{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T04:06:25Z","timestamp":1758945985712,"version":"3.40.5"},"reference-count":64,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T00:00:00Z","timestamp":1629417600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291721003287_sec_a1\"><jats:title>Background<\/jats:title><jats:p>We aimed to examine the temporal relationships between traumatic events (TE), post-traumatic stress disorder (PTSD) and non-affective psychotic disorders (NAPD).<\/jats:p><\/jats:sec><jats:sec id=\"S0033291721003287_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>A prospective cohort study of 1 965 214 individuals born in Sweden between 1971 and 1990 examining the independent effects of interpersonal and non-interpersonal TE on incidence of PTSD and NAPD using data from linked register data (Psychiatry-Sweden). Mediation analyses tested the hypothesis that PTSD lies on a causal pathway between interpersonal trauma and NAPD.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291721003287_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Increasing doses of interpersonal and non-interpersonal TE were independently associated with increased risk of NAPD [linear-trend incidence rate ratios (IRR)<jats:sub>adjusted<\/jats:sub> = 2.17 [95% confidence interval (CI) 2.02\u20132.33] and IRR<jats:sub>adjusted<\/jats:sub> = 1.27 (95% CI 1.23\u20131.31), respectively]. These attenuated to a relatively small degree in 5-year time-lagged models. A similar pattern of results was observed for PTSD [linear-trend IRR<jats:sub>adjusted<\/jats:sub> = 3.43 (95% CI 3.21\u20133.66) and IRR<jats:sub>adjusted<\/jats:sub> = 1.45 (95% CI 1.39\u20131.50)]. PTSD was associated with increased risk of NAPD [IRR<jats:sub>adjusted<\/jats:sub> = 8.06 (95% CI 7.23\u20138.99)], which was substantially attenuated in 5-year time-lagged analyses [IRR<jats:sub>adjusted<\/jats:sub> = 4.62 (95% CI 3.65\u20135.87)]. There was little evidence that PTSD diagnosis mediated the relationship between interpersonal TE and NAPD [IRR<jats:sub>adjusted<\/jats:sub> = 0.92 (percentile CI 0.80\u20131.07)].<\/jats:p><\/jats:sec><jats:sec id=\"S0033291721003287_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>Despite the limitations to causal inference inherent in observational designs, the large effect-sizes observed between trauma, PTSD and NAPD in this study, consistent across sensitivity analyses, suggest that trauma may be a component cause of psychotic disorders. However, PTSD diagnosis might not be a good proxy for the likely complex psychological mechanisms mediating this association.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291721003287","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T07:01:40Z","timestamp":1629442900000},"page":"1620-1628","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Association of trauma, post-traumatic stress disorder and non-affective psychosis across the life course: a nationwide prospective cohort 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