Childhood adversity, symptoms, and cortisol in first episode psychosis: a cross-sectional, secondary, observational analysis of a subsample of FEP patients

Abstract

Background

Although it has been proposed that childhood adversities (CAs) may affect the hypothalamic-pituitary-adrenal (HPA) axis activity and psychotic symptoms severity, these associations have not been fully confirmed in first-episode psychosis (FEP). This study explored the association between CA, cortisol and psychotic symptoms in FEP patients.

Methods

81 FEP patients were enrolled. CAs were evaluated by the Childhood Experience of Care and Abuse Questionnaire and a semi-structured interview. Psychotic symptoms were evaluated by the Positive and Negative Syndrome Scale. Cortisol level was collected using saliva samples. ANCOVA and partial correlation analyses were run.

Results

FEP patients with childhood abuse reported severe positive symptoms than those without CA. FEP patients with at least one CA had higher levels of cortisol awaking, cortisol at 12 a.m., and cortisol at 8 p.m. Morning cortisol levels were negatively correlated with the severity of negative symptoms and positively correlated with the severity of general psychopathology. Evening cortisol levels were positively correlated with severity of general psychopathology.

Conclusion

FEP patients with CAs, compared with those without CA, might report more severe positive symptoms and higher cortisol, even though these findings as prone to bias due to the small sample size, and should be seen in the larger perspective of conflicting evidence in the field.

Keywords:

• Childhood trauma
• early abuse
• early neglect
• early loss
• cortisol
• psychosis

Acknowledgments

The authors are grateful for the generosity of the subjects whose time and effort make the GET‐UP project possible.

Author contributions

Giovanni Mansueto: assessed early life events, ran statistical analyses and wrote the manuscript; Silvia Casale, Giulia Fioravanti evaluated and scored the child adversity procedure; Sarah Tosato: revised the first draft of the manuscript; Natascia Brondino: ran the cortisol dosage; Chiara Bonetto, Simona Tomassi, Pierluigi Politi, Antonio Lasalvia, Katia Desanti, Mariaelena Bertani, Marcella Bellani, Paolo Brambilla: revised the final version of the manuscript; Mirella Ruggeri: responsible of the GET UP project, coordinated the study and revised the final version of the manuscript; Carlo Faravelli: responsible of the life event unit, projected the study, supervised the data collection and revised all drafts of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was supported by the Ministry of Health, Italy, Ricerca Sanitaria Finalizzata, Code H61J08000200001.

Notes on contributors

Giovanni Mansueto

Giovanni Mansueto: PhD, psychologist, cognitive behaviour psychotherapist, Post Doctoral Research Fellow in Clinical Psychology, Department of Health Sciences, University of Florence, Florence, Italy.

Sarah Tosato

Sarah Tosato: psychiatrist, Associate Professor of Psychiatry at the Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy.

Natascia Brondino

Natascia Brondino: psychiatrist, Associate Professor of Psychiatry at the Section of Psychiatry, at the Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.

Chiara Bonetto

Chiara Bonetto: statistician, at the Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy.

Simona Tomassi

Simona Tomassi: psychiatrist, UOC 1 Psichiatria, ULSS 9 SCALIGERA, Verona, Italy.

Pierluigi Politi

Pierluigi Politi: psychiatrist, Full Professor of Psychiatry at the Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.

Antonio Lasalvia

Antonio Lasalvia: psychiatrist, Associate Professor of Psychiatry at the Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy.

Giulia Fioravanti

Giulia Fioravanti: PhD, Assistant Professor in Clinical Psychology, Department of Health Sciences, Psychology and Psychiatry Unit, University of Florence, Italy.

Silvia Casale

Silvia Casale: PhD, Associate Professor in Clinical Psychology, Department of Health Sciences, Psychology and Psychiatry Unit, University of Florence, Italy.

Katia De Santi

Katia De Santi: psychiatrist, UOC Psichiatria B, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy.

Mariaelena Bertani

Mariaelena Bertani: psychologist, UOC Psichiatria B, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy.

Marcella Bellani

Marcella Bellani: psychiatrist, Associate Professor of Psychiatry, at the Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy.

Paolo Brambilla

Paolo Brambilla: psychiatrist, Full Professor of Psychiatry at the Department of Pathophysiology and Transplantation at the University of Milan, Milan, Italy.

Mirella Ruggeri

Mirella Ruggeri: psychiatrist, Full Professor of Psychiatry at the Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy.

Carlo Faravelli

Carlo Faravelli: psychiatrist, Full Professor of Psychiatry (retired) at the Department of Health of Sciences, University of Florence, Florence, Italy.