Association of early life stress and cognitive performance in patients with schizophrenia and healthy controls.

As core symptoms of schizophrenia, cognitive deficits contribute substantially to poor outcomes. Early life stress (ELS) can negatively affect cognition in patients with schizophrenia and healthy controls, but the exact nature of the mediating factors is unclear. Therefore, we investigated how ELS, education, and symptom burden are related to cognitive performance. The sample comprised 215 patients with schizophrenia (age, 42.9 ± 12.0 years; 66.0 % male) and 197 healthy controls (age, 38.5 ± 16.4 years; 39.3 % male) from the PsyCourse Study. ELS was assessed with the Childhood Trauma Screener (CTS). We used analyses of covariance and correlation analyses to investigate the association of total ELS load and ELS subtypes with cognitive performance. ELS was reported by 52.1 % of patients and 24.9 % of controls. Independent of ELS, cognitive performance on neuropsychological tests was lower in patients than controls ( p  < 0.001). ELS load was more closely associated with neurocognitive deficits (cognitive composite score) in controls ( r  = -0.305, p  < 0.001) than in patients ( r  = -0.163, p  = 0.033). Moreover, the higher the ELS load, the more cognitive deficits were found in controls ( r  = -0.200, p  = 0.006), while in patients, this correlation was not significant after adjusting for PANSS. ELS load was more strongly associated with cognitive deficits in healthy controls than in patients. In patients, disease-related positive and negative symptoms may mask the effects of ELS-related cognitive deficits. ELS subtypes were associated with impairments in various cognitive domains. Cognitive deficits appear to be mediated through higher symptom burden and lower educational level.
Competing Interests: Ion-George Anghelescu has been member of advisory boards and received speakers honoraria of Janssen-Cilag and Dr. Willmar Schwabe and received speakers honoraria of Recordati. P. Falkai has been an honorary speaker for AstraZeneca, Bristol Myers Squibb, Lilly, Essex, GE Healthcare, GlaxoSmithKline, Janssen Cilag, Lundbeck, Otsuka, Pfizer, Servier, and Takeda and has been a member of the advisory boards of Janssen-Cilag, AstraZeneca, Lilly, Lundbeck, Richter, Recordati and Boehringer Ingelheim. C. Konrad received fees for an educational program from Aristo Pharma, Janssen-Cilag, Lilly, MagVenture, Servier, and Trommsdorff as well as travel support and speakers honoraria from Aristo Pharma, Janssen-Cilag, Lundbeck, Neuraxpharm and Servier. A. Schmitt was an honorary speaker for TAD Pharma and Roche and a member of Roche advisory boards. J. Wiltfang has been an honorary speaker for Actelion, Amgen, Beeijing Yibai Science and Technology Ltd., Janssen Cilag, Med Update GmbH, Pfizer, Roche Pharma, and has been a member of the advisory boards of Abbott, Biogen, Boehringer Ingelheim, Lilly, MSD Sharp & Dohme, and Roche Pharma and receives fees as a consultant for Immungenetics and Roboscreen. All other authors report no conflicts of interest.
(© 2023 The Authors. Published by Elsevier Inc.)