The mediating role of psychache in the relationship between childhood trauma and treatment adherence in psychiatric patients

Purpose:This study examines the influence of childhood trauma (CT) and psychache (PA) on treatment adherence among individuals with psychiatric diagnoses, emphasizing the potential mediating function of psychache in the linkage between childhood trauma and adherence outcomes. Method:The study was conducted at the Psychiatry Outpatient Clinic of Cukurova University Faculty of Medicine. The sample consisted of individuals diagnosed with depressive disorder, anxiety disorder, obsessive-compulsive disorder, bipolar disorder, psychosis, as well as a healthy control group. Participants were administered the Sociodemographic Data Form, Childhood Trauma Questionnaire (CTQ), Psychache Scale (PAS), Morisky Medication Adherence Scale (MMAS), Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Yale-Brown Obsessive Compulsive Scale, Young Mania Rating Scale, and the Positive and Negative Syndrome Scale (PANSS). Data were analyzed using correlation, regression, and mediation analyses. Results:In the entire diagnostic sample (n=275), psychache was found to have a statistically significant partial mediating role in the relationship between childhood trauma and treatment adherence (p<0.001). Mediation analyses revealed a negative association between the total score on the CTQ and treatment adherence, which was partially explained through psychache. At the subscale level, scores on sexual abuse, physical abuse, physical neglect, emotional neglect and emotional abuse were all positively associated with psychache, while psychache was negatively associated with treatment adherence. Conclusion:CT is a significant predictor of nonadherence to treatment in psychiatric patients, and this effect is partially mediated by the level of psychache. Keywords: Childhood trauma, psychache, treatment adherence, mediation, psychiatric disorders