Background: Incidence of trauma is known to be higher in patients with psychosis compared to general population. Little is known on its impact in the pre-morbid phase of psychosis and on outcome after a first psychotic episode.
Methods: Medical records review of patients treated at EPPIC between 1998 and 2000. Comparison between patients who had been exposed either to physical or to sexual trauma and those who had not been exposed to such events.
Results: Information on trauma was available for 658 FEP patients: 26% had been exposed to physical abuse and 16% to sexual abuse. Characteristics linked with past sexual abuse were schizophrenia diagnosis, female gender, substance abuse co-morbidity, history of previous treatment for psychiatric disorder and suicide attempt before FEP, as well as higher rate of admissions and suicide attempts during treatment. Characteristics linked with past history of physical abuse were schizophrenia diagnosis, substance abuse co-morbidity, history of previous treatment for psychiatric disorder and suicide attempt before FEP, as well as higher rate of non-adherence to treatment, suicide attempts during treatment and persistence of psychotic symptoms after 18 months.
Conclusions: Sexual and physical traumas are highly prevalent in FEP patients and have an important impact both before and after FEP. Life history of such events needs to be explored by clinicians, and impact of additional psychological treatment needs to be studied, in order to develop strategies that may limit consequences of past trauma and decrease risk of suicide.