Anxiety disorders and childhood maltreatment as predictors of outcome in bipolar disorder

Pavlová, Barbara; Perroud, Nader; Cordera, Paolo; Uher, Rudolf; Alda, Martin; Dayer, Alexandre; Aubry, Jean‐Michel

doi:10.1016/j.jad.2017.08.048

Cited by 16 publications

(13 citation statements)

References 53 publications

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“…On the other hand, the effect of negative events in childhood on comorbid anxiety symptoms, also shown in our study, is a recent discovery [34]. Pavlova et al [35] also demonstrated that comorbid anxiety disorders are associated with greater severity of bipolar disorder.…”

Section: Discussionsupporting

confidence: 80%

Childhood adversity and clinical features of bipolar mood disorder

Jaworska-Andryszewska¹,

Rybakowski²

2018

Arch Psych Psych

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Aim: Assessing associations between a type of childhood adversity and clinical features of the illness in patients with bipolar disorder. Materials and methods: The study involved 52 patients with bipolar disorder aged 47+12 years. A questionnaire on family history and the course of the disorder, the Childhood Trauma Questionnaire (CTQ)-Polish version and a dedicated study questionnaire on negative experiences in childhood were employed on patients during a period of remission. Results: Emotional abuse and neglect were associated with the highest number of unfavorable clinical features of bipolar disorder, predicting psychotic symptoms, suicidal attempts, rapid cycling and anxiety disorders. Emotional abuse was also connected with a lower risk of hypertension. The total result on the CTQ was correlated with psychotic symptoms and rapid cycling, sexual abuse was linked to earlier onset of the illness, and long-term separation from parents was associated with comorbid anxiety disorders and obesity. Some of these associations were sex-dependent. A connection was also found between unfavorable clinical features of bipolar disorder and family history of psychiatric disorders. Discussion: The results of the study confirm a relationship between negative events in childhood and unfavorable features of bipolar disorder. They also suggest an enduring effect of these events manifesting as somatic conditions in adult bipolar disorder patients. Conclusions: In studying patients with bipolar disorder, we found specific associations between the type of childhood adversity and psychiatric and somatic aspects of the illness. Emotional abuse and neglect appear to exert the biggest impact in this respect.

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Section: Discussionsupporting

confidence: 80%

Childhood adversity and clinical features of bipolar mood disorder

Jaworska-Andryszewska¹,

Rybakowski²

2018

Arch Psych Psych

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“…Of the 404 abstracts and records originally identified in previous systematic reviews, 13 met the inclusion criteria for this systematic review ( Table 1). The quality of each study was assessed independently by two reviewers (DD and SRD) using the Crombie criteria adapted by Petticrew et al 27 Although eligible and included in the systematic review (Table 1), five studies were not included in the metaanalysis because: 1) precise means and standard deviations (SD) were not available in the paper 35 ; 2) they did not report CTQ scores for BD patients who attempted suicide vs. those who did not, and they did not report CTQ sub-scores 29 ; 3) only the most recent study of Janiri et al 28 was selected to prevent sample overlapping. 34 Of note, the second study performed a logistic regression to explore the association between childhood maltreatment and each BD severity indicator (i.e., unemployment, more than five lifetime depressive episodes, more than five lifetime manic episodes, history of psychotic symptoms, one or more hospitalizations for BD, and suicide attempts).…”

Section: Study Selectionmentioning

confidence: 99%

Childhood-maltreatment subtypes in bipolar patients with suicidal behavior: systematic review and meta-analysis

