Citation

Dualibe AL, Osório FL. Harv. Rev. Psychiatry 2017; 25(5): 198-208.

Affiliation

From the Department of Neurosciences and Behaviour, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo State, Brazil; Brazilian National Institute of Science and Translational Technology in Medicine, Brazil (Dr. Osório).

Copyright

(Copyright © 2017, President and Fellows of Harvard College, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/HRP.0000000000000154

PMID

28759479

Abstract

OBJECTIVES: We performed a systematic literature review to (1) evaluate the prevalence rates of early emotional trauma (EET) in patients with bipolar disorder (BD) and the impact of these traumas on the development of the disorder, and (2) integrate the findings of our review with those previously reported by Fisher and Hosang, Daruy-Filho and colleagues, and Maniglio.

METHODS: The literature search was performed on PubMed, SciELO, and PsycINFO databases using the keywords bipolar disorder, early trauma, physical abuse, emotional abuse, sexual abuse, maltreatment, adversity, and neglect.

RESULTS: Twenty-eight articles were selected and analyzed. Taken together, the articles described a high prevalence of EET in BD, consisting mainly of emotional neglect/abuse (approximately 40%), particularly when compared to healthy subjects. The review also identified substantial evidence regarding an association between the presence of EET, early disease onset, rapid cycling, comorbidity with anxiety/stress disorders, and cannabis use.

CONCLUSION: The integration of the current findings with the identified studies reveals that (1) the methodological limitations noted by Daruy-Filho and colleagues have been largely resolved in more recent studies and (2) the presence of EET in patients with BD is associated with worse clinical outcomes, particularly early disease onset, presence of clinical or psychiatric comorbidities, suicide, and presence of psychotic episodes/symptoms. The review shows that patients with BD experience more traumatic situations than controls and that emotional trauma is the most frequent type of trauma in this group.

Language: en