Lan Zhou & Marieke Begemann

Why do some people go on to develop psychosis, while others do not? Psychosis can involve hearing voices, seeing things others do not, or have strong convictions that are not shared by most others. Scientists have long wondered whether adverse experiences in childhood, such as abuse or neglect, might play a role in its onset and clinical trajectory.

A new study initiated by the lab of Professor Iris Sommer (University Medical Center Groningen), led by PhD student Lan Zhou and Dr. Marieke Begemann, together with students Pengyuan Yang and Lev Sikirin, collaborated with Professor Jim van Os (University Medical Center Utrecht), Professor Richard Bentall (University of Manchester), and Dr. Filippo Varese (University of Sheffield). The team pulled together findings from over 40 years of research to get a clearer picture (Zhou et al., 2025).

What was the goal of the study?

The researchers wanted to know:

  • Do people who exposed to adversity in childhood have higher odds of developing psychosis or psychotic symptoms?
  • Are some types of adversity more strongly linked to psychosis than others?
  • Does adversity affect how early in life psychosis has its first onset?
  • Do these patterns look different for men and women?

Why does it matter?

Understanding these connections could help in two ways:

  1. Care – if someone with psychosis has a history of childhood adversity, treatments that address trauma may help.
  2. Prevention – if we know which factors are associated with the risk for psychosis, we can design better ways to design prevention and early intervention methods.

What did the researchers do?

They ran what is called a meta-analysis, meaning they combined findings from many previous studies that have been conducted during the past 40 years in over 45 countries to see the big picture.

  • They analyzed 183 study samples, covering about 349,000 people.
  • They first examined the overall link between childhood adversity and the risk of psychosis, and compared the results for men and women.
  • They then broke things down by type of adversity—such as emotional abuse, neglect, physical abuse, and parental separation.
  • They checked if adversity was linked to an earlier onset of psychosis

What did they find?

  • People with childhood adversity had about three times higher odds of psychosis or psychotic symptoms compared to those without adversity.
  • All types of adversity showed a significant link, but emotional abuse had the strongest association. Neglect also showed high risks.
  • On average, people who had adversity developed psychosis slightly earlier than those who did not.
  • The patterns were similar for men and women overall, though the link between sexual abuse and psychosis was stronger for women.

What does this mean?

Childhood adversity and psychosis are strongly linked, though this does not prove one causes the other. Genetics, social support, and resilience also matter, but the repeated findings suggest e adversity is an important factor to pay attention to.

Key take-away

Childhood adversity is strongly linked to psychosis: people who experience neglect, abuse, or other harmful childhood situations are around three times more likely to develop psychotic symptoms or illness, and tend to develop them earlier. Everyone in mental health—from clinicians to policymakers to community services—should take childhood adversity seriously, both to prevent it and to address it in those already affected.

Reference

  • Zhou, L., Sommer, I. E., Yang, P., Sikirin, L., van Os, J., Bentall, R. P., Varesa, F., & Begemann, M. J. (2025). What do four decades of research tell us about the association between childhood adversity and psychosis: an updated and extended multi-level meta-analysis. American Journal of Psychiatry, 182(4), 360-372.