Child sexual abuse survivors: Differential complex multimodal treatment outcomes for pre-COVID and COVID era cohorts.

BACKGROUND: Child sexual abuse (CSA) is a form of early-life trauma that affects youth worldwide. In the midst of the current COVID-19 pandemic, it is imperative to investigate the potential impact of added stress on already vulnerable populations. OBJECTIVE: The aim of this study was to evaluate the effectiveness of a multimodal treatment program on mental health outcomes for youth CSA survivors aged 8-17. Secondary to this, we explored the potential impact of the COVID-19 on treatment outcomes. PARTICIPANTS AND SETTING: Participants of this study were children and youth aged 8-17 who were engaged in a complex multimodal treatment program specifically designed for youth CSA survivors. METHODS: Participants were asked to complete self-report surveys at baseline and at the end of two subsequent treatment rounds. Surveys consisted of measures pertaining to: (1) PTSD, (2) depression, (3) anxiety, (4) quality of life, and (5) self-esteem. RESULTS: Median scores improved for all groups at all timepoints for all five domains. For the pre-Covid participants, the largest improvements in the child program were reported in depression (36.6 %, p = 0.05); in the adolescent program anxiety showed the largest improvement (-35.7 %, p = 0.006). Improvements were generally maintained or increased at the end of round two. In almost every domain, the improvements of the pre-COVID group were greater than those of the COVID-I group. CONCLUSIONS: A complex multimodal treatment program specifically designed for youth CSA survivors has the capacity to improve a number of relevant determinants of mental health and well-being. The COVID-19 pandemic may have retraumatized participants, resulting in treatment resistance.

The effect of childhood trauma on age of onset in patients with schizophrenia.

PURPOSE: Childhood trauma (CT) has been shown to affect the etiology and clinical features of schizophrenia. In this study, it was aimed to investigate the effects of CT on the age of onset (AoO) and clinical features of the disease by considering factors such as family history, head trauma, birth trauma, alcohol and substance abuse that may affect AoO of the disease. METHODS: The sample comprising 200 patients admitted to the outpatient and inpatient care at the Izmir Katip Çelebi University, Atatürk Education and Research Hospital psychiatry clinic, were included in the study. Socio-demographic information form, Positive and Negative Syndrome Scale (PANSS), Childhood Trauma Questionnaire-Short Form (CTQ-SF) and subscale of Mini-International Neuropsychiatric Interview (MINI) were applied. RESULTS: All types of trauma, except physical abuse, were found related to the disease onset age earlier. It was also detected that the factors of head trauma, birth complication, presence of an individual diagnosed with schizophrenia in the family and migration history were not related to AoO of the disease. On the other hand, it was found that physical, emotional and sexual abuses lead to more positive psychotic symptoms, and all types of CT increase the severity of disease and the risk of suicide. CONCLUSION: This study draws attention to the etiological importance of CT in schizophrenia as an environmental factor by showing that it affects AoO of the disease along with symptomatology. Future studies should focus on the pathogenesis of CT in schizophrenia and the interaction between CT and biological and genetic predisposition.