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T130. ASSOCIATIONS BETWEEN DIFFERENT TYPES OF CHILDHOOD ADVERSITY AND 5-YEAR OUTCOMES IN FIRST-EPISODE PSYCHOSIS PATIENTS

BACKGROUND: Little is known about the impact of different forms of childhood adversity (CA) on outcomes in first episode psychosis (FEP) patients beyond the first year of treatment. We investigated associations between different types of CA and 5-year outcomes in a well-characterised sample of FEP p...

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Autores principales: Ajnakina, Olesya, Trotta, Antonella, Di Forti, Marta, Stilo, Simona, Kolliakou, Anna, Gardner-Sood, Poonam, Lopez-Morinigo, Javier-David, Gaughran, Fiona, David, Anthony, Dazzan, Paola, Pariante, Carmine, Mondelli, Valeria, Murray, Robin, Fisher, Helen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5888107/
http://dx.doi.org/10.1093/schbul/sby016.406
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author Ajnakina, Olesya
Trotta, Antonella
Di Forti, Marta
Stilo, Simona
Kolliakou, Anna
Gardner-Sood, Poonam
Lopez-Morinigo, Javier-David
Gaughran, Fiona
David, Anthony
Dazzan, Paola
Pariante, Carmine
Mondelli, Valeria
Murray, Robin
Fisher, Helen
author_facet Ajnakina, Olesya
Trotta, Antonella
Di Forti, Marta
Stilo, Simona
Kolliakou, Anna
Gardner-Sood, Poonam
Lopez-Morinigo, Javier-David
Gaughran, Fiona
David, Anthony
Dazzan, Paola
Pariante, Carmine
Mondelli, Valeria
Murray, Robin
Fisher, Helen
author_sort Ajnakina, Olesya
collection PubMed
description BACKGROUND: Little is known about the impact of different forms of childhood adversity (CA) on outcomes in first episode psychosis (FEP) patients beyond the first year of treatment. We investigated associations between different types of CA and 5-year outcomes in a well-characterised sample of FEP patients. METHODS: A total of 237 FEP cases aged 18–65 years were followed on average for 5 years after first presentation to psychiatric services in South-London, UK. CA was assessed at service entry using the Childhood Experience of Care and Abuse Questionnaire. Using electronic clinical notes, extensive information was collected on clinical and social outcomes, service use, and self-injurious behaviours. As case analysis with missing data provides the most severely biased results we conducted multiple imputations to handle the missing data. We imputed the missing values using multiple imputations by chained equations (MICE). MICE has been shown to be a robust method for dealing with missing data across empirical and longitudinal studies. RESULTS: 72.1% of the sample reported at least one form of CA. Childhood parental separation was associated with greater likelihood of non-compliance with antipsychotic medications (OR=2.44, 95% CI=1.11–5.39), compulsory admission (OR=2.40, 95% CI=1.32–4.37), and living alone (OR=1.99, 95% CI=1.04–3.81) by the end of the follow-up. Institutional care was associated with longer total length of inpatient stay (IRR=1.34, 95% CI=1.01–1.79); parental death was associated with compulsory admissions (OR=2.87, 95% CI=1.02–8.05) during the follow-up. DISCUSSION: Our findings suggest some specificity in the detrimental impact of CA on service use and social functioning over a 5-year period following first contact with mental health services for psychosis. Clinicians should screen patients for CA and tailor interventions accordingly to improve outcomes.
