Emotional maltreatment shapes the relationship between psychosocial functioning and hippocampal structure in schizophrenia spectrum disorders.

BACKGROUND

The hippocampus and amygdala are important limbic structures involved in memory, emotional regulation, and stress response, which are pivotal for social interactions, everyday functioning, and participation in community life. However, the presumably bidirectional relationship between limbic structure and psychosocial functioning-and the potential moderating role of early-life environmental risk factors-remains poorly understood in schizophrenia spectrum (SSD) and mood disorders (MOD).

METHODS

Structural 3 T MRI data were collected from SSD (n = 64) and MOD (n = 66) patients as well as healthy controls (HC, n = 46). Hippocampal subfields and amygdala nuclei were segmented using FreeSurfer v7.3.2. Psychosocial functioning was assessed with the Personal and Social Performance Scale (PSP). Childhood maltreatment, urban upbringing, and migration background were examined as potential moderators.

RESULTS

SSD patients showed significant volume reductions in left hippocampal subfields compared to HC (FDR-corrected p < .05). Within SSD, PSP scores were associated with volumes of the left hippocampal body, tail, and molecular layer (FDR-corrected p < .05), with emotional abuse and neglect significantly moderating these associations. No other environmental risk factors showed significant interaction effects. In MOD, only the left fimbria differed from HC (FDR-corrected p < .05), but this was unrelated to PSP scores, and no significant interactions were found.

CONCLUSION

Our findings indicate that early-life emotional adversity moderates the relationship between psychosocial functioning and hippocampal structure in SSD, but not in MOD, highlighting the need to consider emotional trauma histories when investigating functional outcomes in SSD patients.