Childhood maltreatment and clinical outcomes of bipolar disorder

Abstract

Daruy‐Filho L, Brietzke E, Lafer B, Grassi‐Oliveira R. Childhood maltreatment and clinical outcomes of bipolar disorder.Objective: Adverse life events, especially early trauma, play a major role in the course and expression of bipolar disorder (BD). The aim of this article is to present a systematic review about the impact of childhood trauma on the clinical course of BD.Method: A computer‐aided search was performed in Medline, ISI database, EMBASE, PsychInfo, Centre for Reviews and Dissemination, and Databases of Thomson Reuters at April 2011, supplemented by works identified from the reference lists of the first selected papers. Two investigators systematically and independently examined all articles, selecting those according inclusion and exclusion criteria.Results: Four hundred fifteen articles were identified, of which 19 remained in the review after exclusion criteria were applied. In general, childhood maltreatment predicted worsening clinical course of BD. After assessing the quality of the data and of the measurements, childhood maltreatment can be strongly associated to early onset of disorder, suicidality, and substance abuse disorder in patients with BD.Conclusion: Data suggest that childhood abuse and neglect are risk factors associated with worsening clinical course of BD. The conclusions should be interpreted with caution because all the studies included are cross‐sectional and the majority are showing inconsistencies regarding childhood trauma as independent variable and how it is assessed.

The influence of childhood abuse, adult stressful life events and temperaments on depressive symptoms in the nonclinical general adult population

“…This study suggests the possibility that childhood abuse might increase soft bipolarity in the general adult population, which, in turn, might affect the pathogenesis or clinical outcomes of mood disorders. Several studies have reported that the history of childhood abuse is closely related to the onset, course, and treatment response of mood disorders (Alloy et al, 2006;Caspi et al, 2003;Daruy-Filho et al, 2011;Levitan et al, 1998;Nanni et al, 2012). The results of this study link childhood abuse to affective temperaments in aspects of depressive symptoms.…”

Comparison of the Patient Groups With and Without Dissociative Disorder Comorbidity Among the Inpatients with Bipolar Disorder

“…This may suggest that the presence of dissociation may have unfavorable effects on the course of the disease. Childhood abuse and neglect are the risk factors associated with worsening of clinical course in bipolar disorder (42). Childhood abuse was associated with suicidal ideation and suicide attempts in adults with bipolar disorder (43).…”

Clinical characteristics and influence of childhood trauma on the prodrome of bipolar disorder

“…21,22 Childhood trauma also appears to impact the course of the illness, being associated with earlier illness onset, an increased number of comorbidities, and suicidal behavior. 20,23 Although childhood trauma is assumed to have an important role in the early expression of symptoms in BD, to the best of our knowledge, no studies that investigated the prodromal period of this disorder have systematically evaluated the presence of childhood trauma or its influence on the prodromal manifestations of BD.…”

“…Environmental factors, such as childhood trauma, may influence the expression of symptoms in BD, 20 as well as the prodromal features of the disorder. Patients with BD exhibit higher vulnerability to traumatic events during childhood.…”