Patterns of childhood adverse events are associated with clinical characteristics of bipolar disorder

Sara Larsson; Monica Aas; Ole Klungsøyr; Ingrid Agartz; Erlend Mork; Nils Eiel Steen; Elizabeth A. Barrett; Trine V. Lagerberg; Jan Ivar Røssberg; Ingrid Melle; Ole A. Andreassen; Steinar Lorentzen

doi:10.1186/1471-244X-13-97

Patterns of childhood adverse events are associated with clinical characteristics of bipolar disorder

Sara Larsson, Monica Aas, Ole Klungsøyr, Ingrid Agartz, Erlend Mork, Nils Eiel Steen, Elizabeth A. Barrett, Trine V. Lagerberg, Jan Ivar Røssberg, Ingrid Melle, Ole A. Andreassen, Steinar Lorentzen^*

^*Corresponding author for this work

Social Genetic & Developmental Psychiatry

Research output: Contribution to journal › Article › peer-review

57 Citations (Scopus)

Abstract

Background: Previous studies in bipolar disorder investigating childhood trauma and clinical presentations of the illness have mainly focused on physical and sexual abuse. Our aim was to explore further the relationship between childhood trauma and disease characteristics in bipolar disorder to determine which clinical characteristics were most strongly associated with childhood trauma total score, as well as subtypes of adverse childhood events, including physical, sexual, emotional abuse and neglect.Methods: 141 Patients with bipolar disorder were consecutively recruited, and disease history and clinical characteristics were assessed. History of childhood abuse was obtained using the Childhood Trauma Questionnaire (CTQ). Statistical methods used were factor analysis, Poisson and linear regression, and generalized additive modeling (GAM).Results: The factor analysis of CTQ identified three factors: emotional abuse/neglect, sexual abuse and physical abuse. There were significant associations between CTQ total score and earlier onset of illness, reduced level of psychosocial functioning (GAF; Global Assessment of Functioning) and decreased number of hospitalization, which mainly were due to the factor emotional abuse/neglect. Physical abuse was significantly associated with lower GAF scores, and increased number of mood episodes, as well as self-harm. Sexual abuse was significantly associated with increased number of mood episodes. For mood episodes and self-harm the associations were characterized by great variance and fluctuations.Conclusions: Our results suggest that childhood trauma is associated with a more severe course of bipolar illness. Further, childhood abuse (physical and sexual), as well as emotional abuse and neglect were significantly associated with accelerating staging process of bipolar disorder. By using specific trauma factors (physical abuse, sexual abuse and emotional abuse/neglect) the associations become both more precise, and diverse.

Original language	English
Article number	97
Journal	BMC Psychiatry
Volume	13
DOIs	https://doi.org/10.1186/1471-244X-13-97
Publication status	Published - 22 Mar 2013

Keywords

Bipolar disorder
Childhood trauma
Clinical characteristics

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10.1186/1471-244X-13-97

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@article{0a6a0a779f7a42c8858f4b9c7a8c4cc6,

title = "Patterns of childhood adverse events are associated with clinical characteristics of bipolar disorder",

abstract = "Background: Previous studies in bipolar disorder investigating childhood trauma and clinical presentations of the illness have mainly focused on physical and sexual abuse. Our aim was to explore further the relationship between childhood trauma and disease characteristics in bipolar disorder to determine which clinical characteristics were most strongly associated with childhood trauma total score, as well as subtypes of adverse childhood events, including physical, sexual, emotional abuse and neglect.Methods: 141 Patients with bipolar disorder were consecutively recruited, and disease history and clinical characteristics were assessed. History of childhood abuse was obtained using the Childhood Trauma Questionnaire (CTQ). Statistical methods used were factor analysis, Poisson and linear regression, and generalized additive modeling (GAM).Results: The factor analysis of CTQ identified three factors: emotional abuse/neglect, sexual abuse and physical abuse. There were significant associations between CTQ total score and earlier onset of illness, reduced level of psychosocial functioning (GAF; Global Assessment of Functioning) and decreased number of hospitalization, which mainly were due to the factor emotional abuse/neglect. Physical abuse was significantly associated with lower GAF scores, and increased number of mood episodes, as well as self-harm. Sexual abuse was significantly associated with increased number of mood episodes. For mood episodes and self-harm the associations were characterized by great variance and fluctuations.Conclusions: Our results suggest that childhood trauma is associated with a more severe course of bipolar illness. Further, childhood abuse (physical and sexual), as well as emotional abuse and neglect were significantly associated with accelerating staging process of bipolar disorder. By using specific trauma factors (physical abuse, sexual abuse and emotional abuse/neglect) the associations become both more precise, and diverse.",

keywords = "Bipolar disorder, Childhood trauma, Clinical characteristics",

author = "Sara Larsson and Monica Aas and Ole Klungs{\o}yr and Ingrid Agartz and Erlend Mork and Steen, {Nils Eiel} and Barrett, {Elizabeth A.} and Lagerberg, {Trine V.} and R{\o}ssberg, {Jan Ivar} and Ingrid Melle and Andreassen, {Ole A.} and Steinar Lorentzen",

note = "Funding Information: We thank the patients who took part in the study and the TOP study researchers who contributed to the data collection. This study was funded by grants from the Eastern Norway Health Authority (#2004123, #2006258) and the Research Council of Norway (#167153/V50).",

year = "2013",

month = mar,

day = "22",

doi = "10.1186/1471-244X-13-97",

language = "English",

volume = "13",

journal = "BMC Psychiatry",

issn = "1471-244X",

publisher = "BioMed Central",

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TY - JOUR

T1 - Patterns of childhood adverse events are associated with clinical characteristics of bipolar disorder

