Abstract
Study on Childhood Trauma and Schizophrenia
This study investigates the role of plasma oxytocin as a mediator between childhood trauma and schizophrenia psychopathology. The research involved 160 patients with schizophrenia and 80 healthy controls, assessing childhood trauma experiences through questionnaires and interviews. Psychopathology was evaluated using the Positive and Negative Syndrome Scale, and plasma oxytocin levels were measured. The findings revealed that patients with schizophrenia had lower oxytocin levels and higher childhood trauma scores than healthy controls. A significant correlation was found between childhood trauma scores and psychopathology, with plasma oxytocin levels inversely associated with psychopathology, except for positive symptoms. Hierarchical regression analysis showed that both childhood trauma scores and plasma oxytocin levels significantly predicted psychopathology. Plasma oxytocin levels partially mediated the relationship between childhood trauma and schizophrenia psychopathology, highlighting the potential role of oxytocin in bridging the gap between childhood trauma and schizophrenia.
Introduction
Childhood Trauma as a Risk Factor for Schizophrenia
Childhood trauma is recognized as a risk factor for psychotic symptoms and schizophrenia. Patients with schizophrenia are more likely to report a history of childhood adversity or trauma than healthy controls. Research has consistently identified increased risks of developing psychotic disorders and schizophrenia in individuals with childhood adversity or trauma experiences. Patients with schizophrenia who experienced childhood trauma typically have an earlier age at schizophrenia onset, worse psychotic symptoms, more severe functional impairment, poorer response to treatment, and a higher risk of suicide than those without such experiences.
The biological mechanisms underlying the association between childhood trauma and schizophrenia remain poorly understood. Few studies have explored potential mediators, such as neurotransmitters and hormones. Oxytocin, a hormonal neuropeptide that regulates social cognition, stress, learning, and memory, has been reported to have a role in regulating the expression of schizophrenia. Studies examining endogenous oxytocin levels in patients with schizophrenia have reported mixed findings, with some suggesting lower levels than in the healthy population.
Methods
Participants and Procedures
The study was conducted between August 2020 and April 2022, approved by the Joint Institutional Review Board of Taipei Medical University. Participants included 160 patients with schizophrenia and 80 healthy controls matched by age and sex. All participants provided written informed consent.
Childhood Trauma Assessment
Childhood trauma experiences were assessed using the Childhood Trauma Questionnaire—Short Form (CTQ-SF) and structured interviews.
Psychopathology Evaluation
The Positive and Negative Syndrome Scale (PANSS) was used to evaluate the severity of psychotic symptoms in patients with schizophrenia.
Oxytocin Laboratory Assessment
Plasma oxytocin levels were determined using an enzyme immunosorbent assay kit.
Covariates Considered
Demographic characteristics, disease-specific variables, cognitive function, age, sex, education years, age of schizophrenia onset, antipsychotic dose, and MMSE scores were included as covariates in the analysis.
Statistical Analysis
Data were analyzed using SPSS Statistics version 26.0. Hierarchical regression analysis was used to investigate predictors of psychopathology. Mediation analysis was conducted to explore the potential association between plasma oxytocin levels and psychopathology in relation to childhood trauma.
Results
Demographic Characteristics, Plasma Oxytocin Levels, Childhood Trauma, and Psychopathology
Patients with schizophrenia had significantly lower plasma oxytocin levels and higher childhood trauma scores compared to healthy controls. There was a higher prevalence of all types of childhood trauma among patients with schizophrenia.
Correlations between Psychopathology and Other Variables
A significant correlation was found between the total CTQ-SF score and the total PANSS score. Plasma oxytocin levels were inversely correlated with both factors.
Hierarchical Regression Analysis of Predictors of Psychopathology
Both childhood trauma scores and plasma oxytocin levels significantly predicted psychopathology.
Mediation Effect of Plasma Oxytocin
Plasma oxytocin levels partially mediated the effect of childhood trauma on schizophrenia psychopathology.
Discussion
The study supports the idea that oxytocinergic system dysfunction is associated with schizophrenia. The findings suggest that oxytocin partially mediates the relationship between childhood trauma and the clinical manifestations of schizophrenia. These insights reinforce the need for preventive measures, early recognition, and targeted interventions in schizophrenia, particularly in individuals with a history of childhood trauma.
