%0 Journal Article
%T Impact of childhood abuse on the clinical course of bipolar disorder
%J British journal of psychiatry
%D 2005
%A Garno, Jessica L.
%A Goldberg, Joseph F.
%A Ramirez, Paul M.
%A Ritzler, Barry A.
%V 186
%N 
%P 121-125
%X 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.
%G 
%I Royal College of Psychiatry
%@ 0007-1250
%U http://dx.doi.org/10.1192/bjp.186.2.121