Mediation by elevated prolactin in the relationship between childhood trauma and first-episode drug-naïve schizophrenia

Abstract Background The elevated prolactin levels in first-episode drug-naïve (FEDN) schizophrenia patients may correlate with long-term stress caused by childhood trauma. This study aimed to assess the relationship between elevated prolactin levels and childhood trauma in FEDN schizophrenia patient...

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Main Authors: Yuqian Pan, Leijun Li, Xiaowei Xia, Zhinan Li, Jiamin Dai, Junyan Wu, Tong Liu, Ming Chen, Junxiao Ma, Yanxi Liu, Ziyi Zhang, Qingni Shen, Sichu Tao, Zixin Deng, Shimao Kang, Kexin Zhang, Xiaobing Zou, Jihui Wang, Qinling Wei
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-06629-2
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author Yuqian Pan
Leijun Li
Xiaowei Xia
Zhinan Li
Jiamin Dai
Junyan Wu
Tong Liu
Ming Chen
Junxiao Ma
Yanxi Liu
Ziyi Zhang
Qingni Shen
Sichu Tao
Zixin Deng
Shimao Kang
Kexin Zhang
Xiaobing Zou
Jihui Wang
Qinling Wei
author_facet Yuqian Pan
Leijun Li
Xiaowei Xia
Zhinan Li
Jiamin Dai
Junyan Wu
Tong Liu
Ming Chen
Junxiao Ma
Yanxi Liu
Ziyi Zhang
Qingni Shen
Sichu Tao
Zixin Deng
Shimao Kang
Kexin Zhang
Xiaobing Zou
Jihui Wang
Qinling Wei
author_sort Yuqian Pan
collection DOAJ
description Abstract Background The elevated prolactin levels in first-episode drug-naïve (FEDN) schizophrenia patients may correlate with long-term stress caused by childhood trauma. This study aimed to assess the relationship between elevated prolactin levels and childhood trauma in FEDN schizophrenia patients, while also considering sex differences. Methods Utilizing a cross-sectional design, the study involved 88 FEDN schizophrenia patients and 76 healthy controls (HCs). Evaluations encompassed measuring prolactin levels in peripheral blood and assessing mental health using the Positive and Negative Syndrome Scale (PANSS), the Childhood Trauma Questionnaire - Short Form (CTQ-SF), as well as evaluating resilience with the Connor-Davidson Resilience Scale (CD-RISC), perceived social support with the Perceived Social Support Scale (PSSS), and demographic characteristics to control for confounding factors. A mediation model was constructed using the RMediation package of the R software. Methods The results suggested prolactin levels in FEDN schizophrenia patients were higher than in HCs(t=-9.938, p = 0.000). Group classification (HCs vs. FEDN schizophrenia patients) (t = 9.291, p = 0.000) and sex (t = 3.282, p = 0.001) were influential factors for prolactin levels. Elevated prolactin(OR = 1.007, p = 0.000), along with higher scores for childhood emotional(OR = 1.469, p = 0.006)andsexual abuse(OR = 1.592, p = 0.018) and lower social support(OR = 0.946, p = 0.026), were associated with the onset of schizophrenia. Positive correlations were found between prolactin levels and childhood emotional (r = 0.268, p = 0.002) /sexual abuse(r = 0.264, p = 0.002), with no sex differences. No significant relationship was observed between prolactin levels and PANSS scores. Mediation analysis revealed that childhood emotional abuse (95% CI: [0.059 ~ 0.293]) and sexual abuse (95% CI: [0.086 ~ 0.439]) had significant indirect effects on schizophrenia, mediated by elevated prolactin levels. Conclusion These findings suggest that childhood trauma may be associated with the onset of schizophrenia by influencing prolactin levels, highlighting the complex interplay between hormonal disruptions and early-life stress in the development of schizophrenia.
