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ArticleEuropean archives of psychiatry and clinical neuroscience2026

The correlations between psychotic symptoms and childhood maltreatment as well as sex differences in adolescents with major depressive disorder.

Yachen Feng, Xianlin Sun, Xianlong Zhang, Jinyue Xue, Zhiwei Liu, Changhao Chen, Jiawei Wang, Feng Geng, Wenzheng Li, Xiangfen Luo and 3 more

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Article in European archives of psychiatry and clinical neuroscience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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13 authors.

Yachen Feng *Department of Psychiatry, The Fourth Affiliated Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China.
Xianlin Sun *Department of Psychiatry, The Fourth Affiliated Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China.
Xianlong Zhang *Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, Anhui Province, China.
Jinyue XueDepartment of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230032, Anhui Province, China.
Zhiwei LiuDepartment of Psychiatry, Fuyang Third People's Hospital, Fuyang, 236044, Anhui Province, China.
Changhao ChenDepartment of Psychiatry, Suzhou Second People's Hospital, Suzhou, 234099, Anhui Province, China.
Jiawei WangDepartment of Psychiatry, Bozhou People's Hospital, Bozhou, 236800, Anhui Province, China.
Feng GengDepartment of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230000, Anhui Province, China.
Wenzheng LiDepartment of Psychiatry, Hefei Fourth People's Hospital, Hefei, 230000, Anhui Province, China.
Xiangfen LuoDepartment of Psychiatry, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, 233040, Anhui, China.
Xiangwang WenDepartment of Psychiatry, Ma'anshan Fourth People's Hospital, Ma'anshan, 243031, Anhui Province, China.
Lewei LiuDepartment of Psychiatry, The Fourth Affiliated Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China. liulewei0301@126.com.
Huanzhong LiuDepartment of Psychiatry, The Fourth Affiliated Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, 238000, Anhui Province, China. huanzhongliu@ahmu.edu.cn.

Funding

Anhui Health Research Project No. AHWJ2024Aa10004Modern (Evidence-Based) Research Project on Governance Systems and Governance Capacity in Medical Institutions - National Health Commission Hospital Management Institute, 2025 No. YLZLXZ25K006
6 · The paper itself

Abstract

backgroundPrevious studies have demonstrated that childhood maltreatment (CM) is associated with a greater risk of experiencing psychotic symptoms. However, research remains insufficient regarding the prevalence of comorbid psychotic symptoms in adolescents with major depressive disorder (MDD), as well as their links with CM, clinical symptoms, and potential sex differences.

methodsA sample of 398 adolescents with MDD was recruited for this study. The Positive and Negative Syndrome Scale-Positive Subscale (PANSS-P), the Childhood Trauma Questionnaire (CTQ), and the 17-item Hamilton Depression Rating Scale (HAMD-17) were used to evaluate patients' psychotic symptoms, CM, and depression severity. Finally, to identify independent correlates of psychotic symptoms, a stepwise logistic regression analysis was performed.

resultsComorbid psychotic symptoms were identified in 30.2% of adolescents with MDD. In the total sample, younger age, being a non-only child, lack of antidepressant use, history of CM, and depression severity were identified as independent correlates of psychotic symptoms. In males, being a non-only child and depression severity were the independent correlates. In females, the independent correlates were younger age, lack of antidepressant use, history of CM, and depression severity.

conclusionAdolescents with MDD, particularly females, exhibit a high prevalence of comorbid psychotic symptoms, closely associated with CM and depression severity. While these cross-sectional findings reflect observed associations rather than causal relationships, they highlight significant vulnerability. Thus, early screening for psychotic symptoms is warranted in adolescent females with MDD, especially those with CM histories and severe depressive symptoms, to guide timely, individualized psychiatric management.

Indexed as

Child AbuseMajor Depressive DisorderPsychotic DisordersSex CharacteristicsAdolescentChildComorbidityFemaleHumansMalePrevalencePsychiatric Status Rating ScalesSeverity of Illness IndexAdolescentsChildhood maltreatmentMajor depressive disorderPsychotic symptomsSex differences

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