The Impact of Adverse Childhood Experiences on Depression and Suicidality in Patients with Schizophrenia.

Background: This study aims to investigate the association of adverse childhood experiences (ACE) and depressive symptoms on suicidality in patients with schizophrenia (SCZ) in the Outpatient Consultative Department of the Riga Centre of Psychiatry and Narcology (RPNC).

Subjects and methods: A descriptive cross-sectional study was conducted in adult outpatients with SCZ who had not been hospitalized for at least three months. Suicidality was assessed using the Risk Assessment Suicidality Scale (RASS). Depressive symptoms were evaluated with the Calgary Depression Scale for Schizophrenia (CDSS), and ACE were investigated using the Childhood Trauma Questionnaire - Short Form (CTQ-SF). Statistical methods used: Chi-squared test, Fisher's exact test.

Results: In total 60 outpatients diagnosed with SCZ were interviewed. It was found that the association between ACE and the frequency of suicide attempts in the study participants during lifetime was statistically significant (χ²=7.255, p=0.027). Self-harm attempts during whole life also differed between participants with and without childhood abuse history (χ²=9.902, p=0.002). Suicidal ideation was observed statistically significantly more often in patients with ACE in comparison with those without ACE (χ²=24.935, p<0.001). Patients with positive childhood abuse history were also observed to be depressed more often (χ²=4.659, p=0.031) in comparison with patients without ACE. Suicidal ideation was found to be more frequent among respondents who were observed to be depressed (CDSS score > 6) during the interview (χ²=14.614, p<0.001).

Conclusions: This study contributes to the existing body of knowledge on suicide attempts, suicidal ideation, and the prevalence of depression in patients with schizophrenia (SCZ) who have a history of childhood abuse. Findings indicate that suicidal ideation is more prevalent among patients experiencing depression at the time of the interview. Personalized interventions are recommended for patients with SCZ who have adverse childhood experiences (ACE) due to their increased risk of suicide attempts.