The cumulative and individual effects of stressful life events on first-episode psychosis

Abstract

While there is some evidence linking stressful life events (SLEs) to the risk of first-episode psychosis (FEP), literature remains inconclusive. This study aims to investigate the cumulative influence of SLEs experienced throughout the lifespan, across various domains, on the development of FEP and to explore the specific SLEs that contribute to the onset of psychosis. A descriptive, cross-sectional, case-control study was conducted as part of the PROFEP study in Barcelona, Spain. The sample included 86 FEP patients (24 females; 62 males) and 93 healthy controls (38 females;55 males), aged 13-52 years. SLEs were assessed using the Questionnaire of Stressful Life Events (QSLE). A higher total number of SLEs was associated with FEP. Associations were also found among higher SLEs in the education, work, family, social and health domains, and FEP. Specific SLEs related to FEP were: failing more than three subjects during a school year, being bullying, being fired, being promoted to a higher position, being demoted to a lower position, experiencing sexual problems, being abused by a partner, having an abortion, experiencing abandonment, abuse or mistreatment by family, having separated parents, emancipation or the departure of a family member, death of a non-first degree familiar, and breaking up with a circle of friends. SLEs contribute cumulatively to the development of FEP, particularly those events related to education, work, family, social life, and health. Certain specific events may also impact FEP, highlighting the importance of evaluating SLEs both cumulatively and individually.

Keywords: First-episode psychosis; Stressful life events.