A sib-pair study into patients with recent onset psychotic illness and their non-psychotic siblings was conducted.
After controlling for cannabis use and neuroticism, childhood trauma was related to an increased risk of psychosis.
Childhood trauma, cannabis use and neuroticism were independently associated with an increased risk of psychosis.
Childhood trauma, cannabis use and certain personality traits have been related to the development of psychosis. This study uses a sib-pair design to examine the association between childhood trauma and psychosis controlling for cannabis use and neuroticism.
After controlling for cannabis use and neuroticism, the odds of suffering psychosis for subjects who experienced a childhood trauma were 7.3 times higher than the odds for subjects who did not experience a childhood trauma [95% CI, (1.06–50.01); P = 0.04]. Also, after controlling for experiencing childhood trauma and neuroticism, subjects who were heavy cannabis users had odds of suffering psychosis that were 6.4 times higher than the odds of the remaining subjects [95% CI, (1.2–35.2); P = 0.03].
Both childhood trauma and cannabis use were significantly associated with an increased risk of suffering functional psychosis. A neurotic personality also contributed independently to this risk. These findings might help improve the prevention of psychosis and the development of specific treatment strategies on this specific population.
My own underlying view is that there has to be an underlying susceptibility for psychosis as well to trigger psychosis. Are those who are traumatised more likely to experience psychosis or is it that those with psychosis have a lower stress threshold and are more prone to feeling traumatised?
I think it’s both. Speaking only for myself - I think it’s a combination of being sensitive (generally, not specifically to psychosis) and experiencing trauma that made me develop psychotic disorder. I think the ratio trauma - sensitivity varies for each person.
I think there is almost always some kind of trauma involved. There are probably people that are so sensitive they are already traumatized by normal life events and develop psychosis without (objectively seen) a major trauma. But I believe with the “right kind of trauma” you can get almost everyone into psychotic disorder.
Two incidents of sexual abuse kind of disrupted my development as a child. Then as an adult, I experienced another, bigger trauma and everything crumbled. I developped first brief reactive psychosis and then psychotic disorder nos. But I do believe I was always sensitive. Not so much specifically very sensitive to schizophrenia, or I would have developped it earlier in life (now, only at 30y/o). But more generally sensitive (to trauma, emotions, food, medicine, etc).
My brother is also a highly sensitive person, maybe even more so than I am. But he did not experience trauma in childhood or adult life. I believe, with the same trauma, he could have become psychotic as well.
Add to that the very widespread awareness that PTSD co-exists with sz in almost all cases, either as the result of the sz itself, or as the result of events in the developmental history of the patient. (Any junior college nursing school graduate who paid attention in class when they explained the autonomic nervous system can see PTSD in a sz patient.)
I don’t think I have ever seen an un-medicated sz patient who wasn’t in allostatic overload. And I have seen so many effectively medicated sz patients who were not – because dopamine-channel-blocking anti-Ps reduce allostatic loading – that I am compelled to say that the D-S model holds water.