G. DELL’ERBA, P. VENTURI, V. TALLARICO - Vol. 9, March 2003, Issue 1
Testo Immagini Bibliografia Summary Indice
Esperienze stressanti infantili in pazienti
con schizofrenia familiare e sporadica
Childhood Stressful Experiences in Familial and Sporadic Schizophrenic
Patients
Objective
Psychosocial risk factors such as early loss of a parent, separation or
pathogenetic rearing practices are indicated as possible antecedents of schizophrenia,
but their role is still unclear. Further, results from various high-risk studies
suggest a possible role of early psychosocial stress in association with genetic
vulnerability in the development of schizophrenia. Therefore, the aim of the
present study was to investigate: 1) type and frequency of childhood stressful
experiences (CSE) in an unselected population of schizophrenics compared to
non psychiatric controls; 2) frequency of CSE in schizophrenic patients divided
according to the familial-sporadic distinction; 3) epidemiological and clinical
features that may help to distinguish familial from sporadic schizophrenia’
subtypes.
Methods
CSE were investigated in 54 schizophrenics and 60 non-psychiatric controls.
These events were defined as: loss of a parent, institutional rearing, or
physical abuse occurred within the first ten years of life of the subject.
The subjects were in-patients attending the Servizio Psichiatrico Diagnosi
e Cura (the acute psychiatric emergency ward) of the San Giuseppe Hospital
of Albano Laziale, Rome: Mental Health Department Azienda USL Roma H, re-admitted
to hospital for an acute relapse of the disease.
We enrolled all 54 patients (35 men and 19 women) whose reliable data were
available through interview of parents and other relatives, case-note review,
and clinical interviews. Retrospective information on Childhood Stress Experiences
was obtained from clinical records, interviews with the patients, and from
any available relative. Family discord, broken homes, or non specific mistreatment
recall was excluded because we were aware of the difficulty to have reliable
information on this topic due to possible recall bias. All patients were followed
by our Psychiatric services and thus, information accuracy was verified with
clinical records and directly interviewing all case managers of the patients
in the study.
Results
Schizophrenic patients experienced more CSE compared with control subjects.
When the overall sample of schizophrenic patients was subdivided according
to the familial Vs sporadic distinction of schizophrenic disorders, family
history positive patients showed an increased frequency of CSE than did sporadic
cases. Early stressful events occurred within the first 7 years of life in
15 out of 17 subjects (88%) that experienced these events.
Conclusions
This results confirm findings of other authors, and further, lend partial
support to a number of studies showing the possible role of timing of exposure
to early psychosocial stressors in determining adult psychopathology in subjects
at risk for schizophrenia. It is argued that the systematic assessment of
CSE may contribute to explain which role is played by social adverse events
experimented from schizophrenic patients during infancy, thus providing important
clues to the explanation of schizophrenic disorders.