Childhood maltreatment and social functioning in psychotic disorders: a systematic review protocol

<b>Background</b>: Childhood maltreatment (CM) is thought to play a key role in the etiology and course of psychotic disorders (PD). In addition, CM is related to neurobiological and clinical characteristics that can lead to poor social functioning. However, the extent to which CM and social functioning are directly associated in individuals with PD, is unclear. Therefore, we aim to systematically review the literature to provide an estimate on the strength of the association between CM and different domains of social functioning in PD and to summarize potential moderators and mediators of this association. <b>Methods and analysis</b>: To identify relevant studies, we will systematically search the following databases: Pubmed (Medline), PsycInfo, Embase, Web of Science (Core Collection), and Pilots (trauma), manually search reference lists and contact experts in the field. Studies will be included if they investigate and report on the association between CM (exposure) and social functioning (outcome) in adults with PD. Two independent reviewers will screen titles, abstracts and full texts according to eligibility criteria, perform data extraction and assess study quality according to a modified version of the Newcastle–Ottawa Scale. <b>Analysis</b>: Effect estimates will be pooled in a meta-analysis. Heterogeneity and publication bias will be assessed and the effects of potential moderators (genetic factors, type of diagnosis, duration of illness, type of CM and age at the time of CM exposure) will be analyzed using meta-regressions. Candidate moderators and mediators (neurocognition, cognitive schemas, comorbidities, stress sensitivity, attachment) will be also examined qualitatively. <b>Ethics and dissemination</b>: Because this review will make use of already published data, ethical approval will not be sought. This work has the potential to inform upcoming investigations on the association between the exposure to CM in PD and social functioning. PROSPERO registration number CRD42020175244. The first systematic review (and meta-analysis) of the association between CM and different domains of social functioning in individuals with PD.Evidence on both moderators and mediators of the association is summarized. The first systematic review (and meta-analysis) of the association between CM and different domains of social functioning in individuals with PD. Evidence on both moderators and mediators of the association is summarized.

**背景**：学界普遍认为童年期虐待（Childhood Maltreatment, CM）在精神病性障碍（Psychotic Disorders, PD）的病因学与病程进展中发挥关键作用。此外，童年期虐待还与可导致社会功能受损的神经生物学及临床特征相关。然而，目前尚不清楚精神病性障碍患者群体中，童年期虐待与社会功能之间的直接关联程度究竟如何。因此，本研究拟通过系统回顾文献，量化分析精神病性障碍患者的童年期虐待与不同维度社会功能之间的关联强度，并总结该关联的潜在调节因素与中介因素。
**方法与分析**：为筛选相关研究，本研究将系统检索PubMed（Medline）、PsycInfo、Embase、Web of Science（核心合集）及Pilots（创伤领域）数据库，同时手工检索参考文献列表并联系该领域专家。纳入标准为：研究针对成年精神病性障碍患者，探讨并报告了童年期虐待（暴露因素）与社会功能（结局指标）之间的关联。将由2名独立评审员按照纳入排除标准筛选文献标题、摘要及全文，进行数据提取，并采用改良版纽卡斯尔-渥太华量表（Newcastle–Ottawa Scale）评估研究质量。
**分析**：本研究将通过元分析合并效应量，同时评估异质性与发表偏倚，并采用元回归分析潜在调节因素（遗传因素、诊断类型、病程时长、童年期虐待类型及童年期虐待暴露时的年龄）的效应。此外，还将对候选调节与中介因素（神经认知功能、认知图式、共病情况、应激敏感性、依恋类型）进行定性分析。
**伦理与传播**：由于本综述仅使用已发表数据，因此无需申请伦理批准。本研究有望为后续针对精神病性障碍患者童年期虐待暴露与社会功能关联的研究提供参考。本研究已在PROSPERO平台注册，注册号为CRD42020175244。本研究是首个针对精神病性障碍患者童年期虐待与不同维度社会功能关联的系统综述（及元分析），并系统总结了该关联的调节因素与中介因素相关证据。