TY - JOUR
T1 - Association Between Childhood Adversity and Functional Outcomes in People With Psychosis
T2 - A Meta-analysis
AU - Christy, Angeline
AU - Cavero, Daniela
AU - Navajeeva, Sujeena
AU - Murray-O'Shea, Rachel
AU - Rodriguez, Victoria
AU - Aas, Monica
AU - Trotta, Giulia
AU - Moudiab, Socayna
AU - Garrido, Nathalia
AU - Zamora, Blanca
AU - Sideli, Lucia
AU - Wrobel, Anna L
AU - Salazar de Pablo, Gonzalo
AU - Alameda, Luis
N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: [email protected].
Funding Information:
Dr Gonzalo Salazar de Pablo is supported by the Alicia Koplowitz Foundation. Dr Gonzalo Salazar de Pablo has received honoraria from Janssen Cilag. Miss Anna L. Wrobel is supported by a Deakin University Centre of Research Excellence in Psychiatric Treatment Postgraduate Research Scholarship. Miss Anna L. Wrobel has received grant/research support from Deakin University and the Rotary Club of Geelong. Dr Monica Aas is supported by NARSAD Young Investigator Award [22388] and the MRC CDA.
Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved.
PY - 2023/3/15
Y1 - 2023/3/15
N2 - Background and Hypothesis: Despite the accepted link between childhood adversity (CA) and psychotic disorders, evidence on the relationship between CA and poor functional outcome remains less consistent and has never been reviewed quantitatively. The aim of this meta-analysis was to systematically examine the association between CA and functional outcomes in people with psychotic disorders. Study Design: The study protocol was registered on the International Prospective Register of Systematic Reviews (CRD42021254201). A search was conducted across EMBASE, MEDLINE, PsycINFO, and Cochrane Libraries (CENTRAL) using search terms related to psychosis; CA (general, sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect); and functional outcomes (social, occupational, and general functioning [GF]). We conducted random-effects models, sensitivity and heterogeneity analyses, meta-regressions, and we assessed quality. Study Results: Our meta-analysis comprised 35 studies, including 10 568 cases with psychosis. General CA was negatively associated with GF (28 studies; r = −0.109, 95%CI = −0.161 to −0.05, P < .001), with greater effects in prospective data (10 studies; r = −0.151, 95% CI = −0.236 to −0.063, P = .001). General CA was also associated with social functioning (r = −0.062, 95% CI = −0.120 to −0.004, P = .018) but not occupational outcomes. All CA subtypes except sexual abuse were significantly associated with GF, with emotional and physical neglect showing the largest magnitudes of effect (ranging from r = −0.199 to r = −0.250). Conclusions: This meta-analysis provides evidence for a negative association between general CA, specific subtypes, and general and social functional outcomes in people with psychosis.
AB - Background and Hypothesis: Despite the accepted link between childhood adversity (CA) and psychotic disorders, evidence on the relationship between CA and poor functional outcome remains less consistent and has never been reviewed quantitatively. The aim of this meta-analysis was to systematically examine the association between CA and functional outcomes in people with psychotic disorders. Study Design: The study protocol was registered on the International Prospective Register of Systematic Reviews (CRD42021254201). A search was conducted across EMBASE, MEDLINE, PsycINFO, and Cochrane Libraries (CENTRAL) using search terms related to psychosis; CA (general, sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect); and functional outcomes (social, occupational, and general functioning [GF]). We conducted random-effects models, sensitivity and heterogeneity analyses, meta-regressions, and we assessed quality. Study Results: Our meta-analysis comprised 35 studies, including 10 568 cases with psychosis. General CA was negatively associated with GF (28 studies; r = −0.109, 95%CI = −0.161 to −0.05, P < .001), with greater effects in prospective data (10 studies; r = −0.151, 95% CI = −0.236 to −0.063, P = .001). General CA was also associated with social functioning (r = −0.062, 95% CI = −0.120 to −0.004, P = .018) but not occupational outcomes. All CA subtypes except sexual abuse were significantly associated with GF, with emotional and physical neglect showing the largest magnitudes of effect (ranging from r = −0.199 to r = −0.250). Conclusions: This meta-analysis provides evidence for a negative association between general CA, specific subtypes, and general and social functional outcomes in people with psychosis.
KW - Humans
KW - Adverse Childhood Experiences
KW - Systematic Reviews as Topic
KW - Psychotic Disorders/epidemiology
KW - Emotions
KW - Social Adjustment
UR - http://www.scopus.com/inward/record.url?scp=85152943067&partnerID=8YFLogxK
U2 - 10.1093/schbul/sbac105
DO - 10.1093/schbul/sbac105
M3 - Article
C2 - 36107860
SN - 0586-7614
VL - 49
SP - 285
EP - 296
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
IS - 2
ER -