A Study On The Effect And Mechanism Of Childhood Trauma On Psychiatric And Affective Symptoms In Patients With First-episode Schizophrenia

Schizophrenia is a highly destructive mental disorder that reduces the life span of patients by 10-20 years and severely affects the normal life of patients,and the causes are very complex.The initial stage of schizophrenia(i.e.,the first episode),which is a critical period for treatment and prevention.Childhood trauma has been recognized as a predisposing environmental factor for schizophrenia and has a causal relationship with the first onset of schizophrenia,but the specific mechanism is still unclear.Cognitive dysfunction and metabolic abnormalities are common problems of mental illness.Studies have found that childhood trauma can not only directly affect the development of symptoms,but also affect the mood and behavior of patients through executive function,a commonly used evaluation index of cognitive function.The structure and function of the prefrontal cortex,which is responsible for executive function,are abnormal in people who have suffered childhood trauma,and damage to the prefrontal cortex leads to poorer emotional behavior control and more adverse outcomes.In addition,adverse experiences such as sexual or physical abuse alter metabolic function and are associated with unhealthy lifestyles and behaviors,ultimately leading to schizophrenia complications and a high mortality rate.Therefore,this study attempted to explore the mechanism of childhood trauma on the symptoms of first-episode schizophrenia through two levels of executive function and glycolipid metabolism.This study included in 49 patients with first-episode schizophrenia.Frist,the T-test and Chi-square test were used to analyze the differences in general information,symptom scores,glucose and lipid metabolism and executive function between patients with and without childhood trauma.Secondly,we explored the mechanism of childhood trauma on psychotic and affective symptoms through correlation analysis and path analysis.Finally,mediation analysis is used to verify the results of path analysis.The results showed as follows:1.The incidence of childhood trauma was as high as 89.8%.Different subtypes of trauma also had a high incidence:emotional neglect,emotional abuse,physical neglect,physical abuse and sexual abuse,respectively :49.0%,34.7%,67.3%,30.6%,36.7%.2.In the subtype of childhood trauma we found that: the positive symptoms,general psychopathological symptoms,and PANSS total scores of the patients with emotional neglect were significantly higher than the unaccompanied group;the scores of general psychopathological symptoms of patients accompanied by emotional abuse were significantly higher than the unaccompanied group;the scores of general psychopathological symptoms and depression of patients accompanied by sexual abuse were significantly higher than the unaccompanied group;and there were also statistically significant differences in mean task response time and HDL-C between patients with and without physical abuse.3.There was a high correlation between childhood trauma and symptoms,executive function,and glycolipid metabolism.Furthermore the pathway analysis model 1 and model 2 showed that the childhood trauma could not only be directly related to the symptom scores of patients with first-episode schizophrenia,but also influence symptoms through executive function and glycolipid metabolism.Subsequent mediation model validation also confirmed this result.Childhood trauma is highly prevalent in patients with first-episode schizophrenia and has an impact on the occurrence of symptoms.We hope that through continuous improvement of the research on the mechanism of childhood trauma on the pathogenesis of schizophrenia in the future,we can realize early screening and timely prevention of high-risk groups.