Relationship between childhood trauma and level of insight in schizophrenia: A path-analysis in the national FACE-SZ dataset

SCHIZOPHRENIA RESEARCH

卷:208

Article

Pignon, Baptiste^{1,12,21,25,26}  Lajnef, Mohamed^12,21  Godin, Ophelia¹²  Geoffray, Marie-Maud^12,6  Rey, Romain^12,6  Mallet, Jasmina^12,23  Dubertret, Caroline^12,23  Roux, Paul^12,15,16  Passerieux, Christine^12,15,16  Marulaz, Laurent^{1,12,21,25,26}  Brunel, Lore^{1,12,21,25,26}  Dubreucq, Julien^12,8  Leignier, Sylvain^12,8  Capdevielle, Delphine^12,18  Andre, Myrtille^12,18  Aouizerate, Bruno^12,7,19,24  Misdrahi, David^12,7,17,24  Berna, Fabrice^12,20  Vidailhet, Pierre^12,20  Chereau, Isabelle^12,22  Llorca, Pierre-Michel¹²  Fond, Guillaume^12,10  Lancon, Christophe^12,10  Leboyer, Marion^{1,12,21,25,26}  Schurhoff, Franck^{1,12,21,25,26}  Andrianarisoa, M. D.¹²  Aouizerate, B.^1,12,13,26  Berna, F.^2,12  Blanc, O.^3,12  Brunel, L.^4,12  Bulzacka, E.^4,12  Capdevielle, D.^5,12  Chereau-Boudet, I.^3,12  Chesnoy-Servanin, G.¹²  Danion, Jm^2,12  D'Amato, T.¹²  Deloge, A.^12,14  Delorme, C.¹²  Denizot, H.^3,12  Dorey, J. M.¹²  Dubertret, C.^9,12  Dubreucq, J.¹²  Faget, C.¹²  Fluttaz, C.¹²  Fond, G.^4,12  Fonteneau, S.^11,12  Gabayet, F.¹²  Giraud-Baro, E.¹²  Hardy-Bayle, M. C.^11,12  Lacelle, D.^3,12  Lancon, C.¹²  Laouamri, H.¹²  Leboyer, M.^4,12  Le Gloahec, T.^4,12  Le Strat, Y.^9,12  Llorca, P. M.^3,12  Mallet, J.^9,12  Metairie, E.¹²  Misdrahi, D.^12,14  Offerlin-Meyer, I.^2,12  Passerieux, C.¹²  Peri, P.¹²  Pires, S.^3,12  Portalier, C.^9,12  Rey, R.¹²  Roman, C.¹²  Sebilleau, M.¹²  Schandrin, A.^5,12  Schurhoff, F.^4,12  Tessier, A.^12,14  Tronche, Am^3,12  Urbach, M.¹²  Vaillant, F.¹²  Vehier, A.¹²  Vidailhet, P.^2,12  Vila, E.^12,14  Yazbek, H.^5,12  Zinetti-Bertschy, A.^2,12 

[1] Ctr Hosp Charles Pereas, F-33076 Bordeaux, France

[2] Univ Strasbourg, Hop Univ Strasbourg, INSERM, U1114,Federat Med Translat Strasbourg, Strasbourg, France

[3] Univ Auvergne, Fac Med, EA 7280, CHU,CMP B, BP 69, F-63003 Clermont Ferrand 1, France

[4] Univ Paris Est Creteil, Hop Univ H Mondor, AP HP,INSERM,U955, DHU Pe PSY,Pole Psychiat & Addictol,Eq 15 Psychia, Creteil, France

[5] Univ Montpellier I, Hop Colombiere, CHRU Montpellier, Serv Univ Psychiat Adulte,Inserm 1061, Montpellier, France

[6] Univ Claude Bernard Lyon 1, Ctr Hosp Vinatier Pole Est, BP 300 39-95 Bd Pinel, F-69678 Bron, France

