B. M. Hogg*
Affiliation:
Hospital del Mar Medical Research Institute, Barcelona Department of Psychiatry and Legal Medicine, Universitat Autonòma de Barcelona, Bellaterra Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona Centro de Investigación Biomédica en Red de Salut Mental (CIBERSAM), Madrid
I. Gardoki-Souto
Affiliation:
Centre Fòrum
A. Valiente-Gómez
Affiliation:
Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona Centro de Investigación Biomédica en Red de Salut Mental (CIBERSAM), Madrid Hospital del Mar Research Institute, Barcelona, Spain
A. Ribeiro Rosa
Affiliation:
Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
L. Fortea
Affiliation:
Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Institute of Neurosciences, University of Barcelona, Barcelona, Spain
J. Radua
Affiliation:
Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Department of Psychosis Studies, King’s College London, London, United Kingdom Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
B. L. Amann
Affiliation:
Hospital del Mar Medical Research Institute, Barcelona Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona Universitat Pompeu Fabra, Barcelona, Spain Clinic for Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
A. Moreno-Alcázar
Affiliation:
Centre Fòrum Research Unit, Hospital del Mar Research Institute, Barcelona, Spain
*
*Corresponding author.

Abstract

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Introduction

This umbrella review is the frst to systematically examine psychological trauma as a transdiagnostic risk factor across psychiatric conditions.

Objectives

This review aimed to be the frst to evaluate whether psychological trauma fulflilled criteria as a transdiagnostic risk factor cutting across various diagnostic categories and spectra. Transdiagnosticity will be assessed against the framework of the TRANSD criteria (Fusar-Poli, World Psychiatry 2019; 18 361-362). The paper additionally aimed to analyse the association of psychopathology with specifc trauma type.

Methods

We searched Pubmed, Scopus, and PsycNET databases from inception until 01/05/2021 for systematic reviews/meta-analyses evaluating the association between psychological trauma and at least one diagnosed mental disorder. We re-calculated the odds ratio (OR), then classifed the association as convincing, highly suggestive, suggestive, or weak, based on the number of cases and controls with and without psychological trauma, random-efects p value, the 95% conf- dence interval of the largest study, heterogeneity between studies, 95% prediction interval, small-study efect, and excess significance bias. Additional outcomes were the association between specifc trauma types and specific mental disorders, and a sensitivity analysis for childhood trauma. Transdiagnosticity was assessed using TRANSD criteria. The review was pre-registered in Prospero CRD42020157308 and followed PRISMA/MOOSE guidelines.

Results

Fourteen reviews met inclusion criteria, comprising 16,277 cases and 77,586 controls. Psychological trauma met TRANSD criteria as a transdiagnostic factor across diferent diagnostic criteria and spectra. There was highly suggestive evidence of an association between psychological trauma at any time-point and any mental disorder (OR=2.92) and between childhood trauma and any mental disorder

(OR=2.90). Regarding specifc trauma types, convincing evidence linked physical abuse (OR=2.36) and highly suggestive evidence linked sexual abuse (OR=3.47) with a range of mental disorders, and convincing evidence linked emotional abuse to anxiety disorders (OR=3.05); there were no data for emotional abuse with other disorders.

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Conclusions

These fndings highlight the importance of preventing early traumatic events and providing trauma-informed care in early intervention and psychiatric services.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S982 - S983
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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