The history of multiple adverse childhood experiences in patients with schizophrenia is associated with more severe symptomatology and suicidal behavior with gender-specific characteristics

Psychiatry Res. 2020 Nov:293:113411. doi: 10.1016/j.psychres.2020.113411. Epub 2020 Aug 18.

Abstract

The current study aims to compare the prevalence of adverse childhood experiences (ACEs) between patients with schizophrenia and non-psychiatric control group, and to analyze the association of having suffered multiple ACEs with clinical symptoms of schizophrenia and suicidal behavior. A multicenter, cross-sectional study was conducted across three facilities in Buenos Aires, Argentina. One-hundred patients with schizophrenia and 50 healthy subjects were assessed with the Adverse Childhood Experiences questionnaire (ACE-Q), the Positive and Negative Syndrome Scale (PANSS), and the Columbia-Suicide Severity Rating Scale (C-SSRS). We observed that the prevalence of at least one ACE in schizophrenic patients was almost double in comparison with the non-psychiatric control group. Multiple ACEs were associated with persistent auditory hallucinations and lower negative symptoms in both sexes. Higher frequency of death ideation and a higher number of suicide attempts were reported among women. The strength of this study is the possibility of comparing the presence of ACEs between schizophrenic patients and non-psychiatric control using the same questionnaire in an under-reported sample of low socio-economic patients assisted in public hospitals. A limitation is that the history of ACEs relied on the retrospective assessment of childhood experiences, and adults could over-report ACEs because of recall bias.

Keywords: Adverse childhood experiences; Adverse childhood experiences questionnaire; Hallucinations; Schizophrenia; Suicidal behavior.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Adverse Childhood Experiences / psychology*
  • Adverse Childhood Experiences / trends
  • Argentina / epidemiology
  • Child
  • Child Abuse / psychology
  • Child Abuse / trends
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Schizophrenia / diagnosis*
  • Schizophrenia / epidemiology
  • Schizophrenic Psychology*
  • Sex Factors
  • Suicidal Ideation*
  • Suicide, Attempted / psychology*
  • Surveys and Questionnaires
  • Young Adult