Childhood maltreatment and the course of bipolar disorders among adults: Epidemiologic evidence of dose-response effects

Abstract

BACKGROUND Childhood maltreatment (CM) is highly prevalent among individuals with bipolar disorders (BP); however few studies have examined its potential role in the course and outcome of individuals with BP. We aim to examine the dose response relationship between the number of types of CM and the course of individuals with BP. METHODS As part of the National Epidemiologic Survey on Alcohol and Related Conditions, 1600 adults who met lifetime DSM-IV criteria for BP-I (n=1172) and BP-II (n=428) were included. Individuals were evaluated using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DMS-IV Version and data was analyzed lifetime and from Waves 1 and 2, approximately 3 years apart. RESULTS Around half of individuals with BP had a history of at least one type of CM. Overall, there was a clear dose-response relationship between number of CM and severity of BP across several domains, including clinical characteristics, probability of treatment, lifetime prevalence of psychiatric comorbidity, incidence of anxiety disorders, substance use disorder, and nicotine dependence, and level of psychosocial functioning. LIMITATIONS The interviews were conducted by lay professional interviewers rather than clinicians, use of retrospective report to determine CM in individuals with BP, and not all respondents from Wave 1 were able to be interviewed in Wave 2. CONCLUSIONS The number of types of CM confers developmental differences in the course of BP with a worse course and outcome of BP. Early identification and treatment of CM are warranted to improve the course and outcome of individuals with BP.

Bipolar disorder in Asia: Illness course and contributing factors

“…Research on personality pathology has revealed that both Cluster B and C traits are common than Cluster A (George et al, 2003). Asian studies concur with the global literature that childhood maltreatment and emotional neglect in childhood are reported to have strong associations with BD in adults (Romero et al, 2009;Sala et al, 2014;Watson et al, 2014). The findings reveal that psychiatric comorbidities in BD can begin to occur at the early stages of the life and tend to worsen the illness course through various mechanisms.…”

Childhood and Adolescent Adversity and Cardiometabolic Outcomes: A Scientific Statement From the American Heart Association

“…For example, childhood adversity is an important indicator of a more persistent and treatment-refractory course of illness and affects response to both pharmacological and psychosocial treatment for youth and adults with mental health conditions. [91][92][93][94][95] Among people with mental health conditions, childhood adversity, compared with no childhood adversity, results in greater cumulative exposure to mental health symptoms, associated stress, and biological perturbations. [96][97][98] Beyond the direct effects of mental health problems on cardiometabolic outcomes, there are also indirect effects that further exacerbate cardiometabolic risk factors.…”

Peripheral blood brain-derived neurotrophic factor in bipolar disorder: a comprehensive systematic review and meta-analysis

“…133 Childhood abuse and neglect have been associated with worsening of the clinical course of BD 134 in a possible dose-response relationship. 135 Childhood abuse has further been associated with alterations in peripheral BDNF levels, 121,136 but with inconsistent findings of opposite direction of such association, leaving uncertainty as to the relationship between peripheral BDNF levels and childhood abuse. A lack of Information on childhood abuse in the included studies in the present meta-analysis did not allow for evaluation of the potential relationship between this and peripheral BDNF levels.…”