Association between Adverse Childhood Experiences and long-term outcomes in people at Clinical High-Risk for Psychosis

Adverse childhood experiences (ACEs) are common in people at clinical high-risk for psychosis (CHR), however, the relationship between ACEs and long-term clinical outcomes is still unclear. This study examined associations between ACEs and clinical outcomes in CHR individuals. 344 CHR individuals and 67 healthy controls (HC) were assessed using the Childhood Trauma Questionnaire (CTQ), the Bullying Questionnaire and the Childhood Experience of Care and Abuse (CECA). CHR were followed up for up to 5 years. Remission from the CHR state, transition to psychosis (both defined with the Comprehensive Assessment of an At Risk Mental State), and level of functioning (assessed with the Global Assessment of Functioning) were assessed. Stepwise and multilevel logistic regression models were used to investigate the relationship between ACEs and outcomes. ACEs were significantly more prevalent in CHR individuals than in HC. Within the CHR cohort, physical abuse was associated with a reduced likelihood of remission (OR = 3.64, p = 0.025). Separation from a parent was linked to an increased likelihood of both remission (OR = 0.32, p = 0.011) and higher level of functioning (OR = 1.77, p = 0.040). Death of a parent (OR = 1.87, p = 0.037) was associated with an increased risk of transitioning to psychosis. Physical abuse and death of a parent are related to adverse long-term outcomes in CHR. The counter-intuitive association between separation from a parent and outcomes may reflect the removal of a child from an adverse environment. Future studies should investigate whether interventions targeting the effect of specific ACEs might help to improve outcomes in this population.

Authors

Institutions

Publication Details

Journal
Schizophrenia
Published
2025-02-20
DOI
https://doi.org/10.1038/s41537-025-00562-9
Citations
5
Primary Topic
Child and Adolescent Psychosocial and Emotional Development
Type
article
Field-Weighted Citation Impact
11.53

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Association between Adverse Childhood Experiences and long-term outcomes in people at Clinical High-Risk for Psychosis

Manel Monsonet, Marie‐Odile Krebs, Stephan Ruhrmann, Dorte Nordholm et al.
5 citations
Schizophrenia
Child and Adolescent Psychosocial and Emotional Development
11.53
article

Association between Adverse Childhood Experiences and long-term outcomes in people at Clinical High-Risk for Psychosis

Manel Monsonet, Marie‐Odile Krebs, Stephan Ruhrmann, Dorte Nordholm, Gemma Modinos, Mathilde Kazès, Matthew J. Kempton, Christos Pantelis, Célia Mam-Lam-Fook, Tecelli Domínguez‐Martínez, Joachim Klosterkötter, Dominika Gebhard, Thomas R. Kwapil, Jim van Os, Mark van der Gaag, Julie Bourgin, Bart P. F. Rutten, Erich Studerus, Merete Nordentoft, Ryan Hammoud, Barnaby Nelson, Kristine Krakauer, Anja Richter, Maria Calem, Claire Daban, Lieuwe de Haan, Daniëlla S. van Dam, Anita Riecher‐Rössler, Lucia Valmaggia, Birte Yding Glenthoj, Clàudia Aymerich, Patrick D. McGorry, Elson Asevedo, Iñigo Gorostiza, Eva Velthorst, Ana Catalán, Joanne Goodall, Lasse Randers, Gabriele Sachs, Philippe Delespaul, Evangelos Vassos, Neus Barrantes‐Vidal, G. Paul Amminger, Athena Politis, Elisa Brietzke, Iris Lasser, Julia Arnhold, André Zugman, Nadine Burger, Stefan Borgwardt, Ary Gadelha, Bernadette Winklbaur, Olivier Gay, Rodrigo A. Bressan, Graccielle Asevedo, Stefania Tognin, Louise Birkedal Glenthøj, Lídia Hinojosa, Anna Racciopi, Tamar Kraan
article en
5 citations

Abstract

Adverse childhood experiences (ACEs) are common in people at clinical high-risk for psychosis (CHR), however, the relationship between ACEs and long-term clinical outcomes is still unclear. This study examined associations between ACEs and clinical outcomes in CHR individuals. 344 CHR individuals and 67 healthy controls (HC) were assessed using the Childhood Trauma Questionnaire (CTQ), the Bullying Questionnaire and the Childhood Experience of Care and Abuse (CECA). CHR were followed up for up to 5 years. Remission from the CHR state, transition to psychosis (both defined with the Comprehensive Assessment of an At Risk Mental State), and level of functioning (assessed with the Global Assessment of Functioning) were assessed. Stepwise and multilevel logistic regression models were used to investigate the relationship between ACEs and outcomes. ACEs were significantly more prevalent in CHR individuals than in HC. Within the CHR cohort, physical abuse was associated with a reduced likelihood of remission (OR = 3.64, p = 0.025). Separation from a parent was linked to an increased likelihood of both remission (OR = 0.32, p = 0.011) and higher level of functioning (OR = 1.77, p = 0.040). Death of a parent (OR = 1.87, p = 0.037) was associated with an increased risk of transitioning to psychosis. Physical abuse and death of a parent are related to adverse long-term outcomes in CHR. The counter-intuitive association between separation from a parent and outcomes may reflect the removal of a child from an adverse environment. Future studies should investigate whether interventions targeting the effect of specific ACEs might help to improve outcomes in this population.

SchizophreniaVol. 11(1)
Universitat Autònoma de Barcelona (ES), University of Copenhagen (DK), University of Illinois Urbana-Champaign (US), The University of Melbourne (AU), University of the Basque Country (ES), University of Cologne (DE), King's College London (GB), University of Basel (CH), Université Paris Cité (FR), Maastricht University Medical Centre (NL), Mental Health Services (DK), Instituto de Salud Carlos III (ES), Glostrup Hospital (DK), National Institute for Health and Care Research (GB), University of Oxford (GB), Parnassia Groep (NL), Centro de Investigación Biomédica en Red de Salud Mental (ES), Hospital de Basurto (ES), Departament de Salut (ES), Orygen (AU), Centre Hospitalier Sainte-Anne (FR), Mondriaan GGZ (NL), University Hospital Cologne (DE), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX), Melbourne Health (AU), Medical University of Vienna (AT), Universidade Federal de São Paulo (BR), Icahn School of Medicine at Mount Sinai (US)
Fundación Alicia Koplowitz, National Institute for Health and Care Research, Department of Health and Social Care, King's College London, Generalitat de Catalunya, Institució Catalana de Recerca i Estudis Avançats, NIHR Maudsley Biomedical Research Centre, Medical Research Council, National Health and Medical Research Council
Openalex Percentile: Top 2%
Child and Adolescent Psychosocial and Emotional Development
11.53
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.