Traumatic childhood linked to psychotic experiences

Researchers have found a link between trauma in childhood and psychotic experiences at the age of 18. The findings are the first to comprehensively examine the association between different types of trauma, and their timing in childhood with later psychotic experiences using a large population study. Psychotic experiences include abnormal experiences such as hearing voices or feelings of paranoia.

Researchers used  Children of the 90s longitudinal data to examine 4,433 participants who had clinical interviews and attended clinics at the age of 18. The study concludes that between 25 and 60 per cent of the young people who reported psychotic experiences (five per cent of the sample) would not have developed these if they had not been exposed to trauma such as bullying, domestic violence or emotional neglect as a child.

The results were consistent regardless of socio-economic status or genetic risk of mental health difficulties, which could inform future research and the development of interventions.

A researcher said: "As around five per cent of the population have psychotic experiences at some point in their life, and these often lead to further mental health issues, it is important that we understand more about the role trauma has in increasing this risk.

"I wanted to look at traumatic experiences during childhood using Children of the 90s data because it allowed us to answer questions about the timing and type of trauma that previous studies have not been able to examine comprehensively."

"The findings support that routine screening for psychotic experiences in children or young people exposed to trauma, particularly those exposed to frequent occurrences, should be considered as a way of preventing later mental health problems. Understanding how trauma leads to psychotic experiences could lead to the development of more novel treatments for psychosis.

Professor of Psychiatry added: "This work helps to establish the importance of trauma in the aetiology of psychotic experiences, and can help inform the clinical approach to reducing the impact of these often very distressing symptoms."    

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Living in cities 'puts teens at greater risk of psychotic experiences'

Teenagers who live in large cities could be at greater risk of having psychotic experiences, according to research examining the impact of urban life on mental health.

The finding ties in with previous studies and suggests that early interventions for young people in deprived urban neighbourhoods could be valuable.

“There is a growing interest in early interventions for psychosis and although it is important to highlight that the vast majority of these adolescents won’t go on to develop a psychotic disorder, early psychotic experiences are shown to be associated with a heightened risk for other mental health problems as well,” said Joanne Newbury, co-author of the research from King’s College London.

The research was published in Schizophrenia Bulletin by teams in the UK and US.

It drew on the Environmental Risk Longitudinal Twin Study, in which 2,063 18-year-olds in England and Wales were asked whether they had had any psychotic experiences since the age of 12, including delusions, hallucinations or concerns that their food had been poisoned. Just over 30% of the teens reported at least one psychotic experience over the period. 

Once factors including family psychiatric history, socioeconomic status and alcohol or cannabis dependence were taken into account, the odds were 43% higher for adolescents living in very urban settings – such as cities like London or Birmingham – than for rural teens.

Further analysis revealed the effect was at least in partly down to low levels of social cohesion, meaning poor relationships between neighbours, and high levels of neighbourhood disorder.

“We found that these factors explained around half of the association, or the effect of urbanicity on psychotic experiences,” said Newbury.

Being a victim of violence made the odds of an adolescent having psychotic experiences three times greater, while teens living in neighbourhoods with high disorder and low social cohesion were more likely to have been victimised.

The rate of psychotic experiences was three times higher among that group, at 62%, than among those who lived in more favourable neighbourhoods and had not been the victim of violent crimes, for whom the rate was 21%. 

However, the authors noted that the research does not prove that particular environmental settings are the cause of the higher rates of teen psychotic experiences. They pointed out that it was possible that those at greater risk of psychosis might move into urban environments.

But they said the study suggested that early interventions for the mental health of those living in urban neighbourhoods and deprived areas could prove valuable. 

James Kirkbride, a psychiatric epidemiologist from University College London, said: “We already know that people who are born, brought up in and live in cities have a higher chance of experiencing a psychotic disorder in their life. This new study shows that this extends to psychotic symptoms in adolescence as well.”

Kirkbride added that it was not yet clear what might be behind the link, although he noted that the latest study suggests that living in disadvantaged neighbourhoods or settings with high crime rates could be a factor. 

“Above all, this data shows that our most disadvantaged communities face a disproportionate burden of psychosis-related health inequalities in the UK, and require the provision of appropriate mental health services to tackle this issue,” he said. 

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