Influence of childhood trauma on diagnosis and substance use in first-episode psychosis.

Abstract

<b>Background</b>Childhood trauma has been significantly associated with first-episode psychosis, affective dysfunction and substance use.<b>Aims</b>To test whether people with first-episode psychosis who had experienced childhood trauma, when compared with those who had not, showed a higher rate of affective psychosis and an increased lifetime rate of substance use.<b>Method</b>The sample comprised 345 participants with first-episode psychosis (58% male, mean age 29.8 years, s.d. = 9.7).<b>Results</b>Severe sexual abuse was significantly associated with a diagnosis of affective psychosis (χ² = 4.9, <i>P</i> = 0.04) and with higher rates of lifetime use of cannabis (68% <i>v</i> 41%; <i>P</i> = 0.02) and heroin (20% <i>v</i> 5%; <i>P</i> = 0.02). Severe physical abuse was associated with increased lifetime use of heroin (15% <i>v</i> 5%; <i>P</i> = 0.03) and cocaine (32% <i>v</i> 17%; <i>P</i> = 0.05).<b>Conclusions</b>Patients with first-episode psychosis exposed to childhood trauma appear to constitute a distinctive subgroup in terms of diagnosis and lifetime substance use.