Threatening Life Events and Difficulties and Psychotic Disorder

Stephanie Beards; Helen L. Fisher; Charlotte Gayer-Anderson; Kathryn Hubbard; Ulrich Reininghaus; Thomas J. Craig; Marta Di Forti; Valeria Mondelli; Carmine Pariante; Paola Dazzan; Robin Murray; Craig Morgan

doi:10.1093/schbul/sbaa005

Threatening Life Events and Difficulties and Psychotic Disorder

Stephanie Beards, Helen L. Fisher, Charlotte Gayer-Anderson, Kathryn Hubbard, Ulrich Reininghaus, Thomas J. Craig, Marta Di Forti, Valeria Mondelli, Carmine Pariante, Paola Dazzan, Robin Murray, Craig Morgan

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Abstract

Objective Stressful life events have been implicated in the onset of psychotic disorders, but there are few robust studies. We sought to examine the nature and magnitude of associations between adult life events and difficulties and first-episode psychoses, particularly focusing on contextual characteristics, including threat, intrusiveness, and independence. Method This study forms part of the Childhood Adversity and Psychosis Study (CAPsy), an epidemiological case-control study in London, United Kingdom. Data on life events and difficulties (problems lasting 4 wk or more) during 1 year prior to onset (cases) or interview (controls) were assessed using the semi-structured Life Events and Difficulties Schedule (LEDS). Data were available on 253 individuals with a first episode of psychosis and 301 population-based controls. Results We found strong evidence that odds of exposure to threatening and intrusive events in the 1 year prior to onset were substantially higher among cases compared with controls, independent of age, gender, ethnicity, and social class (ORs > 3). This was consistent across diagnostic categories. We found further evidence that the effect of threatening events and difficulties was cumulative (1 event odds ratio [OR] 2.69 [95% confidence interval (CI) 1.51–4.79]; 2 events OR 4.87 [95% CI 2.34–10.16]; ≥3 events OR 5.27 [95% CI 1.83–15.19]; 1 difficulty OR 3.02 [95% CI 1.79–5.09]; 2 difficulties OR 9.71 [95% CI 4.20–22.40]; ≥3 difficulties OR 12.84 [95% CI 3.18–51.85]). Conclusions Threatening and intrusive life events and difficulties are common in the year pre-onset among individuals with a first episode of psychosis. Such experiences may contribute to the development of psychotic disorders.

Original language	English
Pages (from-to)	814-822
Number of pages	9
Journal	Schizophrenia Bulletin
Volume	46
Issue number	4
Early online date	12 Feb 2020
DOIs	https://doi.org/10.1093/schbul/sbaa005
Publication status	Published - 1 Jul 2020

Keywords

difficulties
intrusiveness
life events
psychotic disorder

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10.1093/schbul/sbaa005Licence: CC BY

Threatening and Intrusive Life_BEARDS_Accepted12January2020Published12February2020_GOLD VoR (CC BY)Final published version, 222 KBLicence: CC BY

Cite this

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title = "Threatening Life Events and Difficulties and Psychotic Disorder",

abstract = "Objective Stressful life events have been implicated in the onset of psychotic disorders, but there are few robust studies. We sought to examine the nature and magnitude of associations between adult life events and difficulties and first-episode psychoses, particularly focusing on contextual characteristics, including threat, intrusiveness, and independence. Method This study forms part of the Childhood Adversity and Psychosis Study (CAPsy), an epidemiological case-control study in London, United Kingdom. Data on life events and difficulties (problems lasting 4 wk or more) during 1 year prior to onset (cases) or interview (controls) were assessed using the semi-structured Life Events and Difficulties Schedule (LEDS). Data were available on 253 individuals with a first episode of psychosis and 301 population-based controls. Results We found strong evidence that odds of exposure to threatening and intrusive events in the 1 year prior to onset were substantially higher among cases compared with controls, independent of age, gender, ethnicity, and social class (ORs > 3). This was consistent across diagnostic categories. We found further evidence that the effect of threatening events and difficulties was cumulative (1 event odds ratio [OR] 2.69 [95% confidence interval (CI) 1.51–4.79]; 2 events OR 4.87 [95% CI 2.34–10.16]; ≥3 events OR 5.27 [95% CI 1.83–15.19]; 1 difficulty OR 3.02 [95% CI 1.79–5.09]; 2 difficulties OR 9.71 [95% CI 4.20–22.40]; ≥3 difficulties OR 12.84 [95% CI 3.18–51.85]). Conclusions Threatening and intrusive life events and difficulties are common in the year pre-onset among individuals with a first episode of psychosis. Such experiences may contribute to the development of psychotic disorders.",

keywords = "difficulties, intrusiveness, life events, psychotic disorder",

author = "Stephanie Beards and Fisher, {Helen L.} and Charlotte Gayer-Anderson and Kathryn Hubbard and Ulrich Reininghaus and Craig, {Thomas J.} and {Di Forti}, Marta and Valeria Mondelli and Carmine Pariante and Paola Dazzan and Robin Murray and Craig Morgan",

year = "2020",

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doi = "10.1093/schbul/sbaa005",

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AU - Beards, Stephanie

AU - Fisher, Helen L.