[7] Ctr Hosp Charles Perrens, F-33076 Bordeaux, France

[8] CH Alpes Isere, Ctr Referent Rehabil Psychosociale, Grenoble, France

[9] Univ Paris Diderot, Sorbonne Paris Cite, Louis Mourier Hosp, AP HP,Dept Psychit,Colombes,Inserm U894,Fac Med, Paris, France

[10] AP HM, Pole Univ Psychiat, Marseille, France

[11] Univ Versailles St Quentin Yvelines, UFR Sci Sante Simone Veil, EA 4047 HANDIReSP, Serv Psychiat Adulte,Ctr Hosp Versailles, Versailles, France

[12] Fondat Fundamental, Creteil, France

[13] Univ Bordeaux, Laserm, Neuroctr Magendie, Physiopathol Plast Neuronale,U862, F-33000 Bordeaux, France

[14] Univ Bordeaux, CNRS, UMR 5287 INCIA, Bordeaux, France

[15] Ctr Hosp Versailles, Serv Univ Psychiat Adultes, 177 Rue Versailles, F-78157 Le Chesnay, France

[16] Univ Versailles St Quentin En Yvelines, UFR Sci Sante Simone Veil, EA4047, Lab HandiRESP, 2 Ave Source Bievre, F-78180 Montigny Le Bretonneux, France

[17] CNRS, UMR 5287, INCIA, Bordeaux, France

[18] Univ Montpellier I, CHRU Montpellier, Hop Colombiere, Serv Univ Psychiat Adulte,Inserm 1061, Montpellier, France

[19] INSERM, Neuroctr Magendie, Physiopathol Plast Neuronale, U862, F-33000 Bordeaux, France

[20] Univ Strasbourg, Hop Univ Strasbourg, INSERM U1114, Federat Med Trauslat Strasbourg, Strasbourg, France

[21] INSERM U955, Translat Psychiat Team, Creteil, France

[22] Univ Auvergne, Fac Med, CHU, CMP B,EA 7280, BP 69, Clermont Ferrand 1, France

[23] Univ Pans Diderot, Sorbonne Paris Cite, Louis Mourier Hosp, AP HP,Dept Psychit,Fac Med,Inserm U894, Colomhes, France

[24] Univ Bordeaux, Bordeaux, France

[25] Hop Univ H Mondor, Pole Psychiat, Creteil, France

[26] UPEC, AP HP, DHU Pe PSY, Creteil, France

关键词: Schizophrenia;    Childhood trauma;    Insight;    Negative symptoms;    Path-analysis;   

DOI  :  10.1016/j.schres.2019.04.006

来源: Elsevier

【 摘 要 】

Introduction: This study aimed was to investigate the relationship between different types of childhood trauma and the level of insight (i.e., awareness of having a psychiatric disorder) in subjects suffering from schizophrenia, as well as the putative role of clinical mediators. Methods: 294 community-dwelling subjects with stable schizophrenia were included into FACE-SZ, a multicentre cross-sectional study. All patients were assessed by specialized multidisciplinary teams. The level of insight was assessed by the Scale to assess Unawareness of Mental Disorder (SUMD), and childhood trauma by the Childhood Trauma Questionnaire (CTQ). Path analyses from the five CTQ subscales (physical abuse and neglect, emotional abuse and neglect, and sexual abuse) and the SUMD, with current symptomatology (i.e., positive, negative, global psychopathology and depression) as mediator, was performed. Results: Physical neglect (beta= 0.14) and abuse (beta=0.13) were significantly associated with poor insight. Negative symptoms were a clinical mediator of the relationship between physical neglect and poor insight. Moreover, positive (beta=0.21) and negative (beta=0.30) symptoms were associated with poor insight, whereas depression (beta=-0.14) was associated with higher levels of insight. Discussion: For the first time, this study shows a significant relationship between childhood trauma, specifically physical neglect and abuse, and poor insight. The level of insight was linked to different clinical dimensions. Among subjects with schizophrenia, these results provide support for a role of childhood trauma in poorer management outcomes, and the need to provide treatment, including psycho-education that better targets the consequences of childhood trauma. (C) 2019 Elsevier B.V. All rights reserved.

【 授权许可】

Free