Study On The Effect Of The Childhood Trauma In Suicidal Symptoms In Schizophrenia Patients

Background and Objective: With the advancement of modern society,the burden of mental illness has drastically increased,and China has gradually become the largest country in the world with mental illness burdens.Among the heavy-burden mental illnesses,schizophrenia is the most common and the most serious mental disease;thus,the study of schizophrenia is of great significance.Many studies have shown that childhood trauma is a risk factor for schizophrenia and suicidal symptoms in adults.However,the specific relationship between childhood trauma and suicidal symptoms remains unclear,which is the biggest challenge facing the diagnosis and treatment of schizophrenia patients in China.Therefore,this study aimed to explore the possible relationship between childhood trauma and suicidal symptoms in schizophrenia patients at different stages of illness.Methods: A total of 91 patients were enrolled in this study,all of whom met the diagnostic criteria of schizophrenia according to DSM-5（Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition）and were inpatients in the Affiliated Psychological Hospital of Anhui Medical University from February 2018 to December2021.Enrolled patients were divided into a first-episode schizophrenia group（first-episode schizophrenia,n = 46）and a relapsing schizophrenia group（relapsing schizophrenia,n = 45）.The Positive And Negative Syndrome Scale（PANSS）was used to assess the severity of psychotic symptoms,and the Beck’s Suicidal Ideation Scale（BSIS）and Nurse’s Suicide Risk Assessment Scale（NGASR）were self-rated by patients to assess suicidal symptoms.Additionally,the Childhood Trauma Questionnaire（CTQ）was used to assess the severity of trauma experienced during childhood.First,we used a t-test to determine whether there were differences in general demographic information and psychotic symptoms between the two groups.Then,another T-test was used to analyze the differences in suicidal symptoms and childhood trauma between the two groups.Next,the predictors correlated with suicidal symptoms in the two groups were analyzed by Spearman correlation analysis.Finally,according to the results of the correlation analysis,a stepwise regression analysis was conducted to analyze which factors could be the risk predictors of suicidal symptoms.Results: There were no significant differences in age,sex,BMI,and years of education between the first schizophrenia group and the relapsing schizophrenia group（P >0.05）.There was no statistical significance in the PANSS score between the two groups（P >0.05）.Through analysis,we found that the severity of suicidal symptoms and childhood trauma differed between the first-episode schizophrenia group and the relapsing schizophrenia group significantly.In BSIS,the differences in suicide risk between the two groups was statistically significant.In NGASR,we found statistically significant differences between the two groups in severe mental illness and recent psychosocial stress.The CTQ analysis results showed statistically significant differences between the two groups in emotional abuse,emotional neglect,and physical neglect.Regarding the correlation between suicidal symptoms in the first-episode schizophrenia group and the relapsing schizophrenia group,we found that in the first-episode schizophrenia group,physical abuse and sexual abuse were significantly positively correlated with recent psychosocial stress（P <0.05）.BMI was significantly positively correlated with recent psychosocial stress,suicide risk,suicide ideation,and proneness to suicide behaviour in relapsing group（P <0.05）.Overall,there was a significant positive correlation between years of education and severe mental illness（P<0.05）,a significant positive correlation between sexual abuse and suicidal ideation（P<0.05）,and a significant positive correlation between body neglect and recent psychosocial stress,severe mental illness,suicide risk,suicide ideation,and proneness to suicide behaviour（P <0.05）.As for the risk factors of suicide symptoms,we found that BMI accounted for 22.4% of the recent psychosocial stress in the first-episode schizophrenia group,BMI was positively correlated with recent psychosocial stress（β=0.473,t =3.521,P <0.001）.There was a significant correlation positively between BMI and severe mental illness（β=0.672,t =5.949,P <0.001）.Emotional neglect accounted for 38.2% of the suicide risk,and accounted for 41.4% of the proneness to suicide behaviour.There was a positive correlation between emotional neglect and suicide risk（β=0.618,t =5.518,P <0.001）,and a positive correlation between emotional neglect and proneness to suicide behaviour（β= 0.809,t = 5.356,P < 0.001）.In addition,we found that BMI weas positively correlated with suicidal ideation and emotional neglect（β= 0.909,T = 2.463,P = 0.018）,and accounted for 75.5%of emotional neglect and suicidal ideation.These results suggest that BMI and emotional neglect（C4）might be predictors in suicidal symptoms in schizophrenia.Conclusion : Compared with first-episode schizophrenia patients,recurrent schizophrenia patients have more severe suicidal symptoms and childhood trauma.In the first-episode schizophrenia group,BMI might be a predictor of suicidal symptoms from the perspective of recent psychosocial stress.In recurrent schizophrenia patients,BMI could be a predictor for the severity of suicidal symptoms in terms of severe mental illness and suicidal ideation,while emotional neglect could be a predictor for the severity of suicide symptoms in terms of suicide risk,suicidal ideation,and proneness to suicide behaviour.