Childhood maltreatment and the medical morbidity in bipolar disorder: a case–control study

Abstract

BackgroundChildhood maltreatment (abuse and neglect) can have long-term deleterious consequences, including increased risk for medical and psychiatric illnesses, such as bipolar disorder in adulthood. Emerging evidence suggests that a history of childhood maltreatment is linked to the comorbidity between medical illnesses and mood disorders. However, existing studies on bipolar disorder have not yet explored the specific influence of child neglect and have not included comparisons with individuals without mood disorders (controls). This study aimed to extend the existing literature by examining the differential influence of child abuse and child neglect on medical morbidity in a sample of bipolar cases and controls.MethodsThe study included 72 participants with bipolar disorder and 354 psychiatrically healthy controls (average age of both groups was 48 years), who completed the Childhood Trauma Questionnaire, and were interviewed regarding various medical disorders.ResultsA history of any type of childhood maltreatment was significantly associated with a diagnosis of any medical illness (adjusted OR = 6.28, 95% confidence intervals 1.70–23.12, p = 0.006) and an increased number of medical illnesses (adjusted OR = 3.77, 95% confidence intervals 1.34–10.57, p = 0.012) among adults with bipolar disorder. Exposure to child abuse was more strongly associated with medical disorders than child neglect. No association between childhood maltreatment and medical morbidity was detected among controls.ConclusionsTo summarise, individuals with bipolar disorder who reported experiencing maltreatment during childhood, especially abuse, were at increased risk of suffering from medical illnesses and warrant greater clinical attention.

Associations between adverse childhood experiences and health outcomes in adults aged 18–59 years

“…Physical abuse during childhood was significantly related to adult smoking, chronic disease, and poor mental health (ORs ranged from 1.33 to 1.81). Domestic violence, community violence, and sexual abuse during childhood were significantly associated with an increased risk of PTSD in adulthood (ORs ranged from 1.45 to 2.84), which is consistent with previous studies [37, 38]. Abuse and neglect have a deleterious impact on the emergent attachment system and can lead to emotional dysregulation and an increase in cortisol levels [39].…”

Childhood maltreatment and adult medical morbidity in mood disorders: comparison of unipolar depression with bipolar disorder

“…On average people with mood disorders die up to 10 years earlier than the general population, 1 which is largely attributed to the high medical burden in this group 2 , 3 . Emerging evidence suggests that exposure to childhood adversity (for example maltreatment, abuse and neglect) is associated with medical morbidity in mood disorders 4 – 6 . These studies have not distinguished between unipolar depression and bipolar disorder 5 , 7 or have focused on only one disorder 4 , 6 .…”

Gender discrimination, victimisation and women's mental health

“…4 Gender victimisation also includes forced marriage, 'honour' crimes and human trafficking, 4 however, a review of their impact on women's mental health is outside the scope of this discussion. Childhood maltreatment is significantly associated with physical and mental illnesses, 13 such as cardiovascular disease and mood disorders in adulthood; these associations have been shown to be strongest in women. 14,15 The experience of domestic violence and abuse can lead to the development of mental health problems.…”