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Rumination mediates the relationship between childhood trauma and depressive symptoms in schizophrenia patients

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Abstract

Rumination and childhood trauma are related to depressive symptoms in clinical and non-clinical individuals. This is the first study aimed to test the mediating effect of rumination on the relationship between childhood trauma and depressive symptoms in schizophrenia patients. A total of 313 schizophrenia patients were recruited in the present study. The 17-item Hamilton Depression Rating Scale (HAMD-17) was adopted to evaluate depressive symptoms, the short-form Childhood Trauma Questionnaire (CTQ-SF) and the 10-item Ruminative response scale (RRS-10) were utilized to assess the childhood trauma and rumination in patients, respectively. Our results showed that 168 schizophrenia patients (53.67%) had comorbid depressive symptoms. These patients with depressive symptoms had higher levels of childhood trauma [both CTQ-SF total scores and emotional abuse (EA), emotional neglect (EN), physical neglect (PN) subscale scores] and rumination (both RRS-10 total scores and brooding, reflection subscale scores) compared to patients without depressive symptoms. The stepwise logistic regression analysis identified that EN (OR 1.196, P = 0.003), PN (OR 1.1294, P < 0.001), brooding (OR 1.291, P < 0.001) and reflection (OR 1.481, P < 0.001) could independently predict the depressive symptoms in schizophrenia patients. Moreover, RRS-10 and its subscale scores could mediate the relationship between depressive symptoms and childhood trauma, especially EA, EN and PN in schizophrenia. Our preliminary findings suggest that the rigorous assessment and psychosocial interventions of rumination are important to alleviate the influence of childhood trauma on depressive symptoms in schizophrenia patients.

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Data availability statement

Original data of this study are available upon request from the corresponding author.

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Acknowledgements

We are deeply grateful to all participants and psychiatrists who took part in our study.

Funding

This work was supported by the National Key Research and Development Program of China (2018YFC1314302, 2018YFC1314300 and 2016YFC1307002), the National Natural Science Foundation of China (81771450, 81471358, 81971255 and 81571314), the Key Project supported by Medical Science and Technology Development Foundation, Nanjing Department of Health (YKK20090), and the Science and Technology Development Program of Nanjing Medical University (NMUB2019107).

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Author notes

  1. Xinyu Fang, Zenan Wu and Lu Wen have contributed to this work equally. They should be regarded as joint first author.

Authors and Affiliations

  1. Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People’s Republic of China

    Xinyu Fang & Xiangrong Zhang

  2. Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

    Zenan Wu, Dandan Wang, Lingfang Yu, Yewei Wang, Yan Chen & Chen Zhang

  3. Department of Psychiatry, The Second People’s Hospital of Jiangning District, Nanjing, People’s Republic of China

    Lu Wen

  4. The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China

    Yaoyao Zhang, Hongyang Liu & Wei Tang

  5. Department of Psychiatry, School of Mental Health, Wenzhou Medical University, Wenzhou, China

    Lei Chen & Wei Tang

  6. Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Chen Zhang

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Contributions

All authors contributed to the preparation of the manuscript. XF, XZ and CZ: conceptualized and designed the study. ZW, YZ, DW, LY, YW, YC, LC, HL, WT and CZ: recruited the participants and completed the screening assessments. XF, ZW and LW: analyzed the data and performed the statistical analysis. XF, ZW and LW: wrote the first draft of the manuscript. XF, XZ and CZ: acquired funding. All authors approved the final manuscript.

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Correspondence to Xiangrong Zhang or Chen Zhang.

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Fang, X., Wu, Z., Wen, L. et al. Rumination mediates the relationship between childhood trauma and depressive symptoms in schizophrenia patients. Eur Arch Psychiatry Clin Neurosci 273, 1085–1094 (2023). https://doi.org/10.1007/s00406-022-01525-2

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