Basic symptoms of schizophrenia are related to symptoms of traumatic stress: A pivotal role of sensitization. An observational study
Language English Country United States Media electronic
Document type Journal Article, Observational Study
PubMed
35839050
PubMed Central
PMC11132322
DOI
10.1097/md.0000000000029517
PII: 00005792-202207150-00063
Knihovny.cz E-resources
- MeSH
- Antipsychotic Agents * therapeutic use MeSH
- Dissociative Disorders diagnosis etiology MeSH
- Humans MeSH
- Psychotic Disorders * drug therapy MeSH
- Schizophrenia * drug therapy MeSH
- Seizures drug therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Names of Substances
- Antipsychotic Agents * MeSH
INTRODUCTION: Subjective cognitive deficits have been broadly reported in schizophrenia and described by Huber as basic symptoms. It remains unclear however to what extent they may be related to psychosocial stressors including trauma. METHODS: We assessed basic symptoms using the Frankfurt Complaint Questionnaire (FCQ) in a sample of 40 patients with schizophrenia. Trauma-related symptoms were assessed concurrently using the Trauma Symptom Checklist-40, symptoms of dissociation using the Dissociative Experiences Scale, and sensitization phenomena using the Complex Partial Seizure-like Symptoms Inventory and Limbic System Checklist-33. Psychotic symptoms were measured by Health of the Nation Outcome Scales. The dosage of antipsychotic medication was assessed in terms of equivalents of chlorpromazine, and antidepressant medication in terms of equivalents of fluoxetine. Spearman correlations were performed to explore the relationship between FCQ and other trauma-related measures. To determine the relative contributions of trauma-related symptoms to basic symptoms a linear regression analysis was performed. RESULTS: The results showed that higher levels of basic symptoms of schizophrenia were associated with greater levels of symptoms of dissociation, traumatic stress, and sensitization or kindling-like processes in schizophrenia. Among the trauma-related variables, sensitization phenomena assessed with Complex Partial Seizure-like Symptoms Inventory were closely associated with basic symptoms. DISCUSSION: These results indicate that basic symptoms measured by FCQ might be related to trauma. The potential of trauma to influence neurodevelopmental hypotheses of schizophrenia is discussed.
ESET Psychotherapeutic and Psychosomatic Clinic Prague Czech Republic
Roudebush VA Medical Center and the Indiana University School of Medicine Indianapolis IN USA
See more in PubMed
Huber G, Gross G. The concept of basic symptoms in schizophrenic and schizoaffective psychoses. Recenti Prog Med. 1989;80:646–52. PubMed
Schultze-Lutter F. Subjective symptoms of schizophrenia in research and the clinic: the basic symptom concept. Schizophr Bull. 2009;35:5–8. PubMed PMC
Vargas ML, López-Lorenzo S, Legascue I, et al. . Basic symptoms as subjective cognitive deficit in schizophrenia: cognitive, clinical and functional associations. Eur Psychiatry. 2016;33:S110.
Bleuler E. Textbook of Psychiatry, Brill AA. (Trans.). New York, NY: The Macmillan Company. 1924.
Burgy M. The concept of psychosis: historical and phenomenological aspects. Schizophr Bull. 2008;34:1200–10. PubMed PMC
Schultze-Lutter F, Debbané M, Theodoridou A, et al. . Revisiting the basic symptom concept: toward translating risk symptoms for psychosis into neurobiological targets. Front Psychiatry. 2016;7:9. PubMed PMC
Nelson B, Whitford TJ, Lavoie S, et al. . What are the neurocognitive correlates of basic self-disturbance in schizophrenia?: integrating phenomenology and neurocognition. Part 1 (Source monitoring deficits). Schizophr Res. 2014;152:12–9. PubMed
Schultze-Lutter F, Theodoridou A. The concept of basic symptoms: its scientific and clinical relevance. World Psychiatry. 2017;16:104–5. PubMed PMC
Kim JH, Byun HJ, Ann JH, et al. . Relationship between subjective experiences and psychopathological dimensions in schizophrenia. Aust N Z J Psychiatry. 2010;44:952–7. PubMed
Mass R, Hitschfeld K, Wall E, et al. . Validität der Erfassung schizophrener Basissymptome. Nervenarzt. 1997;68:205–11. PubMed
Vita A, De Peri L. Subjective cognitive impairment in schizophrenic patients: clinical and neuropsychological correlates. Eur Psychiatry. 2010;25:1–1.
