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

ackground: Childhood trauma has been significantly associated with firstepisode 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.