Exploring the Interrelationships Among Childhood Maltreatment, Suicidal Ideation, and Social Support in Depression, Bipolar Disorder, and Schizophrenia: A Network Analysis of Distinct Mental Disorders

Abstract

Background: Childhood maltreatment (CM) is a major suicide risk factor, while social support acts as a key protective factor. However, the intricate interactions between subtypes of CM, social support, and suicidal ideation remain underexplored.

Methods: The study included 229 individuals with depression, 102 with bipolar disorder, and 216 with schizophrenia. CM was assessed using the Childhood Trauma Questionnaire-Short Form, suicidal ideation was measured with the Self-Rating Idea of Suicide Scale, and social support was evaluated using the Social Support Rating Scale. Network analysis was conducted for each disorder group to examine symptom relationships and identify central and bridge symptoms. Cross comparisons of network structures were also performed to compare the networks across the three disorders.

Results: Preliminary partial correlation analyses revealed that lower subjective support was associated with more severe emotional maltreatment in depression and bipolar disorder, as well as increased suicidal ideation in schizophrenia. Further analysis identified distinct central and bridge symptoms for each disorder. In depression, desperation was the central and bridge symptom; in bipolar disorder, emotional abuse was the most prominent central and bridge symptom, with sexual abuse also acting as a bridge symptom; and in schizophrenia, emotional maltreatment exhibited the highest centrality and bridge centrality. The general network invariance test revealed significant differences in network structures, including edge weights, and central and bridge symptoms, across the three disorders.

Conclusions: The findings highlight the complex relationships between CM, suicidal ideation, and social support across three major psychiatric disorders, offering insights into key symptoms for clinical intervention.

Keywords: childhood maltreatment; mental disorder; network analysis; social support; suicide ideation.