The overall impression created by the review of Read et al12 is that there is a wealth of evidence suggestive of a causal relationship between childhood trauma and psychosis. COVID-19 is an emerging, rapidly evolving situation. This makes it difficult to directly compare these studies and indeed may explain some of the variability in the findings. Presence or absence, and frequency of events rated. [Epidemiology of schizophrenic disorders, genetic and environmental risk factors]. Instruments have been developed and used in the study of other disorders (eg, depression), which employ a number of strategies to overcome the potential problem of recall bias (eg, use of life history calendar, use of multiple sources of information, assurances of confidentiality).3 However, this issue has not been addressed in the major studies of childhood trauma and psychosis to date and the use of relatively crude measures of traumatic experiences, as was the case in the studies discussed above, increases the risk of systematic information bias. The data reviewed clearly demonstrates that environmental factors have an influence on the risk of developing schizophrenia. In terms of understanding the relationship between childhood trauma and psychosis, however, these estimates are misleading. A small number of recent population-based studies provide more robust evidence of an association, and there are now plausible biological mechanisms linking childhood trauma and psychosis. International Journal of Mental Health: Vol. evidence suggests that certain environmental factors, such as a viral infection, extensive exposure to toxins like marijuana, or highly stressful situations, may trigger schizophrenia in people who ha In another recent large population-based study (n = 17 337), Whitfield et al20 found that respondents reporting a history of hallucinations were more likely to have been both physically (Adj. Records from Victorian Institute of Forensic Medicine of medical examinations confirming sexual abuse. | For example, Read et al12 produce weighted averages for females and males of reported child sexual abuse (48% females, 28% males), incest (29% females, 7% males), and child physical abuse (48% females, 50% males) from 51 studies of psychiatric inpatients and of outpatients when half or more were diagnosed with a psychotic illness. 2017 Jan 1;117(1):436-444. doi: 10.1152/jn.00481.2016. A 2-stage approach was adopted to assess presence of psychotic disorder: (1) Psychosis Screening Questionnaire. With the exception of cannabis, no direct link can yet be established. Epilepsy-Work-Up and Management in Children. A recent survey in the United Kingdom estimated the prevalence of childhood sexual abuse at around 11% and physical abuse at around 24%.1 In the United States, estimates tend to be higher.2 The adverse long-term consequences of childhood sexual and physical abuse have been well documented and include increased risk of adult depression,3 personality disorders,4,5 suicide,6,7 posttraumatic stress disorder (PTSD),8 and drug and alcohol dependence.9 It is possible, moreover, that specific forms of abuse are linked to particular disorders. The term childhood trauma has been used to capture a range of severe adverse experiences, including sexual, physical, and emotional abuse, and neglect. The implications of this for clinical practice require careful consideration. However, the samples used in these studies were invariably small, highly selected and heterogeneous, and the definitions and measures of abuse varied widely. OR, 17 337 subjects (mean age 57) recruited to the Adverse Childhood Experiences study, Self-report postal questionnaire comprising questions from other scales and studies. Front Synaptic Neurosci. It may be, as Read et al12 suggest, that Kapur's31 notion of “psychosis-in-schizophrenia” is relevant here. However, the number of subjects with psychotic symptoms was very small, particularly those with the most severe symptoms (n = 7), meaning the confidence intervals for each odds ratio were very wide, and while there was evidence that the risk of developing psychosis increased in a dose-response fashion with increasing severity of abuse, no formal test for trend across levels of abuse severity was reported. Remote Ecological Momentary Testing of Learning and Memory in Adults With Serious Mental Illness, Predictive Performance of Exposome Score for Schizophrenia in the General Population, Exploring the Development, Validity, and Utility of the Short-Form Version of the CHoice of Outcome In Cbt for PsychosEs: A Patient-Reported Outcome Measure of Psychological Recovery, Understanding Language Abnormalities and Associated Clinical Markers in Psychosis: The Promise of Computational Methods, Associations Between Maternal Prenatal C-Reactive Protein and Risk Factors for Psychosis in Adolescent Offspring: Findings From the Northern Finland Birth Cohort 1986, About the University of Maryland School of Medicine, About the Maryland Psychiatric Research Center, The Prevalence of Childhood Trauma in Clinical Populations, Receive exclusive offers and updates from Oxford Academic, Cumulative Traumas and Psychosis: an Analysis of the National Comorbidity Survey and the British Psychiatric Morbidity Survey, Impact of Interpersonal Trauma on the Social Functioning of Adults With First-Episode Psychosis, Pretreatment and Outcome Correlates of Sexual and Physical Trauma in an Epidemiological Cohort of First-Episode Psychosis Patients. Childhood Trauma Among Inpatients and Outpatients With a Psychotic Disorder. Please enable it to take advantage of the complete set of features! The current state of knowledge does not allow us to determine the mechanisms by which these factors may act. Epub 2016 Nov 2. 5 Howick Place | London | SW1P 1WG. Discussion: The findings from such studies, however, have not been wholly consistent, and a number of methodological limitations mean we should be cautious in overinterpreting these.