PMID- 27884931 OWN - NLM STAT- MEDLINE DCOM- 20180528 LR - 20191210 IS - 1745-1701 (Electronic) IS - 0586-7614 (Print) IS - 0586-7614 (Linking) VI - 43 IP - 5 DP - 2017 Sep 1 TI - Mild Depressive Symptoms Mediate the Impact of Childhood Trauma on Long-Term Functional Outcome in Early Psychosis Patients. PG - 1027-1035 LID - 10.1093/schbul/sbw163 [doi] AB - INTRODUCTION: The mechanism linking childhood trauma (CT) to the functional deficits observed in early psychosis (EP) patients is as yet unknown. We aim to examine the potential mediating effect of depressive symptoms in this well-established association. METHODS: Two hundred nine EP subjects aged 18-35 were assessed for functioning and psychopathology after 2, 6, 12, 18, 24, 30, and 36 months of treatment. Patients were classified into early trauma if they had faced at least one experience of abuse (physical, sexual, or emotional) or neglect (physical or emotional) before age 12, and late trauma if the exposure had occurred between ages 12 and 16. Diagnosis was based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). Psychopathology was assessed with the Positive and Negative Syndrome Scale and the Montgomery-Asberg Depression Rating Scale. Functioning was measured with the Global Assessment of Functioning (GAF) and the Social and Occupational Functioning Assessment Scale (SOFAS). Mediation analyses were performed in order to study whether the relationship between CT and functioning was mediated by depressive symptoms. RESULTS: When compared with nonexposed patients, early but not late trauma patients showed lower levels of GAF and SOFAS scores over all the time points, excepting after the first assessment. After 30 and 36 months, the effect of early trauma on functioning was completely mediated by depressive symptoms. No mediating effect of positive or negative symptoms was highlighted at those time points. CONCLUSION: Mild depressive symptoms mediated the impact of early trauma on long-term functional outcome. Intensifying pharmacologic and/or psychotherapeutic treatment, focused on the depressive dimension, may help traumatized EP patients to improve their functioning. CI - (c) The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com FAU - Alameda, Luis AU - Alameda L AD - Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland. AD - Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland. AD - Psychiatric Liaison Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland. FAU - Golay, Philippe AU - Golay P AD - Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland. FAU - Baumann, Philipp S AU - Baumann PS AD - Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland. AD - Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland. FAU - Progin, Pierre AU - Progin P AD - Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland. AD - Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland. FAU - Mebdouhi, Nadir AU - Mebdouhi N AD - Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland. FAU - Elowe, Julien AU - Elowe J AD - Mobile Psychiatry Unit, Department of Psychiatry, Prangins Psychiatric Hospital (CHUV), Prangins, Switzerland. FAU - Ferrari, Carina AU - Ferrari C AD - Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland. FAU - Do, Kim Q AU - Do KQ AD - Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland. AD - Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland. FAU - Conus, Philippe AU - Conus P AD - Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV), Lausanne, Switzerland. LA - eng PT - Journal Article PL - United States TA - Schizophr Bull JT - Schizophrenia bulletin JID - 0236760 SB - IM MH - Adolescent MH - Adult MH - Adult Survivors of Child Adverse Events/*statistics & numerical data MH - Age Factors MH - Comorbidity MH - *Depression/epidemiology/physiopathology/therapy MH - Female MH - Follow-Up Studies MH - Humans MH - Male MH - *Outcome Assessment, Health Care MH - *Psychotic Disorders/epidemiology/physiopathology/therapy MH - Young Adult PMC - PMC5581905 OTO - NOTNLM OT - childhood trauma OT - depression OT - first episode psychosis OT - functional outcome OT - mediation OT - prospective OT - psychopathology EDAT- 2016/11/26 06:00 MHDA- 2018/05/29 06:00 PMCR- 2018/09/01 CRDT- 2016/11/26 06:00 PHST- 2016/11/26 06:00 [pubmed] PHST- 2018/05/29 06:00 [medline] PHST- 2016/11/26 06:00 [entrez] PHST- 2018/09/01 00:00 [pmc-release] AID - sbw163 [pii] AID - 10.1093/schbul/sbw163 [doi] PST - ppublish SO - Schizophr Bull. 2017 Sep 1;43(5):1027-1035. doi: 10.1093/schbul/sbw163.