Citation

Çakır S, Tasdelen Durak R, Ozyildirim I, Ince E, Sar V. J. Trauma Dissociation 2015; 17(4): 397-409.

Affiliation

a Istanbul Medical School, Psychiatry Dep. , Istanbul University , 34390, CAPA- Fatih- Istanbul / Turkey.

Copyright

(Copyright © 2015, Informa - Taylor and Francis Group)

DOI

10.1080/15299732.2015.1132489

PMID

26683845

Abstract

The aim of the present study was to investigate the potential influence of childhood trauma on clinical presentation, psychiatric comorbidity, and long-term treatment outcome of the bipolar disorder. One hundred thirty-five consecutive patients with bipolar disorder type I were recruited from an ongoing prospective follow-up project. The Childhood Trauma Questionnaire (CTQ) and the Structured Clinical Interview for DSM-IV (SCID-I) were administered to all participants. Response to long-term treatment was determined from the records of life charts of the prospective follow-up project. There were no significant differences between good and poor response groups to long-term lithium treatment on childhood trauma scores. Poor responders to long-term anticonvulsant treatment, however, had elevated emotional and physical abuse scores. Lifetime diagnosis of posttraumatic stress disorder (PTSD) was associated with poor response to lithium treatment and antidepressant use but not with response to treatment with anticonvulsants. Total childhood trauma scores were related to total number of lifetime comorbid psychiatric disorders, antidepressant use and presence of psychotic features. There were significant correlations between all types of childhood abuse and total number of lifetime comorbid psychiatric diagnoses. While physical neglect was related to mean severity of the mood episodes and psychotic features, emotional neglect was related to suicide attempts. A history of childhood trauma or PTSD may be a poor prognostic factor in the long-term treatment of bipolar disorder. While abusive experiences of childhood seem to lead to nosological fragmentation (comorbidity), childhood neglect tends to contribute to the severity of the mood episodes.

Language: en