AU - Gayer-Anderson, Charlotte

AU - Hubbard, Kathryn

AU - Reininghaus, Ulrich

AU - Craig, Thomas J.

AU - Di Forti, Marta

AU - Mondelli, Valeria

AU - Pariante, Carmine

AU - Dazzan, Paola

AU - Murray, Robin

AU - Morgan, Craig

PY - 2020/7/1

Y1 - 2020/7/1

N2 - Objective Stressful life events have been implicated in the onset of psychotic disorders, but there are few robust studies. We sought to examine the nature and magnitude of associations between adult life events and difficulties and first-episode psychoses, particularly focusing on contextual characteristics, including threat, intrusiveness, and independence. Method This study forms part of the Childhood Adversity and Psychosis Study (CAPsy), an epidemiological case-control study in London, United Kingdom. Data on life events and difficulties (problems lasting 4 wk or more) during 1 year prior to onset (cases) or interview (controls) were assessed using the semi-structured Life Events and Difficulties Schedule (LEDS). Data were available on 253 individuals with a first episode of psychosis and 301 population-based controls. Results We found strong evidence that odds of exposure to threatening and intrusive events in the 1 year prior to onset were substantially higher among cases compared with controls, independent of age, gender, ethnicity, and social class (ORs > 3). This was consistent across diagnostic categories. We found further evidence that the effect of threatening events and difficulties was cumulative (1 event odds ratio [OR] 2.69 [95% confidence interval (CI) 1.51–4.79]; 2 events OR 4.87 [95% CI 2.34–10.16]; ≥3 events OR 5.27 [95% CI 1.83–15.19]; 1 difficulty OR 3.02 [95% CI 1.79–5.09]; 2 difficulties OR 9.71 [95% CI 4.20–22.40]; ≥3 difficulties OR 12.84 [95% CI 3.18–51.85]). Conclusions Threatening and intrusive life events and difficulties are common in the year pre-onset among individuals with a first episode of psychosis. Such experiences may contribute to the development of psychotic disorders.

AB - Objective Stressful life events have been implicated in the onset of psychotic disorders, but there are few robust studies. We sought to examine the nature and magnitude of associations between adult life events and difficulties and first-episode psychoses, particularly focusing on contextual characteristics, including threat, intrusiveness, and independence. Method This study forms part of the Childhood Adversity and Psychosis Study (CAPsy), an epidemiological case-control study in London, United Kingdom. Data on life events and difficulties (problems lasting 4 wk or more) during 1 year prior to onset (cases) or interview (controls) were assessed using the semi-structured Life Events and Difficulties Schedule (LEDS). Data were available on 253 individuals with a first episode of psychosis and 301 population-based controls. Results We found strong evidence that odds of exposure to threatening and intrusive events in the 1 year prior to onset were substantially higher among cases compared with controls, independent of age, gender, ethnicity, and social class (ORs > 3). This was consistent across diagnostic categories. We found further evidence that the effect of threatening events and difficulties was cumulative (1 event odds ratio [OR] 2.69 [95% confidence interval (CI) 1.51–4.79]; 2 events OR 4.87 [95% CI 2.34–10.16]; ≥3 events OR 5.27 [95% CI 1.83–15.19]; 1 difficulty OR 3.02 [95% CI 1.79–5.09]; 2 difficulties OR 9.71 [95% CI 4.20–22.40]; ≥3 difficulties OR 12.84 [95% CI 3.18–51.85]). Conclusions Threatening and intrusive life events and difficulties are common in the year pre-onset among individuals with a first episode of psychosis. Such experiences may contribute to the development of psychotic disorders.

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KW - intrusiveness

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U2 - 10.1093/schbul/sbaa005

DO - 10.1093/schbul/sbaa005

M3 - Article

SN - 0586-7614

VL - 46

SP - 814

EP - 822

JO - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

IS - 4

ER -

Threatening Life Events and Difficulties and Psychotic Disorder

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