SA61. Association Between Childhood Adversity and Ultra-High Risk for Psychosis Status in a Populational Sample of Sao Paulo, Brazil

Abstract

history of psychosis was associated with poor occupational (r = .17) and global (r = .13) outcome. Earlier onset age associated with more hospital-izations, negative symptoms, relapses, worse social/occupational function-ing, and poorer global outcome (correlations .11–.17). Conclusion: The prognosis of schizophrenia is of great scientific and pub-lic health importance. Approximately 1 in 7 individuals with schizophrenia met criteria for recovery. Despite major changes in treatment options in recent decades, the proportion of recovered cases has not increased. It is possible that schizophrenia patients are not treated efficiently or efficient treatments are not available for all patients. Family history of psychosis, earlier onset age, and longer duration of untreated psychosis associated moderately with poorer long-term outcomes in schizophrenia. Current outcomes are unsatisfactory and their exact mechanisms, trajectories, and predictors are partly unknown. Background: The relationship between childhood adversity and psychosis is now well established, and research has been broadened to the ultra-high risk for psychosis (UHR) phase. Some studies showed positive findings regarding this link, but results are still inconsistent and unavailable cross-culturally. Our aim was to assess the association between childhood adver-sity and UHR status in a Latin American sample. Methods: 1950 individuals from the general population between 18 and 35 years of age were randomly drawn from the city of Sao Paulo, Brazil. Participants completed the 92-item Prodromal Questionnaire and those with the highest scores are currently being recruited for the second phase of this cohort study (ongoing). Second phase consists of an interview with the Structured Interview for Psychosis-Risk Syndromes (SIPS), neuropsy-chological assessment (PennCNP), assessments with the 28-item self-report Childhood Trauma Questionnaire (CTQ) and other instruments (for religi-osity, stigma, and so on), and whole blood extraction. The CTQ contains 5 subscales, assessing abuse (Emotional, Physical, and Sexual) and neglect (Emotional and Physical). We present cross-sectional results of participants included in the second phase until the present date (n = 54). Results: Mean age was of 24 years, 55.6% were females, and 51.9% were from income class C (of classes A (highest income), B, C, D, and E). Twenty-three individuals were classified as UHR and 31 as controls; both groups did not statistically differ regarding demographic variables mentioned earlier. Mann-Whitney U test showed significant differences between controls and UHR individuals in the CTQ-Emotional Abuse sub-scale (Mean rank = 20.87 vs 36.43, respectively, P < .001), and in the CTQ-Sexual abuse subscale (Mean rank = 25.05 vs 30.80, respectively, P = .50). Backward stepwise logistic regression included age, sex, income level, and CTQ-subscales scores as independent variables and UHR-status as the dependent variable. Only CTQ-Emotional abuse subscale was retained in the final model (OR = 4.08, 95% confidence interval = 1.60–10.42, P = .003). Conclusion: Our results suggest that, likewise in psychosis, UHR individu-als tend to present more childhood emotional abuse than controls. To the best of our knowledge, this is the first time an UHR sample is assessed concerning childhood abuse in a Latin American country. Further investi-gation should determine whether childhood trauma is able to predict full-blown psychosis and persistence of psychotic experience.