Associations of Childhood Trauma with Psychopathology and Clinical Characteristics in Patients with Schizophrenia

Hyun-Soo Lee; Yuran Jeong; Taeyoung Yoo; Ju-Yeon Lee; Soo-In Lee; Jae-Min Kim; Jin-Sang Yoon; Sung-Wan Kim

doi:10.16946/kjsr.2017.20.2.37

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Lee, Jeong, Yoo, Lee, Lee, Kim, Yoon, and Kim: Associations of Childhood Trauma with Psychopathology and Clinical Characteristics in Patients with Schizophrenia

Original Article

Korean J Schizophr Res 2017;20(2):37-43.

Published online: 20 January 2017

DOI: https://doi.org/10.16946/kjsr.2017.20.2.37

Associations of Childhood Trauma with Psychopathology and Clinical Characteristics in Patients with Schizophrenia

Hyun-Soo Lee, MD¹, Yuran Jeong, MD¹, Taeyoung Yoo, MD², Ju-Yeon Lee, MD^2,³, Soo-In Lee, MD, PhD⁴, Jae-Min Kim, MD, PhD², Jin-Sang Yoon, MD, PhD², Sung-Wan Kim, MD, PhD^2,^3,

¹Department of Psychiatry, Naju National Hospital, Naju, Korea

²Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea

³Gwangju Bukgu Community Mental Health Center, Gwagnju, Korea

⁴Haemalkeun psychiatric clinic, Gwangju, Korea

Address for correspondence: Sung-Wan Kim, Department of Psychiatry, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea Tel: 062-220-6148, Fax: 062-225-2351 E-mail: swkim@chonnam.ac.kr

Received 21 February 2017 Revised 5 June 2017 Accepted 5 June 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study was aimed to investigate the associations of childhood trauma with psychopathology and clinical characteristics in patients with schizophrenia.

Methods

This study enrolled 66 inpatients with schizophrenia. Korean Childhood Trauma Questionnaire (K-CTQ) and Life Event Questionnaire (LEQ) were administered to assess childhood trauma. Psychopatholgy and clinical characteristics were assessed with the Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI), Korean Version of Internalized Stigma of Mental Illness (K-ISMI), Perceived Stress Scale (PSS), and visual analogue scale of EuroQoL-5 Dimension Index (EQ-5D).

Results

: Total scores on K-CTQ were positively associated with scores on the BDI, K-ISMI, PSS, and PANSS and negatively associated with the score on the EQ-5D. Among subscales of K-CTQ, emotional abuse was significantly associated with all measures for psychopathology and clinical characteristics. Patients with physical abuse (36.5%), emotional abuse (30.2%), or bullying (30.6%) according to the LEQ showed sighificanlty higher the ISMI score and lower EQ-5D score. Emotional abuse and bullying were also significantly associated with higher scores on BDI and/or PSS.

Conclusion

: Our results suggest that childhood trauma negatively influences on internalized stigma, depression, perceived stress and quality of life in patients with schizophrenia. Clinicians should carefully evalute and manage childhood traumatic experience of patients with schizophrenia.

Keywords: Schizophrenia, Childhood trauma, Stigma, Quality of life, Stress, Depression.

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Table 1.

Pearson correlation coefficients of K-CTQ with ISMI, BDI, PSS, EQ-5D, and PANSS

	ISMI	BDI	PSS	EQ-5D	PANSS
K-CTQ-Total	.426^†	.327∗	.424^†	–.394^†	.251
K-CTQ-PA	.221	.314∗	.185	–.397^†	.176
K-CTQ-EA	.525^‡	.351^†	.370^†	–.352^†	.272∗
K-CTQ-SA	.298∗	.121	.267∗	–.117	.234
K-CTQ-PN	.375^†	.145	.267∗	–.227	.205
K-CTQ-EN	.103	.088	.161	–.153	.125

^∗ : p＜.05,†: p＜.01,‡: p＜.001. K-CTQ: Korean Childhood Trauma Questionnaire, PA: Physical abuse, EA: Emotional abuse, SA: Sexual abuse, PN: Physical neglect, EN: Emotional neglect, ISMI: Internal Stigma of Mental Illness, BDI: Beck Depression Inventory, PSS: Perceived Stress Scale, EQ-5D: EuroQOL-5Demension Index, PANSS: Positive and Negative Syndrome Scale

Table 2.

