@article{ref1,
title="Impact of childhood abuse on the clinical course of bipolar disorder",
journal="British journal of psychiatry",
year="2005",
author="Garno, Jessica L. and Goldberg, Joseph F. and Ramirez, Paul M. and Ritzler, Barry A.",
volume="186",
number="",
pages="121-125",
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.",
language="",
issn="0007-1250",
doi="10.1192/bjp.186.2.121",
url="http://dx.doi.org/10.1192/bjp.186.2.121"
}