Relationship between childhood trauma and level of insight in schizophrenia: A path-analysis in the national FACE-SZ dataset
Schizophrenia Research. 2019-06-01; 208: 90-96
DOI: 10.1016/j.schres.2019.04.006
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1. Schizophr Res. 2019 Jun;208:90-96. doi: 10.1016/j.schres.2019.04.006. Epub
2019 Apr 23.
Relationship between childhood trauma and level of insight in schizophrenia: A
path-analysis in the national FACE-SZ dataset.
Pignon B(1), Lajnef M(2), Godin O(3), Geoffray MM(4), Rey R(4), Mallet J(5),
Dubertret C(5), Roux P(6), Passerieux C(6), Marulaz L(7), Brunel L(7), Dubreucq
J(8), Leignier S(8), Capdevielle D(9), André M(9), Aouizerate B(10), Misdrahi
D(11), Berna F(12), Vidailhet P(12), Chereau I(13), Llorca PM(13), Fond G(14),
Lançon C(14), Leboyer M(7), Schürhoff F(7); FondaMental Academic Centers of
Expertise for Schizophrenia (FACE-SZ) collaborators.
Collaborators: Andrianarisoa MD(15), Aouizerate B(16), Berna F(17), Blanc O(18),
Brunel L(19), Bulzacka E(19), Capdevielle D(20), Chereau-Boudet I(18),
Chesnoy-Servanin G(21), Danion J(17), D’Amato T(21), Deloge A(22), Delorme
C(23), Denizot H(18), Dorey JM(21), Dubertret C(24), Dubreucq J(23), Faget
C(25), Fluttaz C(23), Fond G(19), Fonteneau S(26), Gabayet F(23), Giraud-Baro
E(23), Hardy-Bayle MC(26), Lacelle D(18), Lançon C(25), Laouamri H(15), Leboyer
M(19), Le Gloahec T(19), Le Strat Y(24), Llorca PM(18), Mallet J(24), Metairie
E(25), Misdrahi D(22), Offerlin-Meyer I(17), Passerieux C(26), Peri P(25), Pires
S(18), Portalier C(24), Rey R(21), Roman C(23), Sebilleau M(26), Schandrin
A(20), Schurhoff F(19), Tessier A(22), Tronche A(18), Urbach M(26), Vaillant
F(25), Vehier A(21), Vidailhet P(17), Vilà E(22), Yazbek H(20), Zinetti-Bertschy
A(17).
Author information:
(1)Fondation Fondamental, Créteil, France; INSERM U955, Translational Psychiatry
Team, Créteil, France; Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor,
Créteil, France; Université Paris-Est Créteil (UPEC), AP-HP, DHU Pe-PSY,
Créteil, France. Electronic address: .
(2)Fondation Fondamental, Créteil, France; INSERM U955, Translational Psychiatry
Team, Créteil, France.
(3)Fondation Fondamental, Créteil, France.
(4)Fondation Fondamental, Créteil, France; Université Claude Bernard Lyon
1/Centre Hospitalier Le Vinatier Pole Est BP 300 39 – 95 bd Pinel – 69678 BRON
Cedex, France.
(5)Fondation Fondamental, Créteil, France; AP-HP, Department of Psychiatry,
Louis Mourier Hospital, Inserm U894, Université Paris Diderot, Sorbonne Paris
Cité, Faculté de médecine, Colombes, France.
(6)Fondation Fondamental, Créteil, France; Service Universitaire de Psychiatrie
d’adultes, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le
Chesnay, France; Laboratoire HandiRESP, EA4047, UFR des Sciences de la santé
Simone Veil, Université de Versailles Saint-Quentin-En-Yvelines, 2 Avenue de la
Source de la Bièvre, 78180 Montigny-le-Bretonneux, France.
(7)Fondation Fondamental, Créteil, France; INSERM U955, Translational Psychiatry
Team, Créteil, France; Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor,
Créteil, France; Université Paris-Est Créteil (UPEC), AP-HP, DHU Pe-PSY,
Créteil, France.
(8)Fondation Fondamental, Créteil, France; Centre Référent de Réhabilitation
Psychosociale, CH Alpes Isère, Grenoble, France.
(9)Fondation Fondamental, Créteil, France; Service Universitaire de Psychiatrie
Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1,
Inserm 1061, Montpellier, France.