Comparisons of scores on the ISMI, SES, BDI, PSS, EQ-5D, and PANSS according to the presence of early life trauma

		Number (%)	ISMI Mean (SD)	BDI Mean (SD)	PSS Mean (SD)	EQ-5D Mean (SD)	PANSS Mean (SD)
PA	Presence	23 (36.5)	67.9 (15.1)	15.5 (11.6)	19.1 (5.2)	54.9 (23.5)	89.0 (18.0)
	Absence	40 (63.5)	59.9 (14.1)	10.6 (11.2)	17.3 (4.8)	68.7 (22.7)	84.1 (18.5)
	p-value		0.048	0.103	0.160	0.031	0.322
SA	Presence	19 (30.2)	63.2 (12.7)	16.3 (14.5)	18.6 (5.6)	58.1 (28.2)	87.7 (20.3)
	Absence	44 (69.8)	63.0 (15.9)	10.4 (9.8)	17.7 (4.7)	65.9 (21.5)	85.1 (18.5)
	p-value		0.959	0.113	0.496	0.251	0.619
EA	Presence	19 (30.2)	69.1 (14.7)	17.5 (13.5)	20.5 (4.2)	50.2 (26.9)	90.9 (21.2)
	Absence	44 (69.8)	60.2 (14.3)	10.1 (9.9)	16.9 (5.0)	69.4 (19.8)	83.7 (17.7)
	p-value		0.036	0.041	0.009	0.011	0.167
PD	Presence	17 (27.9)	64.4 (13.1)	10.9 (12.5)	16.9 (6.0)	62.3 (25.3)	90.2 (22.1)
	Absence	44 (72.1)	61.9 (15.8)	13.3 (11.4)	18.5 (4.6)	63.8 (24.0)	84.6 (17.8)
	p-value		0.565	0.484	0.305	0.837	0.309
Bullying	Presence	19 (30.6)	71.7 (10.3)	18.3 (12.6)	18.2 (6.3)	53.4 (25.8)	90.6 (20.5)
	Absence	43 (69.4)	58.4 (14.8)	9.8 (10.2)	17.8 (4.5)	67.4 (22.3)	83.7 (18.3)
	p-value		0.001	0.007	0.813	0.047	0.193

PA: Physical abuse, SA: Sexual abuse, EA: Emotional abuse, PD: Parents' divorce, ISMI: Internal Stigma of Mental Illness, BDI: Beck Depression Inventory, PSS: Perceived Stress Scale, EQ-5D: EuroQOL-5Demension Index, PANSS: Positive and Negative Syndrome Scale

Table 3.

Comparisons of scores on the K-CTQ according to the presence of early life events

		K-CTQ-Total Mean (SD)	K-CTQ-PA Mean (SD)	K-CTQ-SA Mean (SD)	K-CTQ-EN Mean (SD)	K-CTQ-EA Mean (SD)	K-CTQ-PN Mean (SD)
PA	Presence	65.0 (13.3)	13.7 (4.3)	10.8 (4.9)	13.1 (5.4)	14.1 (4.4)	12.2 (3.7)
	Absence	45.2 (13.7)	8.0 (3.7)	7.3 (3.3)	11.5 (5.6)	9.6 (4.6)	11.0 (3.9)
	p-value	＜0.001	＜0.001	0.004	0.276	0.001	0.234
SA	Presence	55.8 (13.8)	11.4 (4.7)	10.3 (4.7)	12.2 (5.2)	12.1 (3.8)	10.8 (3.1)
	Absence	50.7 (17.6)	9.4 (4.7)	7.9 (3.9)	12.1 (5.8)	10.9 (5.4)	11.7 (4.1)
	p-value	0.300	0.143	0.042	0.956	0.321	0.435
EA	Presence	65.9 (13.7)	13.2 (5.0)	9.8 (5.7)	15.0 (5.0)	15.1 (4.1)	13.2 (3.7)
	Absence	46.4 (14.0)	8.6 (4.0)	8.1 (3.5)	10.9 (5.4)	9.6 (4.4)	10.6 (3.6)
	p-value	＜0.001	＜0.001	0.243	0.007	＜0.001	0.011
PD	Presence	51.7 (18.7)	10.2 (4.5)	9.5 (4.2)	12.5 (6.1)	10.9 (5.3)	11.8 (3.8)
	Absence	51.3 (15.1)	9.6 (4.8)	8.2 (4.3)	9.6 (4.8)	11.1 (4.9)	11.0 (3.6)
	p-value	0.940	0.687	0.315	0.622	0.855	0.453
Bullying	Presence	59.9 (15.0)	12.0 (5.0)	9.2 (4.4)	13.7 (5.3)	13.8 (4.5)	12.6 (3.6)
	Absence	48.0 (15.1)	8.9 (4.2)	8.5 (4.3)	11.2 (5.3)	10.0 (4.7)	10.6 (3.5)
	p-value	0.010	0.017	0.556	0.102	0.006	0.047

K-CTQ: Korean Childhood Trauma Questionnaire, PA: Physical abuse, SA: Sexual abuse, EN: Emotional neglect, EA: Emotional abuse, PD: Parents' divorce, PN: Physical neglect

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