Childhood adverse events and their association with psychotic symptoms and quality of life in young adults with first episode psychosis and unaffected siblings

Abstract

Childhood adverse events (CAEs) are an important social determinant of health (SDoH) associated with increased risk of adulthood psychosis. In people with psychotic disorders, CAEs have been associated with more severe symptoms and worse functioning. However, less is known about exposure to CAEs and its relationship to functioning in early psychosis and unaffected siblings, who are at a higher genetic and familial risk than the general population. We examined CAE and its relationship with functioning and symptoms in 70 people with early psychosis (EP), 19 unaffected siblings of people with psychosis (SB), and 85 healthy control participants (HC). CAE was measured using the Childhood Trauma Questionnaire. The EP group had more exposure to CAEs than SB and HC, while SB and HC did not differ from each other. Across all groups, exposure to more CAEs predicted worse adult quality of life after controlling for group, sex, and parental education. In people with early psychosis, exposure to more CAEs predicted more severe positive symptoms after controlling for sex, parental education, lifetime substance use, and specific diagnosis. Our findings suggest that CAEs are more common in people with psychosis than unaffected siblings and healthy controls, supporting an association between trauma exposure and psychotic experiences. Moreover, an association between CAEs and later life functioning across all groups speaks to the long-lasting impact of early life SDoH on wellbeing. Early identification and intervention of CAEs is therefore important to consider in the prevention of psychotic disorders, including for individuals at genetic risk of psychosis.