The relationship between childhood trauma and adult psychosis in a UK Early Intervention Service: results of a retrospective case note study
Authors Reeder FD, Husain N, Rhouma A, Haddad PM, Munshi T, Naeem F, Khachatryan D, Chaudhry IB
Received 19 October 2015
Accepted for publication 5 May 2016
Published 8 February 2017 Volume 2017:13 Pages 269—273
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Roger Pinder
Francesca D Reeder,1 Nusrat Husain,2 Abdul Rhouma,3 Peter M Haddad,2 Tariq Munshi,4 Farooq Naeem,4 Davit Khachatryan,4 Imran B Chaudhry2
1School of Medicine, 2Neurosciences and Psychiatry Unit, University of Manchester, Manchester, 3Early Intervention Service, Lancashire Care NHS Foundation Trust, Preston, UK; 4Queen’s University, Kingston, Ontario, Canada
Aim: There is evidence that childhood trauma is a risk factor for the development of psychosis and it is recommended that childhood trauma is inquired about in all patients presenting with psychosis. This study aimed to determine the prevalence of childhood trauma in patients in the UK Early Intervention Service based on a case note review.
Methods: This is a retrospective case note study of 296 patients in an UK Early Intervention Service. Trauma history obtained on service entry was reviewed and trauma experienced categorized. Results were analyzed using crosstab and frequency analysis.
Results: The mean age of the sample was 24 years, 70% were male, 66% were White, and 23% Asian (ethnicity not documented in 11% of the sample). Approximately 60% of patients reported childhood trauma, 21% reported no childhood trauma, and data were not recorded for the remaining 19%. Among those reporting trauma, the prevalence of most frequently reported traumas were: severe or repeated disruption (21%), parental mental illness (19%), bullying (18%), absence of a parent (13%), and ‘other’ trauma (24%) – the majority of which were victimization events. Sixty-six percent of those reporting trauma had experienced multiple forms of trauma.
Conclusion: A high prevalence of childhood trauma (particularly trauma related to the home environment or family unit) was reported. This is consistent with other studies reporting on trauma and psychosis. The main weakness of the study is a lack of a control group reporting experience of childhood trauma in those without psychosis. Guidelines recommend that all patients with psychosis are asked about childhood trauma; but in 19% of our sample there was no documentation that this had been done indicating the need for improvement in assessment.
Keywords: childhood trauma, psychosis, abuse, bullying, family