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. 2023 Jan 12;23(1):29.
doi: 10.1186/s12888-023-04531-3.

Exploring the association between lifetime traumatic experiences and positive psychotic symptoms in a group of long-stay patients with schizophrenia: the mediating effect of depression, anxiety, and distress

Clara Rahme #  1 , Nisreen El Kadri #  2 , Chadia Haddad  1   3   4 , Feten Fekih-Romdhane #  5   6 , Sahar Obeid #  7 , Souheil Hallit #  8   9   10
Affiliations

Exploring the association between lifetime traumatic experiences and positive psychotic symptoms in a group of long-stay patients with schizophrenia: the mediating effect of depression, anxiety, and distress

Clara Rahme et al. BMC Psychiatry. .

Abstract

Background: Positive psychotic symptoms of schizophrenia are generally characterized by hallucinations and delusions. We propose to assess the relationship between total composite trauma and positive psychotic symptoms, along with the mediation effect of cognition, fear of COVID-19, insomnia, anxiety, distress, and depression of Lebanese patients with schizophrenia.

Methods: A cross-sectional study was carried out, between June and July 2021, by deriving data from 155 long-stay in-patients diagnosed with schizophrenia.

Results: Depression, anxiety, and distress but not cognitive impairment, insomnia, and fear of COVID-19) mediated the association between lifetime traumatic experiences and positive psychotic symptoms. Higher traumatic experiences were associated with greater depression, anxiety, and distress, indicating a significant positive total effect on positive psychotic scores. Moreover, higher depression, anxiety, and distress were significantly associated with higher positive psychotic symptoms.

Conclusion: Our results contribute to the existing knowledge by suggesting other possible intervention paths through mediating factors. Interventions that improve anxiety, depression, and distress severity may be effective in reducing positive psychotic symptoms among patients with schizophrenia having experienced lifetime trauma.

Keywords: Anxiety; Depression; Distress; Positive psychotic symptoms; Schizophrenia; Trauma.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Conceptual framework of the association between lifetime traumatic experiences and positive psychosis symptoms, while considering cognitive impairment, insomnia, and psychological factors as mediators [27]
Fig. 2
Fig. 2
(a) Relation between lifetime traumatic experiences and depression (R2 = 20.40%); (b) Relation between depression and positive PANSS (R2 = 20.80%); (c) Total effect of the relation between lifetime traumatic experiences and positive PANSS (R2 = 20.8%); (c’) Direct effect of the relation between lifetime traumatic experiences and positive PANSS. Numbers are displayed as regression coefficients (standard error). **p < 0.01; *p < 0.05
Fig. 3
Fig. 3
(a) Relation between lifetime traumatic experiences and anxiety (R2 = 20.40%); (b) Relation between anxiety and positive PANSS (R2 = 17.70%); (c) Total effect of the relation between lifetime traumatic experiences and positive PANSS (R2 = 14.80%); (c’) Direct effect of the relation between lifetime traumatic experiences and positive PANSS. Numbers are displayed as regression coefficients (standard error). **p < 0.01; *p < 0.05
Fig. 4
Fig. 4
(a) Relation between lifetime traumatic experiences and distress (R2 = 27.80%); (b) Relation between distress and positive PANSS (R2 = 21.10%); (c) Total effect of the relation between lifetime traumatic experiences and positive PANSS (R2 = 14.80%); (c’) Direct effect of the relation between lifetime traumatic experiences and positive PANSS. Numbers are displayed as regression coefficients (standard error). ***p < 0.001; **p < 0.01; *p < 0.05
See this image and copyright information in PMC

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