Childhood trauma, dimensions of psychopathology and the clinical expression of bipolar disorders: A pathway analysis

Lajnef, Mohamed; Aubin, V.; Azorin, J.-M.; Bellivier, Frank; Bougerol, Thierry; Courtet, Philippe; Gard, Sébastien; Kahn, Jean‐Pierre; Passerieux, C.; Henry, Chantal; Étain, Bruno; Leboyer, Marion; Laouamri, H.; Souryis, K.; Godin, O.; Raust, Aurélie; Sportiche, Sarah; Geoffroy, Pierre A.; Aouizerate, Bruno; Desage, A.; Olié, Émilie; Ducasse, Déborah; Molière, Fanny; Belzeaux, Raoul; Viglianaise, N.; Lescalier, L.; Job, Sophie; Cohen, R.; Wajsbrot‐Elgrabli, O.; Polosan, Mircea; Garçon, S.; Hardy-Baylé, Marie-Christine; Roux, Paul; Kayser, N.; Grévin, I.; Loftus, J.; Albertini, Laurie W.

doi:10.1016/j.jpsychires.2017.07.013

Cited by 47 publications

(33 citation statements)

References 72 publications

(86 reference statements)

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“…[71][72][73] Among all subtypes of CM, we found that emotional abuse; sexual abuse and emotional neglect might have a greater contribution to SB in BD. These findings are in line with studies by Etain et al, 38,74 which show that emotional abuse is closely related to worse clinical outcomes in BD, including SB. In addition, sexual abuse seems to be a strong predictor for suicide.…”

Section: Discussionsupporting

confidence: 92%

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

Duarte

Belzeaux

Étain³

et al. 2020

Braz. J. Psychiatry

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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

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Section: Discussionsupporting

confidence: 92%

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

Duarte

Belzeaux

Étain³

et al. 2020

Braz. J. Psychiatry

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“…Impulsivity may mediate the relationship between childhood maltreatment and increased risk for developing alcohol/cannabis abuse [172]. Etain et al (2017) conducted a path-analysis in 485 euthymic bipolar disorder patients and uncovered a significant association between impulsivity and emotional abuse, and impulsivity was associated with increased risk for SUDs [173]. These studies suggest that in some individuals with a history of childhood maltreatment, albeit not all, interventions that focus on alcohol/drug use problems, and specifically externalizing behaviors that may mediate the link between childhood maltreatment and alcohol/drug use problems (e.g.…”

Section: Pathways To Mood Disorder Outcomes-more Work On Mechanisms Amentioning

confidence: 99%

The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders

Lippard

Nemeroff

2020

AJP

330

180

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A large body of evidence has demonstrated that exposure to childhood maltreatment at any stage of development can have long-lasting consequences. It is associated with a marked increase in risk for psychiatric and medical disorders. This review summarizes the literature investigating the effects of childhood maltreatment on disease vulnerability for mood disorders, specifically summarizing cross-sectional and more recent longitudinal studies that demonstrate childhood maltreatment is more prevalent and associated with increased risk for first mood episode, episode recurrence, greater comorbidities, and increased risk for suicidal ideation and attempts in individuals with mood disorders. It summarizes the persistent alterations associated with childhood maltreatment, including alterations in the HPA axis and inflammatory cytokines, which may contribute to disease vulnerability and a more pernicious disease course. We discuss several candidate genes and environmental factors, for example alcohol/substance use, that may alter disease vulnerability and illness course and neurobiological associations that may mediate these relationships following childhood maltreatment. Studies provide insight into modifiable mechanisms and provide direction to improve both treatment and prevention strategies. "It is not the bruises on the body that hurt. It is the wounds of the heart and the scars on the mind."

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“…Moreover, there are consistent findings across studies in BD that childhood maltreatment is associated with a more severe and complex clinical expression of the disorder. Indeed, when exposed to childhood maltreatment, patients with BD will present with an earlier age of onset, more major mood episodes, and an increased risk for suicide attempts and rapid cycling course . In the meta‐analysis published by Agnew‐Blais in 2016, childhood maltreatment is associated with all the 12 indicators of severe or complex course of BD, including greater number of manic and depressive episodes, greater mania, depression and psychosis severity, higher risk of comorbidity with post‐traumatic stress disorder, anxiety disorders and substance use disorders, earlier age at onset, higher risk of rapid cycling and suicide attempt …”

Section: Introductionmentioning

confidence: 99%

“…Indeed, when exposed to childhood maltreatment, patients with BD will present with an earlier age of onset, more major mood episodes, and an increased risk for suicide attempts and rapid cycling course. [4][5][6][7] In the meta-analysis published by Agnew-Blais in 2016, childhood maltreatment is associated with all the 12 indicators of severe or complex course of BD, including greater number of manic and depressive episodes, greater mania, depression and psychosis severity, higher risk of comorbidity with post-traumatic stress disorder, anxiety disorders and substance use disorders, earlier age at onset, higher risk of rapid cycling and suicide attempt. 8 Gene-environment interactions have been suggested to be at stake when investigating the severity and/or complexity of the clinical expression of BD.…”

Section: Introductionmentioning

confidence: 99%

Childhood maltreatment and polygenic risk in bipolar disorders

et al. 2019

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Background Childhood maltreatment is a well‐known risk factor for developing a more severe and complex form of bipolar disorders (BD). However, knowledge is scarce about the interactions between childhood maltreatment and underlying genetic vulnerability on the clinical expression of BD. Method We assigned a BD‐polygenic risk score (BD‐PRS), calculated from the Psychiatric Genomics Consortium, to each individual in a sample of 402 cases with BD. The lifetime clinical expression of BD was characterized using structured interviews and patients completed the Childhood Trauma Questionnaire (CTQ) to assess the severity of childhood maltreatment. Results Cases who reported more severe childhood maltreatment had a lower BD‐PRS (rho = −0.12, P = .01), especially when considering emotional abuse (rho = −0.16, P = .001). An interaction between BD‐PRS and childhood maltreatment was observed for the risk of rapid cycling (P = .01). No further interactions between BD‐PRS and childhood maltreatment were observed for other clinical characteristics (age at onset, suicide attempts, number of mood episodes, mixed features, substance use disorders and psychotic symptoms). Conclusion Our study is the first to show that less genetic risk may be needed to develop a more unstable form of BD when exposed to childhood maltreatment. Our study supports childhood trauma as an independent risk factor for BD.

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Childhood trauma, dimensions of psychopathology and the clinical expression of bipolar disorders: A pathway analysis

Cited by 47 publications

References 72 publications

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

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

The Devastating Clinical Consequences of Child Abuse and Neglect: Increased Disease Vulnerability and Poor Treatment Response in Mood Disorders

Childhood maltreatment and polygenic risk in bipolar disorders

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