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Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness

Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, Maastricht University, The Netherlands

ROSELIND LIEB, PhD

Clinical Psychology and Epidemiology Unit, Max Planck Institute of Psychiatry, Munich, Germany

HANS-ULRICH WITTCHEN, PhD

Clinical Psychology and Epidemiology Unit, Max Planck Institute of Psychiatry, Munich, and Institute of Clinical Psychology and Psychotherapy, Technical University, Dresden, Germany

JIM VAN OS, MD, PhD, MRCPsych

Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, Maastricht University, The Netherlands and Division of Psychological Medicine, Institute of Psychiatry, London, UK

Correspondence: Professor Jim van Os, Department of Psychiatry and Neuropsychology, Maastricht University, PO Box 616 (DRT 10), 6200 MD Maastricht, The Netherlands. Tel: +31 43 3875443; fax: +31 43 3875444; e-mail: j.vanos{at}sp.unimaas.nl

Declaration of interest None.

Background The reported link between psychological trauma and onset of psychosis remains controversial.

Aims To examine associations between self-reported psychological trauma and psychotic symptoms as a function of prior evidence of vulnerability to psychosis (psychosis proneness).

Method At baseline, 2524 adolescents aged 14–24 years provided self-reports on psychological trauma and psychosis proneness, and at follow-up (on average 42 months later) participants were interviewed for presence of psychotic symptoms.

Results Self-reported trauma was associated with psychotic symptoms, in particular at more severe levels (adjusted OR 1.89, 95% CI1.16–3.08) and following trauma associated with intense fear, helplessness or horror. The risk difference between those with and without self-reported trauma at baseline was 7% in the group with baseline psychosis proneness, but only 1.8% in those without (adjusted test for difference between these two effect sizes: ²=4.6, P=0.032).

Conclusions Exposure to psychological trauma may increase the risk of psychotic symptoms in people vulnerable to psychosis.

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