Bang M, Park JY, Kim KR, et al. . Psychotic conversion of individuals at ultra-high risk for psychosis: the potential roles of schizotypy and basic symptoms. Early Interv Psychiatry. 2019;13:546–54. PubMed
Uttinger M, Studerus E, Ittig S, et al. . The Frankfurt Complaint Questionnaire for self-assessment of basic symptoms in the early detection of psychosis—factor structure, reliability, and predictive validity. Int J Methods Psychiatr Res. 2018;27:e1600. PubMed PMC
Read J, van Os J, Morrison AP, et al. . Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr Scand. 2005;112:330–50. PubMed
Popovic D, Schmitt A, Kaurani L, et al. . Childhood trauma in schizophrenia: current findings and research perspectives. Front Neurosci. 2019;13:274. PubMed PMC
Dauvermann MR, Donohoe G. The role of childhood trauma in cognitive performance in schizophrenia and bipolar disorder - a systematic review. Schizophr Res Cogn. 2018;16:1–11. PubMed PMC
Brunner R, Parzer P, Schmitt R, et al. . Dissociative symptoms in schizophrenia: a comparative analysis of patients with borderline personality disorder and healthy controls. Psychopathology. 2004;37:281–4. PubMed
Sar V, Taycan O, Bolat N, et al. . Childhood trauma and dissociation in schizophrenia. Psychopathology. 2010;43:33–40. PubMed
Schafer I, Fisher HL, Aderhold V, et al. . Dissociative symptoms in patients with schizophrenia: relationships with childhood trauma and psychotic symptoms. Compr Psychiatry. 2012;53:364–71. PubMed
Lysaker PH, LaRocco VA. The prevalence and correlates of trauma-related symptoms in schizophrenia spectrum disorder. Compr Psychiatry. 2008;49:330–4. PubMed
Renard SB, Huntjens RJC, Lysaker PH, et al. . Pijnenborg GHM. Unique and overlapping symptoms in schizophrenia spectrum and dissociative disorders in relation to models of psychopathology: a systematic review. Schizophr Bull. 2017;43:108–21. PubMed PMC
Resch F, Koch E, Möhler E, et al. . Early detection of psychotic disorders in adolescents: specificity of basic symptoms in psychiatric patient samples. Psychopathology. 2002;35:259–66. PubMed
Rosen C, Jones N, Chase KA, et al. . Immersion in altered experience: an investigation of the relationship between absorption and psychopathology. Conscious Cogn. 2017;49:215–26. PubMed PMC
Bob P, Palus M, Susta M, et al. . Sensitization, epileptic-like symptoms and local synchronization in patients with paranoid schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34:143–6. PubMed
Collip D, Myin-Germeys I, Van Os J. Does the concept of “sensitization” provide a plausible mechanism for the putative link between the environment and schizophrenia? Schizophr Bull. 2008;34:220–5. PubMed PMC
Weidenauer A, Bauer M, Sauerzopf U, et al. . Making sense of: sensitization in schizophrenia. Int J Neuropsychopharmacol. 2017;20:1–10. PubMed PMC
Yuii K, Suzuki M, Kurachi M. Stress sensitization in schizophrenia. Ann N Y Acad Sci. 2007;1113:276–90. PubMed
Sheehan DV, Lecrubier Y, Sheehan KH, et al. . The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl 20):22–33, quiz 34-57. PubMed
Raven JC. Guide to the Standard Progressive Matrices. London. UK: HK Lewis. 1960.
Atkins M, Burgess A, Bottomley C, et al. . Chlorpromazine equivalents: a consensus of opinion for both clinical and research applications. Psychiatr Bull. 1997;21:224–6.
Hayasaka Y, Purgato M, Magni LR, et al. . Dose equivalents of antidepressants: evidence-based recommendations from randomized controlled trials. J Affect Disord. 2015;180:179–84. PubMed
Woods SW. Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry. 2003;64:663–7. PubMed
Süllwold L. Manual zum Frankfurter Beschwerde-Fragebogen (FBF). Berlin: Springer-Verlag. 1991.
Kuhnova E, Pec O, Dragomirecka E, et al. . Frankfurt Complaint Questionnaire – psychometric characteristics of the Czech version [Frankfurtska skala potizi – nektere psychometricke charakteristiky ceske verze]. Cesk Psychol. 2018;62:477–487.
Elliott DM, Briere J. Sexual abuse trauma among professional women: validating the Trauma Symptom Checklist-40 (TSC-40). Child Abuse Negl. 1992;16:391–8. PubMed
Bob P, Ptacek R, Paclt I, et al. . Dissociation and symptoms of complex partial epilepsy in depressed patients [Disociace a symptomy komplexni parcialni epilepsie u depresivnich pacientu]. Ceska Slov Psychiatr. 2003;99:82–88.
Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis. 1986;174:727–35. PubMed
Bob P. Dissociation processes and their measurement [Disociativni procesy a jejich mereni]. Ceska Slov Psychiatr. 2000;96:301–309.
Ptacek R, Bob P, Paclt I. Dissociative experiences scale – Czech version [Skala disociativnich zazitku – ceska verze]. Cesk Psychol. 2006;50:262–272.
Roberts RJ, Gorman LL, Lee GP, et al. . The phenomenology of multiple partial seizure-like symptoms without stereotyped spells: an epilepsy spectrum disorder? Epilepsy Res. 1992;13:167–77. PubMed
Silberman EK, Post RM, Nurnberger J, et al. . Transient sensory, cognitive and affective phenomena in affective illness. A comparison with complex partial epilepsy. Br J Psychiatry. 1985;146:81–9. PubMed
Varney NR, Garvey MJ, Cook BL, et al. . Identification of treatment-resistant depressives who respond favorably to carbamazepine. Ann Clin Psychiatry. 1993;5:117–22. PubMed
Teicher MH, Glod CA, Surrey J, et al. . Early childhood abuse and limbic system ratings in adult psychiatric outpatients. J Neuropsychiatry Clin Neurosci. 1993;5:301–6. PubMed
Wing JK, Curtis RH, Beevor AS. HoNOS: Health of the Nation Outcome Scales: Report on Research and Development Jul 1993–Dec 1995. London, UK: Royal College of Psychiatrists. 1996.
Pec O, Cechova D, Pecova J, et al. . HoNOS (Health of the Nations Outcome Scales) – an adaptation of the tool for the assessment of symptoms and social functions in serious mentally ill in the Czech conditions and its use [HoNOS (Hodnoceni zdravotniho stavu) – Adaptace nastroje na hodnoceni symptom a socialnich funkci u zavazně duševně nemocnych v ceskych podmínkach a jeho pouziti]. Ceska Slov Psychiatr. 2009;105:245–249.
Walker EF, Diforio D. Schizophrenia: a neural diathesis-stress model. Psychol Rev. 1997;104:667–85. PubMed
Read J, Perry BD, Moskowitz A, et al. . The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry. 2001;64:319–45. PubMed
Barker V, Gumley A, Schwannauer M, et al. . An integrated biopsychosocial model of childhood maltreatment and psychosis. Br J Psychiatry. 2015;206:177–80. PubMed
Kapur S. Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry. 2003;160:13–23. PubMed
Hanssen M, Bak M, Bijl R, et al. . The incidence and outcome of subclinical psychotic experiences in the general population. Br J Clin Psychol. 2005;44:181–91. PubMed
Harris CL, Dinn WM, Marcinkiewicz JA. Partial seizure-like symptoms in borderline personality disorder. Epilepsy Behav. 2002;3:433–8. PubMed
Gorham R, Persinger MA. Emergence of complex partial epilepsy-like experiences following closed head injuries: personality variables and neuropsychological profiles. Epilepsy Behav. 2012;23:152–8. PubMed
Svetlak M, Bob P, Kukleta M. Complex partial seizure-like symptoms and smoking in university students. Scripta Medica Facultatis Medicae Universitatis Brunensis Masarykianae. 2010;83:124–9.
Miret S, Fatjó-Vilas M, Peralta V, et al. . Basic symptoms in schizophrenia, their clinical study and relevance in research. Revista De Psiquiatría Y Salud Mental. 2016;9:111–122. PubMed
Roder V, Brenner HD, Kienzle N. Integriertes Psychologisches Therapieprogramm bei schizophren Enkrankten IPT. Basel: Beltz. 2008.
Pec O, Bob P, Simek J, et al. . Dissociative states in borderline personality disorder and their relationships to psychotropic medication. Neuropsychiatr Dis Treat. 2018;14:3253–3257. PubMed PMC
Schultze-Lutter F, Ruhrmann S, Fusar-Poli P, et al. . Basic symptoms and the prediction of first-episode psychosis. Curr Pharm Des. 2012;18:351–7. PubMed
Carrà G, Crocamo C, Angermeyer M, et al. . Positive and negative symptoms in schizophrenia: a longitudinal analysis using latent variable structural equation modelling. Schizophr Res. 2019;204:58–64. PubMed
Carrà G, Crocamo C, Bartoli F, et al. . The mediating role of depression in pathways linking positive and negative symptoms in schizophrenia. A longitudinal analysis using latent variable structural equation modelling. Psychol Med. 2020;50:566–74. PubMed