Citation

Garno JL, Goldberg JF, Ramirez PM, Ritzler BA. Br. J. Psychiatry 2005; 186: 121-125.

Affiliation

The Zucker Hillside Hospital, 75-79 263rd Street, Glen Oaks, New York 11004, USA. Jgoldber@lij.edu.

Copyright

(Copyright © 2005, Royal College of Psychiatry)

DOI

10.1192/bjp.186.2.121

PMID

15684234

Abstract

BACKGROUND: Few investigations have examined the impact of childhood trauma, and domains of childhood abuse, on outcome in bipolar disorder. AIMS: To evaluate the prevalence and subtypes of childhood abuse reported by adult patients with bipolar disorder and relationship to clinical outcome. METHOD: Prevalence rates of childhood abuse were retrospectively assessed and examined relative to illness complexity in a sample of 100 patients at an academic specialty centre for the treatment of bipolar disorder. RESULTS: Histories of severe childhood abuse were identified in about half of the sample and were associated with early age at illness onset. Abuse subcategories were strongly inter-related. Severe emotional abuse was significantly associated with lifetime substance misuse comorbidity and past-year rapid cycling. Logistic regression indicated a significant association between lifetime suicide attempts and severe childhood sexual abuse. Multiple forms of abuse showed a graded increase in risk for both suicide attempts and rapid cycling. CONCLUSIONS: Severe childhood trauma appears to have occurred in about half of patients with bipolar disorder, and may lead to more complex psychopathological manifestations.