AU - Larsson, Sara

AU - Aas, Monica

AU - Klungsøyr, Ole

AU - Agartz, Ingrid

AU - Mork, Erlend

AU - Steen, Nils Eiel

AU - Barrett, Elizabeth A.

AU - Lagerberg, Trine V.

AU - Røssberg, Jan Ivar

AU - Melle, Ingrid

AU - Andreassen, Ole A.

AU - Lorentzen, Steinar

N1 - Funding Information: We thank the patients who took part in the study and the TOP study researchers who contributed to the data collection. This study was funded by grants from the Eastern Norway Health Authority (#2004123, #2006258) and the Research Council of Norway (#167153/V50).

PY - 2013/3/22

Y1 - 2013/3/22

N2 - Background: Previous studies in bipolar disorder investigating childhood trauma and clinical presentations of the illness have mainly focused on physical and sexual abuse. Our aim was to explore further the relationship between childhood trauma and disease characteristics in bipolar disorder to determine which clinical characteristics were most strongly associated with childhood trauma total score, as well as subtypes of adverse childhood events, including physical, sexual, emotional abuse and neglect.Methods: 141 Patients with bipolar disorder were consecutively recruited, and disease history and clinical characteristics were assessed. History of childhood abuse was obtained using the Childhood Trauma Questionnaire (CTQ). Statistical methods used were factor analysis, Poisson and linear regression, and generalized additive modeling (GAM).Results: The factor analysis of CTQ identified three factors: emotional abuse/neglect, sexual abuse and physical abuse. There were significant associations between CTQ total score and earlier onset of illness, reduced level of psychosocial functioning (GAF; Global Assessment of Functioning) and decreased number of hospitalization, which mainly were due to the factor emotional abuse/neglect. Physical abuse was significantly associated with lower GAF scores, and increased number of mood episodes, as well as self-harm. Sexual abuse was significantly associated with increased number of mood episodes. For mood episodes and self-harm the associations were characterized by great variance and fluctuations.Conclusions: Our results suggest that childhood trauma is associated with a more severe course of bipolar illness. Further, childhood abuse (physical and sexual), as well as emotional abuse and neglect were significantly associated with accelerating staging process of bipolar disorder. By using specific trauma factors (physical abuse, sexual abuse and emotional abuse/neglect) the associations become both more precise, and diverse.

AB - Background: Previous studies in bipolar disorder investigating childhood trauma and clinical presentations of the illness have mainly focused on physical and sexual abuse. Our aim was to explore further the relationship between childhood trauma and disease characteristics in bipolar disorder to determine which clinical characteristics were most strongly associated with childhood trauma total score, as well as subtypes of adverse childhood events, including physical, sexual, emotional abuse and neglect.Methods: 141 Patients with bipolar disorder were consecutively recruited, and disease history and clinical characteristics were assessed. History of childhood abuse was obtained using the Childhood Trauma Questionnaire (CTQ). Statistical methods used were factor analysis, Poisson and linear regression, and generalized additive modeling (GAM).Results: The factor analysis of CTQ identified three factors: emotional abuse/neglect, sexual abuse and physical abuse. There were significant associations between CTQ total score and earlier onset of illness, reduced level of psychosocial functioning (GAF; Global Assessment of Functioning) and decreased number of hospitalization, which mainly were due to the factor emotional abuse/neglect. Physical abuse was significantly associated with lower GAF scores, and increased number of mood episodes, as well as self-harm. Sexual abuse was significantly associated with increased number of mood episodes. For mood episodes and self-harm the associations were characterized by great variance and fluctuations.Conclusions: Our results suggest that childhood trauma is associated with a more severe course of bipolar illness. Further, childhood abuse (physical and sexual), as well as emotional abuse and neglect were significantly associated with accelerating staging process of bipolar disorder. By using specific trauma factors (physical abuse, sexual abuse and emotional abuse/neglect) the associations become both more precise, and diverse.

KW - Bipolar disorder

KW - Childhood trauma

KW - Clinical characteristics

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U2 - 10.1186/1471-244X-13-97

DO - 10.1186/1471-244X-13-97

M3 - Article

C2 - 23522391

AN - SCOPUS:84875183116

SN - 1471-244X

VL - 13

JO - BMC Psychiatry

JF - BMC Psychiatry

M1 - 97

ER -

Patterns of childhood adverse events are associated with clinical characteristics of bipolar disorder

Abstract

Keywords

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