Differential associations of childhood trauma subtypes with clinical symptoms, cognitive function, suicidal intent, and age at onset in Chinese patients with chronic schizophrenia.

BACKGROUND

Childhood trauma has been linked to adverse clinical features in schizophrenia, but whether these associations differ by trauma subtype remains unclear. This study examined the differential associations of trauma subtypes with multiple clinical features in Chinese patients with chronic schizophrenia.

METHODS

This multicenter cross-sectional study included 649 patients with chronic schizophrenia recruited from ten psychiatric hospitals in China. Childhood trauma, psychotic symptoms, cognitive function, insomnia, depressive symptoms, and suicidal intent were assessed using the CTQ-SF, PANSS, RBANS, ISI, HAMD-24, and BSSI, respectively. Partial correlation analyses and stepwise multivariable linear regression models were performed.

RESULTS

Emotional abuse was significantly associated with positive symptoms (B: 0.231, 95% CI: 0.044, 0.418), insomnia severity (B: 0.259, 95% CI: 0.138, 0.379), depressive symptoms (B: 0.362, 95% CI: 0.169, 0.556), suicidal intent (B: 0.543, 95% CI: 0.286, 0.800), and earlier age at onset (B: -0.335, 95% CI: -0.540, -0.131). Sexual abuse was significantly associated with poorer language performance (B: -0.689, 95% CI: -1.276, -0.102) and greater depressive symptom severity (B: 0.330, 95% CI: 0.039, 0.622). No trauma subtype was significantly associated with negative symptoms, general psychopathology, PANSS total score, immediate memory, visuospatial/constructional ability, attention, delayed memory, or RBANS total score.

CONCLUSION

Emotional abuse showed the broadest pattern of associations across symptom domains, whereas sexual abuse was linked only to language performance and depressive symptoms. These findings highlight the potential value of assessing childhood trauma subtypes in schizophrenia, but should be interpreted cautiously given the cross-sectional design and retrospective trauma assessment.