Childhood-maltreatment subtypes in bipolar patients with suicidal behavior: systematic review and meta-analysis

Abstract

Objective: Patients with bipolar disorders have a high risk of suicidal behavior. Childhood maltreatment is a well-established risk factor for suicidal behavior. The objective of this study was to examine the association between childhood-maltreatment subtypes and vulnerability to suicide attempts in bipolar disorder using the Childhood Trauma Questionnaire (CTQ). Methods: A literature review was performed using the MEDLINE, Embase, and PsycINFO databases. Thirteen studies met the selection criteria. In the meta-analysis, the Childhood Trauma Questionnaire (CTQ) was used to assess a wide range of childhood maltreatment subtypes, which were analyzed by using a random-effects model to account for the likely variations of true effect sizes between the included studies. Results: In the systematic review, 13 studies met the selection criteria. The CTQ was selected for the meta-analysis to increase the homogeneity of assessment and to encompass a wide range of childhood-maltreatment subtypes. The data were analyzed using a random-effects model. Compared to bipolar non-attempters, bipolar suicide attempters had experienced childhood maltreatment with a significantly higher frequency and had higher total CTQ scores (Hedges' g =-0.38, 95%CI-0.52 to-0.24, z =-5.27, p o 0.001) and CTQ sub-scores

Influence of childhood maltreatment on prevalence, onset, and persistence of psychiatric comorbidities and suicide attempts in bipolar disorders

“…Childhood maltreatment has also been associated with the prevalence of suicide attempts in at least two independent meta-analyses [20,37]. Noteworthy, effect sizes for the associations with suicide attempts were the highest for both sexual abuse and emotional abuse and the lowest for physical neglect [37]. In this sample, we observed very similar findings, suggesting that the main determinants of suicide attempts might be emotional abuse and sexual abuse.…”

“…Hence, this suggests that emotional abuse may play a central role in the risk of developing psychiatric comorbidities in BD. Childhood maltreatment has also been associated with the prevalence of suicide attempts in at least two independent meta-analyses [20,37]. Noteworthy, effect sizes for the associations with suicide attempts were the highest for both sexual abuse and emotional abuse and the lowest for physical neglect [37].…”

<p>The Impact of Childhood Trauma on Developing Bipolar Disorder: Current Understanding and Ensuring Continued Progress</p>

“… 32 , 33 Even though some studies have shown that different subtypes of CT could increase the risk of developing different types of psychiatric conditions (eg 34 , 35 ), these findings remain mixed and other factors of frequency, severity, or timing of CT may rather be playing a role in this regard. 36 In addition, a recent meta-analysis of 13 independent studies suggests that exposure to CT is associated with an increased risk of suicidal behavior in individuals with BD 37 . In particular, individuals with BD who attempted suicide reported being exposed to CT more frequently than those who were not exposed, in particular when exposed to emotional abuse or sexual abuse (both Hedges’ g = −0.39).…”

The Association Between Suicide Attempts, Anxiety, and Childhood Maltreatment Among Adolescents and Young Adults With First Depressive Episodes

“…And the reduction in long-term social support associated with childhood maltreatment also increases the risk of suicide attempts (23). Previous studies majorly examined the association between SA and childhood maltreatment among adults with MDD and BP (22,24). However, limited studies have discussed this relationship among adolescents and young adults.…”