Stephanie Deighton1, Lisa Buchy1, Kristin S Cadenhead2, Tyrone D Cannon3, Barbara A Cornblatt4, Thomas H McGlashan5, Diana O Perkins6, Larry J Seidman7, Ming T Tsuang3, Elaine F Walker8, Scott W Woods5, Carrie E Bearden9, Daniel Mathalon10, Jean Addington11. 1. Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. 2. Department of Psychiatry, UCSD, La Jolla, CA, United States. 3. Department of Psychology, Yale University, New Haven, CT, United States. 4. Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States. 5. Department of Psychiatry, Yale University, New Haven, CT, United States. 6. Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States. 7. Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States. 8. Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, United States. 9. Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, United States; Department of Psychology, UCLA, Los Angeles, CA, United States. 10. Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States. 11. Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. Electronic address: jmadding@ucalgary.ca.
Abstract
BACKGROUND: Recent research suggests that a traumatic brain injury (TBI) can significantly increase the risk of later development of psychosis. However, it is unknown whether people at clinical high risk (CHR) of psychosis have experienced TBI at higher rates, compared to otherwise healthy individuals. This study evaluated the prevalence of mild TBI, whether it was related to past trauma and the relationship of mild TBI to later transition to psychosis. METHODS: Seven-hundred forty-seven CHR and 278 healthy controls (HC) were assessed on past history of mild TBI, age at first and last injury, severity of worst injury and number of injuries using the Traumatic Brain Injury Interview. Attenuated psychotic symptoms were assessed with the Scale of Psychosis-risk Symptoms. IQ was estimated using the Wechsler Abbreviated Scale of Intelligence and past trauma and bullying were recorded using the Childhood Trauma and Abuse Scale. RESULTS: CHR participants experienced a mild TBI more often than the HC group. CHR participants who had experienced a mild TBI reported greater total trauma and bullying scores than those who had not, and those who experienced a mild TBI and later made the transition to psychosis were significantly younger at the age at first and most recent injury than those who did not. CONCLUSION: A history of mild TBI is more frequently observed in CHR individuals than in HC. Inclusion or study of CHR youth with more severe TBI may provide additional insights on the relationship between TBI and later transition to psychosis in CHR individuals.
BACKGROUND: Recent research suggests that a traumatic brain injury (TBI) can significantly increase the risk of later development of psychosis. However, it is unknown whether people at clinical high risk (CHR) of psychosis have experienced TBI at higher rates, compared to otherwise healthy individuals. This study evaluated the prevalence of mild TBI, whether it was related to past trauma and the relationship of mild TBI to later transition to psychosis. METHODS: Seven-hundred forty-seven CHR and 278 healthy controls (HC) were assessed on past history of mild TBI, age at first and last injury, severity of worst injury and number of injuries using the Traumatic Brain Injury Interview. Attenuated psychotic symptoms were assessed with the Scale of Psychosis-risk Symptoms. IQ was estimated using the Wechsler Abbreviated Scale of Intelligence and past trauma and bullying were recorded using the Childhood Trauma and Abuse Scale. RESULTS: CHR participants experienced a mild TBI more often than the HC group. CHR participants who had experienced a mild TBI reported greater total trauma and bullying scores than those who had not, and those who experienced a mild TBI and later made the transition to psychosis were significantly younger at the age at first and most recent injury than those who did not. CONCLUSION: A history of mild TBI is more frequently observed in CHR individuals than in HC. Inclusion or study of CHR youth with more severe TBI may provide additional insights on the relationship between TBI and later transition to psychosis in CHR individuals.
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