Childhood adversity increases risk of psychotic experiences in patients with substance use disorder. (October 2022)

• Record Type: Journal Article
• Authors: Bórquez-Infante, Ignacio; Vasquez, Javiera; Dupré, Sofía; Undurraga, Eduardo A.; Crossley, Nicolás A.; Undurraga, Juan
• Is Part Of: Psychiatry research. Volume 316(2022)
• Publication Date: 2022-10
• Subjects: Adverse childhood experiences -- Psychotic experiences -- Substance related disorders -- Cumulative risk; ACE adverse childhood experience -- PE psychotic experience -- SUD substance use disorder; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2022.114733
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: Adverse childhood experiences (ACEs) are associated with an increased risk of presenting later psychotic experiences (PE) in substance use disorder patients. There is a cumulative risk effect of ACEs in later PE, with an increase of 10% in the odds of presenting PE for each lifetime ACE exposure. The type of ACE and the period when they occurred is important, suggesting the existence of critical periods where the individual is more susceptible to adverse environmental stimuli. Sexual abuse during childhood and deprivation and complex experiences during adolescence increased the probability of presenting later psychotic experiences in this population. Abstract: Introduction: Adverse childhood experiences (ACEs) increase the risk of psychotic experiences (PE), but little is known about heterogeneities of this association in different developmental stages, dimensions, or whether they are affected by substance use disorder (SUD). This study examines the association between different types of ACEs at various developmental stages and lifetime PE in patients with SUD in Chile. Methods: We included 399 consenting adults in outpatient or residential SUD treatment programs. Sociodemographic data and information about PE and ACEs were obtained by trained clinical psychologists. Results: Patients reporting PE experienced more ACEs compared to patients without PE (4.2 versus 3.4). They also experienced more complex adversities (41.8% versus 25.1%), had more psychiatric comorbidities (85% versus 70.4%), and reported using more substances (mean 4.5 versus 3.9). Adjusted association between ACEs and PE showed the highest OR for arrests (1.88), sexual abuse (1.81), alcohol abuse by parents (1.48), school exclusion (1.39), foster or residential care (18.3). Conclusion: Early exposure to ACEs is a risk factor for later PE among patients with SUD. Type of ACE and the period when they occurred is important, suggesting the existence of critical periods where the individual is more susceptible to adverse environmental stimuli.