Asocciations between environmental factors, extreme stressful life events (ELSE), and first-episode psychosis (FEP): a naturalistic approach

Abstract

Different factors have been described that can influence the presentation of a first-episode psychosis (FEP). Among them are genetic, sociodemographic factors, associated with lifestyle (for example, consumption of psychotropic substances), as well as the different events suffered by the person during their life history. In the present study we have explored the possibility that extreme stressful life events (ESLEs), understood as those that cause high anxiety in the person, influence jointly with other factors, causing differences in the way an FEP is presented. The study subjects are part of the care program for first-episode psychosis of the Community of Cantabria (ITPCan), being treated both in the initial phases of psychosis and in the three years following its debut. Among the results extracted from the study is the intimate relationship between cannabis consumption, the ESLE suffered and the moment of appearance of FEP. Initially, no significant differences were detected in the mean time elapsed from the first ESLE suffered until the onset of psychosis. When covaried by cannabis consumption, said time period is significantly reduced in consumer patients compared to non-user patients. Covarying by the sex factor, it was discovered that this effect was only significant in women, in whom cannabis consumption significantly reduced the average time of onset of psychosis after a first ESLE by more than half, compared to the time of appearance of psychosis in non-using women. Structural differences at the level of brain receptors, hormonal variations and different coping styles between men and women may be behind these results.