Duarte

Belzeaux

Étain³

et al. 2020

Braz. J. Psychiatry

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Objective: Patients with bipolar disorders have a high risk of suicidal behavior. Childhood maltreatment is a well-established risk factor for suicidal behavior. The objective of this study was to examine the association between childhood-maltreatment subtypes and vulnerability to suicide attempts in bipolar disorder using the Childhood Trauma Questionnaire (CTQ). Methods: A literature review was performed using the MEDLINE, Embase, and PsycINFO databases. Thirteen studies met the selection criteria. In the meta-analysis, the Childhood Trauma Questionnaire (CTQ) was used to assess a wide range of childhood maltreatment subtypes, which were analyzed by using a random-effects model to account for the likely variations of true effect sizes between the included studies. Results: In the systematic review, 13 studies met the selection criteria. The CTQ was selected for the meta-analysis to increase the homogeneity of assessment and to encompass a wide range of childhood-maltreatment subtypes. The data were analyzed using a random-effects model. Compared to bipolar non-attempters, bipolar suicide attempters had experienced childhood maltreatment with a significantly higher frequency and had higher total CTQ scores (Hedges' g =-0.38, 95%CI-0.52 to-0.24, z =-5.27, p o 0.001) and CTQ sub-scores

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“…Literature review has emphasized these clinical factors as determinants of unfavorable outcomes of BD and risk factors for suicidality. 11,13,61,62 One previous study in particular proposed that bipolar populations with early life stress and comorbid anxiety might comprise a distinct etiological type of BD. 61 Our findings suggest that bipolar patients with a history of childhood trauma, current anxiety, and impulsivity may constitute a discrete group with a worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Besides, BD patients with lifetime anxiety disorders appear to have a negative course, including higher numbers of mood episodes, more severe depressive and mixed episodes, and higher levels of suicidality. [9][10][11][12] Furthermore, coexisting impulsivity in BD seems to be a crucial determinant of clinical outcomes. 13,14 The severity of suicidal attempts in BD has been related to the level of impulsivity.…”

Section: Introductionmentioning

confidence: 99%

Cortical Volumetric Correlates of Childhood Trauma, Anxiety, and Impulsivity in Bipolar Disorder

Song¹,

Chon²,

Ryu³

et al. 2020

Psychiatry Investig

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Objective More recently, attention has turned to the linkage between childhood trauma and emotional dysregulation, but the evidence in bipolar disorder (BD) is limited. To determine neurobiological relationships between childhood trauma, current anxiety, and impulsivity, we investigated cortical volumetric correlates of these clinical factors in BD.Methods We studied 36 patients with DSM-5 BD and 29 healthy controls. Childhood trauma, coexisting anxiety, and impulsivity were evaluated with the Korean version-Childhood Trauma Questionnaire (CTQ), the Korean version-Beck Anxiety Inventory (BAI), and the Korean version-Barratt Impulsiveness Scale (BIS). Voxel-based morphometry (VBM) was used to assess gray matter volume (GMV) alterations on the brain magnetic resonance imaging (MRI). Partial correlation analyses were conducted to examine associations between the GMV and each scale in the BD group.Results Childhood trauma, anxiety, and impulsivity were interrelated in BD. BD patients revealed significant inverse correlations between the GMV in the right precentral gyrus and CTQ scores (r=-0.609, p<0.0003); between the GMV in the left middle frontal gyrus and BAI scores (r=-0.363, p=0.044). Moreover, patients showed similar tendency of negative correlations between the GMV in the right precentral gyrus and BIS scores; between the GMV in the left middle frontal gyrus and CTQ scores.Conclusion The present study provides evidence for a neural basis between childhood trauma and affect regulations in BD. The GMV alterations in multiple frontal lobe areas may represent neurobiological markers for anticipating the course of BD.

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Anxiety disorders and childhood maltreatment as predictors of outcome in bipolar disorder

Cited by 16 publications

References 53 publications

Childhood adversity and clinical features of bipolar mood disorder

Childhood adversity and clinical features of bipolar mood disorder

Childhood-maltreatment subtypes in bipolar patients with suicidal behavior: systematic review and meta-analysis

Cortical Volumetric Correlates of Childhood Trauma, Anxiety, and Impulsivity in Bipolar Disorder

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