The impact of childhood sexual and physical abuse on needs for care among people with first episode psychosis

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BACKGROUND: Childhood physical and sexual abuse are highly prevalent among individuals with psychotic disorders. These individuals also tend to have poor global and social functioning outcomes. At symptom remission, adequate functioning is restored in only one out of seven patients, and if childhood abuse is present, psychosocial and occupational functioning are more compromised. Lower psychosocial functioning is found to be associated with higher levels of needs for care. This longitudinal study examines how physical and sexual abuse affect the total, met, and unmet needs for care of patients with first-episode psychosis (FEP) at nine months (T1) from the onset. METHODS: We assessed a sample of 276 Italian FEP patients (M 59.1 %, age 29.9 ± 9.8). Needs for care were evaluated at both baseline (T0) and at T1 using the Camberwell Assessment of Need (CAN) scale, covering five areas: basic needs, social needs, health, functioning, and services, measuring both met and unmet needs. Physical and sexual abuse history was recorded using the Childhood Experience of Care and Abuse Questionnaire (CECA-Q). RESULTS: At T1, FEP patients with childhood physical or sexual abuse had higher total and met needs than non-abused patients, with physical abuse showing the strongest association with needs for care. A higher level of psychopathology, a lower global functioning, and childhood physical abuse were the main characteristics related to increased total, met, and unmet care needs. CONCLUSIONS: These findings highlight the importance of assessing trauma history at the onset of psychosis, as this could be a crucial factor in identifying several specific needs for care and guiding treatment to address them.

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