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spelling doaj-art-95a8b71fb6fe45a197b1ee8e115e8e112025-08-20T03:01:38ZengBMCBMC Psychiatry1471-244X2025-03-0125111010.1186/s12888-025-06629-2Mediation by elevated prolactin in the relationship between childhood trauma and first-episode drug-naïve schizophreniaYuqian Pan0Leijun Li1Xiaowei Xia2Zhinan Li3Jiamin Dai4Junyan Wu5Tong Liu6Ming Chen7Junxiao Ma8Yanxi Liu9Ziyi Zhang10Qingni Shen11Sichu Tao12Zixin Deng13Shimao Kang14Kexin Zhang15Xiaobing Zou16Jihui Wang17Qinling Wei18Department of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityGuangdong Mental Health Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical UniversityDepartment of Psychiatry, The First Affiliated Hospital of Xi’an Jiaotong UniversityGuangdong Mental Health Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityDepartment of Medical Division, Sun Yat-sen University Cancer CenterDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityChild Developmental and Behavioral Center, The Third Affiliated Hospital of Sun Yat-sen UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityDepartment of Psychiatry, The Third Affiliated Hospital of Sun Yat- sen UniversityAbstract Background The elevated prolactin levels in first-episode drug-naïve (FEDN) schizophrenia patients may correlate with long-term stress caused by childhood trauma. This study aimed to assess the relationship between elevated prolactin levels and childhood trauma in FEDN schizophrenia patients, while also considering sex differences. Methods Utilizing a cross-sectional design, the study involved 88 FEDN schizophrenia patients and 76 healthy controls (HCs). Evaluations encompassed measuring prolactin levels in peripheral blood and assessing mental health using the Positive and Negative Syndrome Scale (PANSS), the Childhood Trauma Questionnaire - Short Form (CTQ-SF), as well as evaluating resilience with the Connor-Davidson Resilience Scale (CD-RISC), perceived social support with the Perceived Social Support Scale (PSSS), and demographic characteristics to control for confounding factors. A mediation model was constructed using the RMediation package of the R software. Methods The results suggested prolactin levels in FEDN schizophrenia patients were higher than in HCs(t=-9.938, p = 0.000). Group classification (HCs vs. FEDN schizophrenia patients) (t = 9.291, p = 0.000) and sex (t = 3.282, p = 0.001) were influential factors for prolactin levels. Elevated prolactin(OR = 1.007, p = 0.000), along with higher scores for childhood emotional(OR = 1.469, p = 0.006)andsexual abuse(OR = 1.592, p = 0.018) and lower social support(OR = 0.946, p = 0.026), were associated with the onset of schizophrenia. Positive correlations were found between prolactin levels and childhood emotional (r = 0.268, p = 0.002) /sexual abuse(r = 0.264, p = 0.002), with no sex differences. No significant relationship was observed between prolactin levels and PANSS scores. Mediation analysis revealed that childhood emotional abuse (95% CI: [0.059 ~ 0.293]) and sexual abuse (95% CI: [0.086 ~ 0.439]) had significant indirect effects on schizophrenia, mediated by elevated prolactin levels. Conclusion These findings suggest that childhood trauma may be associated with the onset of schizophrenia by influencing prolactin levels, highlighting the complex interplay between hormonal disruptions and early-life stress in the development of schizophrenia.https://doi.org/10.1186/s12888-025-06629-2FEDN schizophrenia patientsProlactinChildhood traumaEmotional abuseSexual abuse
spellingShingle Yuqian Pan
Leijun Li
Xiaowei Xia
Zhinan Li
Jiamin Dai
Junyan Wu
Tong Liu
Ming Chen
Junxiao Ma
Yanxi Liu
Ziyi Zhang
Qingni Shen
Sichu Tao
Zixin Deng
Shimao Kang
Kexin Zhang
Xiaobing Zou
Jihui Wang
Qinling Wei
Mediation by elevated prolactin in the relationship between childhood trauma and first-episode drug-naïve schizophrenia
BMC Psychiatry
FEDN schizophrenia patients
Prolactin
Childhood trauma
Emotional abuse
Sexual abuse
title Mediation by elevated prolactin in the relationship between childhood trauma and first-episode drug-naïve schizophrenia
title_full Mediation by elevated prolactin in the relationship between childhood trauma and first-episode drug-naïve schizophrenia
title_fullStr Mediation by elevated prolactin in the relationship between childhood trauma and first-episode drug-naïve schizophrenia
title_full_unstemmed Mediation by elevated prolactin in the relationship between childhood trauma and first-episode drug-naïve schizophrenia
title_short Mediation by elevated prolactin in the relationship between childhood trauma and first-episode drug-naïve schizophrenia
title_sort mediation by elevated prolactin in the relationship between childhood trauma and first episode drug naive schizophrenia
topic FEDN schizophrenia patients
Prolactin
Childhood trauma
Emotional abuse
Sexual abuse
url https://doi.org/10.1186/s12888-025-06629-2
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