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spelling pubmed-58881072018-04-11 T130. ASSOCIATIONS BETWEEN DIFFERENT TYPES OF CHILDHOOD ADVERSITY AND 5-YEAR OUTCOMES IN FIRST-EPISODE PSYCHOSIS PATIENTS Ajnakina, Olesya Trotta, Antonella Di Forti, Marta Stilo, Simona Kolliakou, Anna Gardner-Sood, Poonam Lopez-Morinigo, Javier-David Gaughran, Fiona David, Anthony Dazzan, Paola Pariante, Carmine Mondelli, Valeria Murray, Robin Fisher, Helen Schizophr Bull Abstracts BACKGROUND: Little is known about the impact of different forms of childhood adversity (CA) on outcomes in first episode psychosis (FEP) patients beyond the first year of treatment. We investigated associations between different types of CA and 5-year outcomes in a well-characterised sample of FEP patients. METHODS: A total of 237 FEP cases aged 18–65 years were followed on average for 5 years after first presentation to psychiatric services in South-London, UK. CA was assessed at service entry using the Childhood Experience of Care and Abuse Questionnaire. Using electronic clinical notes, extensive information was collected on clinical and social outcomes, service use, and self-injurious behaviours. As case analysis with missing data provides the most severely biased results we conducted multiple imputations to handle the missing data. We imputed the missing values using multiple imputations by chained equations (MICE). MICE has been shown to be a robust method for dealing with missing data across empirical and longitudinal studies. RESULTS: 72.1% of the sample reported at least one form of CA. Childhood parental separation was associated with greater likelihood of non-compliance with antipsychotic medications (OR=2.44, 95% CI=1.11–5.39), compulsory admission (OR=2.40, 95% CI=1.32–4.37), and living alone (OR=1.99, 95% CI=1.04–3.81) by the end of the follow-up. Institutional care was associated with longer total length of inpatient stay (IRR=1.34, 95% CI=1.01–1.79); parental death was associated with compulsory admissions (OR=2.87, 95% CI=1.02–8.05) during the follow-up. DISCUSSION: Our findings suggest some specificity in the detrimental impact of CA on service use and social functioning over a 5-year period following first contact with mental health services for psychosis. Clinicians should screen patients for CA and tailor interventions accordingly to improve outcomes. Oxford University Press 2018-04 2018-04-01 /pmc/articles/PMC5888107/ http://dx.doi.org/10.1093/schbul/sby016.406 Text en © Maryland Psychiatric Research Center 2018. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Ajnakina, Olesya
Trotta, Antonella
Di Forti, Marta
Stilo, Simona
Kolliakou, Anna
Gardner-Sood, Poonam
Lopez-Morinigo, Javier-David
Gaughran, Fiona
David, Anthony
Dazzan, Paola
Pariante, Carmine
Mondelli, Valeria
Murray, Robin
Fisher, Helen
T130. ASSOCIATIONS BETWEEN DIFFERENT TYPES OF CHILDHOOD ADVERSITY AND 5-YEAR OUTCOMES IN FIRST-EPISODE PSYCHOSIS PATIENTS
title T130. ASSOCIATIONS BETWEEN DIFFERENT TYPES OF CHILDHOOD ADVERSITY AND 5-YEAR OUTCOMES IN FIRST-EPISODE PSYCHOSIS PATIENTS
title_full T130. ASSOCIATIONS BETWEEN DIFFERENT TYPES OF CHILDHOOD ADVERSITY AND 5-YEAR OUTCOMES IN FIRST-EPISODE PSYCHOSIS PATIENTS
title_fullStr T130. ASSOCIATIONS BETWEEN DIFFERENT TYPES OF CHILDHOOD ADVERSITY AND 5-YEAR OUTCOMES IN FIRST-EPISODE PSYCHOSIS PATIENTS
title_full_unstemmed T130. ASSOCIATIONS BETWEEN DIFFERENT TYPES OF CHILDHOOD ADVERSITY AND 5-YEAR OUTCOMES IN FIRST-EPISODE PSYCHOSIS PATIENTS
title_short T130. ASSOCIATIONS BETWEEN DIFFERENT TYPES OF CHILDHOOD ADVERSITY AND 5-YEAR OUTCOMES IN FIRST-EPISODE PSYCHOSIS PATIENTS
title_sort t130. associations between different types of childhood adversity and 5-year outcomes in first-episode psychosis patients
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5888107/
http://dx.doi.org/10.1093/schbul/sby016.406
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