Article

Impact of childhood abuse on the clinical course of bipolar disorder

Long Island University, New York, New York, United States
The British Journal of Psychiatry (Impact Factor: 7.99). 03/2005; 186:121-5. DOI: 10.1192/bjp.186.2.121
Source: PubMed

ABSTRACT

Few investigations have examined the impact of childhood trauma, and domains of childhood abuse, on outcome in bipolar disorder.
To evaluate the prevalence and subtypes of childhood abuse reported by adult patients with bipolar disorder and relationship to clinical outcome.
Prevalence rates of childhood abuse were retrospectively assessed and examined relative to illness complexity in a sample of 100 patients at an academic specialty centre for the treatment of bipolar disorder.
Histories of severe childhood abuse were identified in about half of the sample and were associated with early age at illness onset. Abuse subcategories were strongly inter-related. Severe emotional abuse was significantly associated with lifetime substance misuse comorbidity and past-year rapid cycling. Logistic regression indicated a significant association between lifetime suicide attempts and severe childhood sexual abuse. Multiple forms of abuse showed a graded increase in risk for both suicide attempts and rapid cycling.
Severe childhood trauma appears to have occurred in about half of patients with bipolar disorder, and may lead to more complex psychopathological manifestations.

Download full-text

Full-text

Available from: Joseph Goldberg, Nov 02, 2014
  • Source
    • "Shared Childhood maltreatment in individuals with BD is related to a poor prognosis, including substance abuse, suicide attempts and occurrence of rapid cycling [196]. Childhood maltreatment is also associated with earlier cigarette use, by increasing likelihood of initiating smoking and smoking persistently [197]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Several biological systems are implicated in the neuroprogression of bipolar disorder including but not limited to cytokine levels, oxidative stress markers, monoamine levels, tryptophan catabolite and glutamate-mediated excitotoxicity, microglial activation as well as structural and functional changes. The high rate of smoking behaviour in individuals with bipolar disorder provides the impetus for exploring shared and discrete pathogenetic mechanisms. In addition to contributing to increased mortality, smoking activates several neurobiological effector systems implicated in the progression of bipolar disorder. Here, a narrative review provides evidence and putative mechanisms of comorbid effects of BD, cigarette use, and nicotine dependence, and discusses the clinical implications of these interactions.
    Full-text · Article · Jan 2016 · Current Molecular Medicine
  • Source
    • "However, to date there has been limited research aimed at exploring the role of intrusive memories of traumatic life events within symptoms associated with a diagnosis of bipolar disorder. There is, however, growing evidence that traumatic life events are associated with an increased prevalence and severity of bipolar disorder (Daruy-Filho, Brietzke, Lafer and Grassi-Oliveira, 2011; Grubaugh, Zinzow, Paul, Egede and Freuh, 2011; Garno, Goldberg, Ramirez and Ritzler, 2005). Emotional abuse has been identified as a predictor of predisposition to mania (Reid, 2005) and associated with early onset "
    [Show abstract] [Hide abstract]
    ABSTRACT: There is a high prevalence of traumatic life events within individuals diagnosed with bipolar disorder. However, currently there is limited theoretical understanding of this relationship. Aims: To explore whether non-clinical symptoms of posttraumatic stress have a direct effect on the non-clinical symptoms of bipolar disorder, or whether this relationship is mediated by cognitive emotion regulation strategies. Method: A cross-sectional design within non-clinical participants completing an online survey including the Impact of Events Scale, Cognitive Emotion Regulation Questionnaire and the Hypomanic Personality Scale. Results: Posttraumatic stress symptoms were associated with hypomanic personality. Intrusive memories contributed a small but significant proportion of the variance between these two measures. Rumination of negative emotions mediated the relationship between posttraumatic stress and hypomanic personality. Conclusions: The relationship between traumatic events and an increased prevalence of bipolar disorder remains poorly understood. Further research should explore rumination as a potential target for treatment within those suffering from both posttraumatic stress and bipolar disorder.
    Full-text · Article · Sep 2015 · Behavioural and Cognitive Psychotherapy
  • Source
    • "Moreover, a family history of affective disorder is associated with a more severe course of BD, including an earlier onset, more episodes, more suicide attempts and lower quality of life (Antypa and Serretti, 2014; Berutti et al., 2014). In addition to hereditary factors, severe childhood abuse is also associated with an earlier onset of BD (Etain et al., 2008; Garno et al., 2005; Suppes et al., 2001). In younger adults with BD it was found that the Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/jad "
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study is to explore the family history of psychiatric disorders, childhood abuse, and stressors in older patients with Bipolar Disorder (BD) and the association of these variables with the age at onset of BD. The Questionnaire for Bipolar Disorder (QBP) and the Mini International Neuropsychiatric Interview (MINI-Plus) were obtained from 78 patients aged 60 and over to determine diagnosis, age at onset of the first affective episode, childhood abuse, family history of psychiatric disorders and past and recent stressful life events. Increased family history of psychiatric disorders was the only factor associated with an earlier age at onset of BD. Less family history of psychiatric disorders and more negative stressors were significantly associated with a later age at onset of the first (hypo)manic episode. Age at onset, history of childhood abuse, and past stressful life events were assessed retrospectively. Family members of BD patients were not interviewed. Our findings suggest that age at onset can define distinct BD phenotypes. More specifically there was a stronger heredity of BD and other psychiatric disorders in patients with an early age of onset of BD. Negative stressors may play a specific role in patients with a late age at onset of a first (hypo)manic episode. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Sep 2015 · Journal of Affective Disorders
Show more