Influence of childhood trauma on diagnosis and substance use in first-episode psychosis

Background Childhood trauma has been significantly associated with first-episode psychosis, affective dysfunction and substance use. Aims To test whether people with first-episode psychosis who had experienced childhood trauma, when compared with those who had not, showed a higher rate of affective psychosis and an increased lifetime rate of substance use. Method The sample comprised 345 participants with first-episode psychosis (58% male, mean age 29.8 years, s.d.=9.7). Results Severe sexual abuse was significantly associated with a diagnosis of affective psychosis (χ2=4.9,P=0.04) and with higher rates of lifetime use of cannabis (68%v.41%;P= 0.02) and heroin (20%v.5%;P=0.02). Severe physical abuse was associated with increased lifetime use of heroin (15%v.5%;P= 0.03) and cocaine (32%v.17%;P= 0.05). Conclusions Patients with first-episode psychosis exposed to childhood trauma appear to constitute a distinctive subgroup in terms of diagnosis and lifetime substance use.