Avaliação da influência de vivências traumáticas na infância e adolescência sobre o primeiro surto psicótico, a funcionalidade e a cognição de pacientes com esquizofrenia

Abstract

Introduction: Schizophrenia is a complex psychiatric disorder, difficult to conceptualize and which causes are still unknown. Several hypotheses involving higher risk and vulnerability factors have been proposed, such as Childhood Trauma as a possible factor involved in the severity of the symptoms and the prognosis of these patients. Objective: To evaluate the correlations between the occurrence of Childhood Trauma in general and also its subtypes, and the known factors that have a prognostic impact in Schizophrenia, such as the age in which the first psychotic episode occured, global functionality and cognitive performance. Methods: 105 patients diagnosed with Schizophrenia according to DSM 5 criteria and those in psychiatric treatment were evaluated using the ILSS-BR / P (for functionality), SCoRS-BR (for cognitive testing) and CTQ (General Childhood Trauma, Emotional Neglect, Physical Neglect, Physical Abuse, Emotional Abuse, and Sexual Abuse). The inclusion of patients and the control of possible variables were conducted through MINI-Plus, PANSS, socio-demographic data, clinical history and treatment. The statistical analysis was performed using the Spearman Correlation Coefficient and Mann-Whitney Test and by multivariate linear regression analysis. Results: The occurrence of Childhood Trauma, in general, showed a significant and inverse correlation with the overall functioning and a significant and direct correlation with the cognitive impairment. Emotional Abuse showed a significant and inverse correlation with the age of onset of symptoms and it showed significant and direct correlation with the cognitive impairment. Emotional Neglect showed a significant and inverse correlation with the overall functioning. Sexual Abuse, Physical Abuse and Physical Neglect showed a significant and direct correlation with the cognitive impairment of patients with Schizophrenia. Conclusion: Childhood Trauma are related to a more severe Schizophrenia prognosis, with impact on the early onset of symptoms, overall functioning and cognition. Childhood Trauma subtypes may be associated with different prognostic risks.