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Traumatic experiences in childhood and adolescence: a meta-analysis of prospective studies assessing risk for psychosis

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Abstract

Evidence of the association between traumatic experiences and psychosis are uncertain with respect to temporal order, clinical outcomes and the role of the age and genetic liability. The aim of the present meta-analysis was to explore the temporal relationship between the development of psychosis and traumatic exposure using prospective studies and to examine the role of moderation factors on overall effect sizes. Studies were identified by searching Embase-Ovid, PsycINFO (EBSCO), Pubmed, Scopus, Web of Science databases, and yielded an initial total of 9016 papers, leaving finally 23 after the screening process. Three sets of meta-analyses estimated the risk of developing psychotic experiences or full clinical psychosis by having experienced maltreatment by an adult or bullying by peers or parental death, using the random-effects model. Bullying by peers (OR = 2.28 [1.64, 4.34]), maltreatment by an adult (OR = 2.20 [1.72, 2.81]) and parental death (OR = 1.24 [1.06, 1.44]) all increased the risk of psychosis. Moderator analysis showed that negative effects of bullying were detected especially in those with genetic liability for psychosis and exposure to multiple trauma types; studies with higher prevalence of males showed a stronger risk for those exposed to parental death. No significant meta-regression was found between the risk of developing a full clinical psychosis or a psychotic experience. Lack of studies hampered the results about the age of trauma occurrence. The cumulative effect of being bullied from peers and experiencing other adversities during childhood and/or adolescence, together with genetic liability for psychosis, appears to confer the highest risk for developing psychotic symptoms later in life.

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Authors and Affiliations

  1. Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Giulio Cesare Square, 11, Bari, Italy

    Adriana Pastore, Aldo Tomasicchio & Francesco Margari

  2. Saint John of God Clinical Research Centre, Brescia, Italy

    Giovanni de Girolamo

  3. Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy

    Silvio Tafuri

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  1. Adriana Pastore
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  2. Giovanni de Girolamo
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  3. Silvio Tafuri
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Correspondence to Adriana Pastore.

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Pastore, A., de Girolamo, G., Tafuri, S. et al. Traumatic experiences in childhood and adolescence: a meta-analysis of prospective studies assessing risk for psychosis. Eur Child Adolesc Psychiatry 31, 215–228 (2022). https://doi.org/10.1007/s00787-020-01574-9

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  • DOI: https://doi.org/10.1007/s00787-020-01574-9

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