Childhood trauma and its influence on the clinical features of bipolar disorder

Abstract

Background: Childhood trauma is an environmental risk factor for bipolar disorder (BD), But its influence on the clinical features of BD has not been examined sufficiently.

Objective: We compared the childhood trauma between patients with BD and healthy controls (HCs) and determined how childhood trauma impacts clinical features, such as severity, mood episodes, and disease duration.

Participants and setting: The study population comprised patients with BD (in a state of euthymia or depression, n = 90) and HCs (n = 94).

Methods: The Structured Clinical Interview for DSM-IV Axis I Disorders was used to diagnose BD and ascertain its clinical features. The Childhood Trauma Questionnaire (CTQ) was used to assess childhood trauma.

Results: The total CTQ score and scores for the CTQ subscales emotional abuse, sexual abuse, emotional neglect, and physical neglect, significantly differed between the BD and HC groups. Emotional abuse was correlated with higher Hamilton Anxiety Rating Scale (HARS) score and more frequent mood episodes; emotional neglect was correlated with higher HARS score, longer disease duration, and more mood episodes; and total CTQ score was positively correlated with HARS score, disease duration, and mood episodes. Regression analysis showed that emotional neglect significantly predicted HARS score, Hamilton Depression Rating Scale score, and disease duration in the BD group (P < 0.05).

Conclusions: Patients with BD have more serious childhood trauma. General childhood trauma, emotional abuse, and emotional neglect negatively affect the clinical features of BD.

Keywords: Bipolar disorder; Childhood trauma; Emotional abuse; Emotional neglect; Physical neglect; Sexual abuse.