Supplementary file 1_Childhood trauma and relationship with the parents: associations with lipids, glucose, and prolactin levels during antipsychotic treatment in patients with first-episode psychosis.docx

BackgroundBesides antipsychotics and other clinical factors, childhood trauma (CT) may also alter metabolic and endocrine profiles. The aim was to determine whether CT influence metabolic profiles and prolactin levels in patients with first-episode psychosis treated with antipsychotics for up to one year. The quality of the relationship with the parents was also investigated.
MethodsTwo hundred twenty-six patients with low-density lipoprotein (LDL), high-density lipoprotein (HDL), non-HDL, total cholesterol, triglycerides, fasting plasma glucose, and prolactin levels monitored routinely before and during antipsychotic treatment were included. CT refers to physical, sexual, or emotional abuse occurring before the prodromal phase and up to 16 years old and was assessed during the patients’ 3 years follow-up. The quality of the relationship with parents was assessed at the beginning of the follow-up.
ResultsAfter 12 months, CT was associated with an increase in total and non-HDL cholesterol levels (+17%, 95%CI:[0.4; 34]; +11%, 95%CI:[0.4; 21], respectively). Lack of a good relationship with the father was associated at 2 and 12 months with above-median levels of LDL (OR=5.5, 95%CI:[1.3, 28]; OR=3.7, 95%CI:[1.3; 12], respectively) and non-HDL (OR=4.7, 95%CI:[1.3; 19]; OR=2.8, 95%CI:[1.0; 8.0], respectively). Lack of a good relationship with the mother was associated with higher baseline prolactin levels in women (124 ng/ml, 95%CI:[91; 157]) and increased total cholesterol levels after 2 and 12 months (21%, 95%CI:[5.9; 36]; 12%, 95%CI:[1.1; 24]), respectively).
ConclusionChildhood trauma or a lack of a good relationship with one parent is associated with worse metabolic and prolactin profiles in first-episode psychosis patients during the first year of antipsychotic treatment.

背景 除抗精神病药物及其他临床因素外，儿童期创伤（childhood trauma, CT）亦可改变机体代谢与内分泌谱。本研究旨在明确接受为期1年以内抗精神病药物治疗的首发精神病患者中，儿童期创伤是否会对其代谢谱及催乳素水平产生影响，同时探究患者与父母的亲子关系质量。
方法 本研究纳入226例患者，所有患者均在抗精神病药物治疗前及治疗期间常规监测低密度脂蛋白（low-density lipoprotein, LDL）、高密度脂蛋白（high-density lipoprotein, HDL）、非高密度脂蛋白（non-HDL）、总胆固醇、甘油三酯、空腹血浆葡萄糖及催乳素水平。儿童期创伤指前驱期前至16岁前发生的躯体虐待、性虐待或情感虐待，于患者3年随访期间进行评估；亲子关系质量则于随访开始时完成评估。
结果 随访12个月后，儿童期创伤与总胆固醇及非高密度脂蛋白胆固醇水平升高相关（分别升高17%，95%置信区间[0.4, 34]；升高11%，95%置信区间[0.4, 21]）。与父亲关系不佳分别在随访2个月及12个月时，与低密度脂蛋白（比值比OR=5.5，95%置信区间[1.3, 28]；OR=3.7，95%置信区间[1.3, 12]）及非高密度脂蛋白胆固醇水平高于中位数相关（OR=4.7，95%置信区间[1.3, 19]；OR=2.8，95%置信区间[1.0, 8.0]）。与母亲关系不佳则与女性患者较高的基线催乳素水平相关（124 ng/ml，95%置信区间[91, 157]），同时分别在随访2个月及12个月时与总胆固醇水平升高相关（分别升高21%，95%置信区间[5.9, 36]；升高12%，95%置信区间[1.1, 24]）。
结论 在接受抗精神病药物治疗的第一年中，首发精神病患者若存在儿童期创伤或与父母一方关系不佳，其代谢及催乳素谱情况更差。