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Major psychotrauma and social stress–risk factors for the unfavorable course of paranoid schizophrenia

Published online by Cambridge University Press:  23 March 2020

T. Udristoiu ,
I. Udristoiu ,
F. Militaru ,
S. Ristea ,
A.G. Vilcea  and
M.C. Pirlog
T. Udristoiu
Affiliation:
University of Medicine and Pharmacy of Craiova, Psychiatry, Craiova, Romania
I. Udristoiu
Affiliation:
University of Medicine and Pharmacy of Craiova, Psychiatry, Craiova, Romania
F. Militaru
Affiliation:
University of Medicine and Pharmacy of Craiova, Psychiatry, Craiova, Romania
S. Ristea
Affiliation:
University Clinic of Psychiatry Craiova, Psychiatry, Craiova, Romania
A.G. Vilcea
Affiliation:
University of Medicine and Pharmacy of Craiova, Psychiatry, Craiova, Romania
M.C. Pirlog
Affiliation:
University of Medicine and Pharmacy of Craiova, Psychiatry, Craiova, Romania

Abstract

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Introduction

Recent studies in the neurobiology of schizophrenia highlighted the role of neuropsychoendocrine activations as a consequence of psychostress followed by the activation of the HPA axis with an excess of endogenous cortisol. The relation endogenous cortisol–glutamatergic hyperactivation enhances the excito-toxic mechanisms and the cortical-subcortical alterations in schizophrenia.

Method

We conducted a retrospective study on 40 patients, with ages between 25 and 55 years, admitted in the university clinic of Craiova between January 1, 2015 and December 31, 2015 for paranoid schizophrenia according to ICD-10 criteria and with positive history of psychotrauma and physical abuse in childhood and adolescence.

Results

The frequency of psychotraumas, social stress and physical abuse in our group was significantly higher in women (63.33%), in patients with urban residence (80.00%) and age group 36–45 years (46.67). There was a pattern of residual defectuality reflected by positive symptoms (83.33%), alcohol abuse (80.00%), aggressive behavior (66.67%) and suicide attempts (30.00%). The poor course with minimal social functioning (GAFS < 40; 36.67%) was correlated with a high number of relapses and hospitalizations (> 9 hospitalizations; 43.33%), cognitive deficit (MMSE < 23; 76.67%). The psychosocial factors involved in the pathogenesis and course of schizophrenia were social stress (60.00%), physical abuse in childhood and adolescence (20.00%) and psychotraumas (20.00%).

Conclusions.

Psychotrauma and physical abuse in childhood and adolescence and during the course of paranoid schizophrenia constitute a risk factor for a poor outcome with cognitive deterioration, aggressive and suicidal behavior that call for prophylactic measures and qualified psycho-social interventions associated to the pharmacological treatments.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Viewing: Schizophrenia and other psychotic disorders
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. s842 - s843
Copyright
Copyright © European Psychiatric Association 2017
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