(10)Fondation Fondamental, Créteil, France; Centre Hospitalier Charles Perrens,
F-33076 Bordeaux, France; Inserm, Neurocentre Magendie, Physiopathologie de la
Plasticité Neuronale, U862, F-33000 Bordeaux, France; Université de Bordeaux,
France.
(11)Fondation Fondamental, Créteil, France; Centre Hospitalier Charles Perrens,
F-33076 Bordeaux, France; CNRS UMR 5287-INCIA, France; Université de Bordeaux,
France.
(12)Fondation Fondamental, Créteil, France; Hôpitaux Universitaires de
Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine
Translationnelle de Strasbourg, Strasbourg, France.
(13)Fondation Fondamental, Créteil, France; CMP B, CHU, EA 7280 Faculté de
Médecine, Université d’Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France.
(14)Fondation Fondamental, Créteil, France; Assistance Publique des Hôpitaux de
Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France.
(15)Fondation Fondamental, France.
(16)Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France; Fondation
Fondamental, France; Université de Bordeaux, Inserm, Neurocentre Magendie,
Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France.
(17)Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM
U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg,
France; Fondation Fondamental, France.
(18)CMP B, CHU, EA 7280 Faculté de Médecine, Université d’Auvergne, BP 69 63003
Clermont-Ferrand Cedex 1, France; Fondation Fondamental, France.
(19)AP-HP, DHU Pe-PSY, Pôle de Psychiatrie et d’addictologie des Hôpitaux
Universitaires H Mondor,INSERM U955, Eq 15 Psychiatrie Translationelle,
Université Paris Est-Créteil, Créteil, France; Fondation Fondamental, France.
(20)Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU
Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France;
Fondation Fondamental, France.
(21)Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP
300 39 – 95 bd Pinel – 69678 BRON Cedex, France; Fondation Fondamental, France.
(22)Centre Hospitalier Charles Perrens, F-33076 Bordeaux, France; Fondation
Fondamental, France; Université de Bordeaux, CNRS UMR 5287-INCIA, France.
(23)Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble,
France; Fondation Fondamental, France.
(24)AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm
U894 Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France;
Fondation Fondamental, France.
(25)Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de
psychiatrie, Marseille, France; Fondation Fondamental, France.
(26)Service de psychiatrie d’adulte, Centre Hospitalier de Versailles, Le
Chesnay, EA 4047 HANDIReSP, UFR des Sciences de la Santé Simone Veil, Université
Versailles Saint-Quentin en Yvelines, Versailles, France; Fondation Fondamental,
France.
INTRODUCTION: This study aimed was to investigate the relationship between
different types of childhood trauma and the level of insight (i.e., awareness of
having a psychiatric disorder) in subjects suffering from schizophrenia, as well
as the putative role of clinical mediators.
METHODS: 294 community-dwelling subjects with stable schizophrenia were included
into FACE-SZ, a multicentre cross-sectional study. All patients were assessed by
specialized multidisciplinary teams. The level of insight was assessed by the
Scale to assess Unawareness of Mental Disorder (SUMD), and childhood trauma by
the Childhood Trauma Questionnaire (CTQ). Path analyses from the five CTQ
subscales (physical abuse and neglect, emotional abuse and neglect, and sexual
abuse) and the SUMD, with current symptomatology (i.e., positive, negative,
global psychopathology and depression) as mediator, was performed.
RESULTS: Physical neglect (β = 0.14) and abuse (β = 0.13) were significantly
associated with poor insight. Negative symptoms were a clinical mediator of the
relationship between physical neglect and poor insight. Moreover, positive
(β = 0.21) and negative (β = 0.30) symptoms were associated with poor insight,
whereas depression (β = -0.14) was associated with higher levels of insight.
DISCUSSION: For the first time, this study shows a significant relationship
between childhood trauma, specifically physical neglect and abuse, and poor
insight. The level of insight was linked to different clinical dimensions. Among
subjects with schizophrenia, these results provide support for a role of
childhood trauma in poorer management outcomes, and the need to provide
treatment, including psycho-education that better targets the consequences of
childhood trauma.
Copyright © 2019 Elsevier B.V. All rights reserved.
DOI: 10.1016/j.schres.2019.04.006
PMID: 31028001 [Indexed for MEDLINE]