Childhood trauma and suicide risk in schizophrenia inpatients: the sequential mediating roles of COVID-19 related psychological impact, sleep quality, and emotional distress (preprint)

Purpose The stressful global situation due to the COVID-19 pandemic has had a tremendous impact on mental health in hospitalized patients with schizophrenia. The mediating roles of psychological impacts related to COVID-19 sleep quality and emotional distress were investigated in the association between childhood trauma and suicide risk in inpatients with schizophrenia. Methods A total of 270 participants, including 125 in-patients with schizophrenia and 145 healthy controls (HCs) were enrolled. Childhood trauma, psychological impact related to COVID-19, global sleep quality, and psychological distress were measured using the Childhood Trauma Questionnaires (CTQ), Impact of Event Scale-Revised (IES-R), Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety and Stress Scale (DASS-21), respectively. Results The total score and subtype scores of CTQ and the mean scores of the IES-R, PSQI, and DASS-21 in patients with schizophrenia were higher than those in HCs (all p < 0.001). Hierarchical linear regression analyses showed that a history of childhood trauma or schizophrenia was a good predictor of psychological impact, global sleep quality, and emotional distress (all p < 0.01). Moreover, the chain mediation model showed that the effect of childhood trauma on suicide risk in hospitalized patients with schizophrenia was totally sequentially mediated by thepsychological impact of COVID-19, sleep quality, and emotional distress. Conclusions It is important for clinicians to recognize the increased suicide risk associated with COVID-19-related psychological distress in patients with schizophrenia with a history of childhood trauma.

Psychological stresses among Chinese university students during the COVID-19 epidemic: The effect of early life adversity on emotional distress.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is leading to numerous psychological outcomes, especially emotional distress. Individuals with early life adversity (ELA) may be more susceptible to those psychological stresses during this epidemic. AIMS: To measure the effect of the ELA on acute stress reactions, anxiety and depression during the COVID-19 epidemic, and to examine whether specific trauma types and frequencies of exposure are associated with a more severe acute stress reaction and increased risk of anxiety and depressive symptoms. METHOD: This investigation was performed at college students in a comprehensive University of China. The online self-report questionnaire included ELA experiences, exposure to epidemic-related events, acute stress reactions, and anxiety and depression symptoms during the COVID-19 epidemic. Logistic regression and stepwise regression were used to assess the associations and interactions among these variables. RESULTS: Participants with ELA reported more exposure to epidemic-related events and more severe stress reactions during the epidemics than did those with no ELA. The experience of ELA is associated with acute stress reactions, anxiety and depression in early adulthood. Furthermore, experiencing more ELA during childhood may not only increase the risk of anxiety and depression episode in early adulthood but also lead to more severe acute stress reactions during the epidemic. CONCLUSION: Regardless of specific ELA types, ELAs have longer time effects on individual's susceptibility to stress. Under this epidemic, the mental health in young adults with ELA needs more attention.