Childhood trauma, antipsychotic medication, and symptom remission in first-episode psychosis
Ottesen, Akiah; Hegelstad, Wenche; Joa, Inge; Ilner, Stein E. Opjordsmoen; Rund, Bjørn Rishovd; Røssberg, Jan Ivar; Simonsen, Erik; Johannessen, Jan Olav; Larsen, Tor Ketil; Haahr, Ulrik H.; McGlashan, T.H.; Friis, Svein; Melle, Ingrid
Peer reviewed, Journal article
Published version
Permanent lenke
https://hdl.handle.net/11250/2832555Utgivelsesdato
2021-11Metadata
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Originalversjon
Ottesen, A., Hegelstad, W.T.V., Joa, I. et al. (2021) Childhood trauma, antipsychotic medication, and symptom remission in first-episode psychosis. Psychological Medicine, 1-10 10.1017/S003329172100427XSammendrag
Background
To what extent psychotic symptoms in first-episode psychosis (FEP) with a history of childhood interpersonal trauma (CIT) are less responsive to antipsychotic medication is not known. In this longitudinal study, we compare symptom trajectories and remission over the first 2 years of treatment in FEP with and without CIT and examine if differences are linked to the use of antipsychotics.
Methods
FEP (N = 191) were recruited from in- and outpatient services 1997–2000, and assessed at baseline, 3 months, 1 and 2 years. Inclusion criteria were 15–65 years, actively psychotic with a DSM-IV diagnosis of psychotic disorder and no previous adequate treatment for psychosis. Antipsychotic medication is reported as defined daily dosage (DDD). CIT (<18) was assessed with the Brief Betrayal Trauma Survey, and symptomatic remission based on scores from the Positive and Negative Syndrome Scale.
Results
CIT (n = 63, 33%) was not associated with symptomatic remission at 2 years follow-up (71% in remission, 14% in relapse), or time to first remission (CIT 12/ no-CIT 9 weeks, p = 0.51). Those with CIT had significantly more severe positive, depressive, and excited symptoms. FEP with physical (N = 39, 20%) or emotional abuse (N = 22, 14, 7%) had higher DDD at 1 year (p < 0.05). Mean DDD did not excerpt a significant between-group effect on symptom trajectories of positive symptoms.
Conclusion
Results indicate that antipsychotic medication is equally beneficial in the achievement of symptomatic remission in FEP after 2 years independent of CIT. Still, FEP patients with CIT had more severe positive, depressive, and excited symptoms throughout.