Impacts Of Childhood Trauma On Mental Disorders

Part ?:Objectives: Childhood trauma has long-term adverse effects on physical and psychological health.Previous studies demonstrated that suicide and mental disorders were related to childhood trauma.In China,there is insufficient research available on childhood trauma in patients with mental disorders.This pilot study was designed to preliminarily investigate the prevalence of childhood trauma in patients with depression,bipolar disorder and schizophrenia in southern China.Methods: Outpatients were recruited from a psychiatric hospital in southern China,and controls were recruited from local communities.The demographic questionnaire,the Childhood Trauma Questionnaire–Short Form(CTQ-SF),and the Social Support Rating Scale(SSRS)were completed by all participants,and the Self-rating Idea of Suicide Scale(SIOSS)were completed only by patients.Prevalence rates of childhood trauma were calculated.Kruskal-Wallis test and Dunnett test were used to compare CTQ-SF and SSRS scores between groups.Logistic regression was used to control demographic characteristics and examine relationships between diagnosis and CTQ-SF and SSRS scores.Spearman's rank correlation test was conducted to analyze relationships between suicidal ideation and childhood trauma and suicidal ideation and social support.Results: The final sample comprised 229 patients with depression,102 patients with bipolar disorder,216 patients with schizophrenia,and 132 healthy controls.In our sample,55.5% of the patients with depression,61.8% of the patients with bipolar disorder,47.2% of the patients with schizophrenia,and 20.5% of the healthy people reported at least one type of trauma.In patient groups,physical neglect(PN)and emotional neglect(EN)were most reported,and sexual abuse(SA)and physical abuse(PA)were least reported.CTQSF and SSRS total scores,and most of their subscale scores in patient groups were significantly different from the control group.After controlling demographic characteristics,mental disorders were associated with higher CTQ-SF scores and lower SSRS scores.CTQSF scores and number of trauma types were positively correlated with the SIOSS score.Negative correlations existed between SSRS scores and the SIOSS score.Limitations: Our sample may not be sufficiently representative.Some results might have been interfered by demographic characteristics.The SIOSS was not completed by controls.Data from self-report scales were not sufficiently objective.Conclusions: In southern China,childhood trauma is more severe and more prevalent in patients with mental disorders(depression,bipolar disorder and schizophrenia)than healthy people.Among patients with mental disorders in southern China,suicidal ideation is associated with childhood trauma and poor social support.Part ?:Objectives: Based on part I,this study was aimed to further investigate physical and mental impacts of childhood trauma and social support on depression outpatients by using salivary cortisol and ?-amylase as biological indicators and scales and tests on more symptomatic dimensions.Methods: Outpatients with depression were recruited as the case group and healthy people were recruited as the control group.Participants needed to complete the demographic questionnaire,the CTQ-SF,the SSRS,the SIOSS,the Self-rating Anxiety Scale(SAS),the Hamilton Anxiety Scale(HAMA),the Self-rating Depression Scale(SDS),the Hamilton Depression Scale(HAMD),the digit symbol substitution test,the digit span test,and the number connection test.Saliva samples were collected 0 minute and 30 minute after awakening and examined for cortisol and ?-amylase using enzyme linked immunosorbent assay(ELISA).Categorical variables were compared using Chi-square test or Fisher's exact test.Numeric variables were compared using t test or Mann-Whitney U test.Covariance analysis was used to compare differences in changes of salivary cortisol and ?-amylase concentrations after awakening between groups.Spearman's correlation test was used to analyze correlations between data.Results: The study sample consisted of 24 patients with depression in the case group and 21 healthy people in the control group.CTQ-SF,SSRS,SIOSS,SAS,SDS,HAMA,HAMD and number connection test A scores in the case group were higher than the control group,while SSRS scores in the case group were lower than the control group.Salivary cortisol and ?-amylase concentrations at each time point were different between groups.There was no statistically difference in changes of salivary cortisol and ?-amylase concentrations over time between the two groups.Spearman's correlation analysis showed that SIOSS,SAS,SDS,HAMA,HAMD scores were positively correlated with CTQ-SF scores and the salivary ?-amylase concentration,and negatively correlated with the SSRS scale and the salivary cortisol concentration.CTQ-SF scores were negatively correlated with the salivary cortisol concentration and positively correlated with the salivary?-amylase concentration,while SSRS scores were positively correlated with the salivary cortisol concentration and negatively correlated with the salivary ?-amylase concentration.Conclusions: More severe childhood trauma and lower social support may be related to more severe anxiety,depression,and suicidal ideation.Childhood trauma may lead to long-term dysfunctions of the HPA axis and the ANS,while social support may contribute to the recovery balance of the HPA axis and the ANS functions.Symptoms including depression,anxiety,and suicidal ideation may be associated with changes in activities of the HPA axis and the ANS functions.