Conclusion
The study links childhood trauma to the psychopathology of schizophrenia through the role of oxytocin. It highlights the importance of addressing childhood trauma in patients with schizophrenia and suggests that oxytocin may offer a promising direction for future clinical research and treatment strategies.
Data Availability
The datasets generated during this study are available from the corresponding author upon reasonable request.
Acknowledgements
The authors acknowledge various institutions for their support in this study.
Author Information
The authors involved in this study are Yuan-Jung Chen, Mong-Liang Lu, Yi-Hang Chiu, Chenyi Chen, Vitor Hugo Jesus Santos, and Kah Kheng Goh.
Ethics Declarations
The authors declare no competing interests.
Rights and Permissions
This article is licensed under a Creative Commons Attribution 4.0 International License.
About This Article
This article was received on 29 October 2023, accepted on 31 December 2023, and published on 22 February 2024.
Which SDGs are addressed or connected to the issues highlighted in the article?
The Sustainable Development Goals (SDGs) addressed or connected to the issues highlighted in the article are:
- SDG 3: Good Health and Well-being
- SDG 4: Quality Education
- SDG 5: Gender Equality
- SDG 10: Reduced Inequalities
- SDG 16: Peace, Justice, and Strong Institutions
What specific targets under those SDGs can be identified based on the article’s content?
The specific targets under those SDGs that can be identified based on the article’s content are:
- Target 3.4: Promote mental health and well-being
- Target 3.5: Strengthen the prevention and treatment of substance abuse
- Target 4.7: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all
- Target 5.2: Eliminate all forms of violence against all women and girls
- Target 10.2: Empower and promote the social, economic, and political inclusion of all
- Target 16.1: Significantly reduce all forms of violence and related death rates everywhere
- Target 16.2: End abuse, exploitation, trafficking, and all forms of violence against and torture of children
Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?
The indicators mentioned or implied in the article that can be used to measure progress towards the identified targets are:
- Indicator for Target 3.4: Prevalence of schizophrenia and other mental health disorders
- Indicator for Target 3.5: Rates of childhood trauma experiences among patients with schizophrenia compared to healthy controls
- Indicator for Target 4.7: Access to education and support for individuals with mental health disorders
- Indicator for Target 5.2: Incidence of childhood trauma, particularly sexual abuse, among female patients with schizophrenia
- Indicator for Target 10.2: Social inclusion measures for individuals with mental health disorders
- Indicator for Target 16.1: Rates of violence experienced during childhood among individuals with schizophrenia
- Indicator for Target 16.2: Measures to protect children from trauma and violence to prevent long-term mental health consequences
Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article.
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 3: Good Health and Well-being | Target 3.4: Promote mental health and well-being Target 3.5: Strengthen the prevention and treatment of substance abuse |
Indicator for Target 3.4: Prevalence of schizophrenia and other mental health disorders Indicator for Target 3.5: Rates of childhood trauma experiences among patients with schizophrenia compared to healthy controls |
| SDG 4: Quality Education | Target 4.7: Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all | Indicator for Target 4.7: Access to education and support for individuals with mental health disorders |
| SDG 5: Gender Equality | Target 5.2: Eliminate all forms of violence against all women and girls | Indicator for Target 5.2: Incidence of childhood trauma, particularly sexual abuse, among female patients with schizophrenia |
| SDG 10: Reduced Inequalities | Target 10.2: Empower and promote the social, economic, and political inclusion of all | Indicator for Target 10.2: Social inclusion measures for individuals with mental health disorders |
| SDG 16: Peace, Justice, and Strong Institutions | Target 16.1: Significantly reduce all forms of violence and related death rates everywhere Target 16.2: End abuse, exploitation, trafficking, and all forms of violence against and torture of children |
Indicator for Target 16.1: Rates of violence experienced during childhood among individuals with schizophrenia Indicator for Target 16.2: Measures to protect children from trauma and violence to prevent long-term mental health consequences |
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Fuente: nature.com
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