Childhood traumas in patients with bipolar disorder: association with alexithymia and dissociative experiences

Yılmaz, Onur; Ateş, Mehmet Alpay; Semiz, Ümit Başar; Tütüncü, Recep; Bez, Yasin; Algül, Ayhan; Balıbey, Hakan; Başoğlu, Cengiz; Ebrinç, Servet; Çetin, Mesut

doi:10.5455/apd.188358

Cited by 13 publications

(10 citation statements)

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“…DS were comparable in BD and schizophrenia in a single study ( 43 ). However, DS scores were significantly higher in patients with BD than in their asymptomatic first-degree relatives ( 23 ) and were consistently higher in BD than in healthy controls ( 28 , 33 , 34 , 37 , 39 , 43 ).…”

Section: Resultsmentioning

confidence: 88%

Dissociative Symptoms and Disorders in Patients With Bipolar Disorders: A Scoping Review

Rajkumar

2022

Front. Psychiatry

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Dissociative disorders are an important group of trauma-related disorders associated with significant disability. The co-occurrence of dissociative disorders (DD) and symptoms (DS) in bipolar disorder has been relatively understudied, but there is some evidence that this comorbidity may have significant mechanistic and clinical implications. This paper presents the results of a scoping review of the frequency and correlates of DS and DD in bipolar disorder. Based on the available evidence, DS/DD are more common in bipolar disorder than in healthy controls or in unipolar depression, are related to childhood trauma, and are associated with psychotic symptoms, suicide attempts, and a poorer response to treatment in patients with bipolar disorder. The implications of these findings, and possible mechanistic pathways underlying them, are discussed based on the current literature. Clinicians should be aware of the frequent occurrence of significant DS or DD when treating patients with bipolar disorder. A tentative future research agenda for this field, based on clinical, risk factor-related and neurobiological considerations, is outlined.

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Section: Resultsmentioning

confidence: 88%

Dissociative Symptoms and Disorders in Patients With Bipolar Disorders: A Scoping Review

Rajkumar

2022

Front. Psychiatry

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“…One study removed analyses found no evidence of potential influential cases across the analyses reported (except for the bipolar subgroup; the relationship between childhood trauma and dissociation became significant after the removal of Yilmaz et al ). As a few studies reported only significant relationships (i.e.…”

Section: Resultsmentioning

confidence: 99%

The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review

Rafiq

Campodonico

Varese

2018

Acta Psychiatr Scand

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The relationship between childhood adversities and dissociation in severe mental illness: a meta-analytic review Rafiq S, Campodonico C, Varese F. The relationship between childhood adversities and dissociation in severe mental illness: a metaanalytic review Objective: Several studies have observed that dissociative experiences are frequently reported by individuals with severe mental illness (SMI), especially amongst patients that report a history of adverse/traumatic life experiences. This review examined the magnitude and consistency of the relationship between childhood adversity (sexual abuse, physical abuse, emotional abuse, neglect, bullying, natural disasters and mass violence) and dissociation across three SMI diagnostic groups: schizophrenia, bipolar disorder and personality disorders. Method: A database search (EMBASE, PubMed and PsycINFO) identified 30 eligible empirical studies, comprising of 2199 clinical participants. Effect sizes representing the relationship between exposure to childhood adversity and dissociation were examined and integrated using a random-effects meta-analysis. Results: The results indicated that exposure to childhood trauma was associated with heightened dissociation across SMIs. Positive significant associations were also found between specific childhood adversities and dissociation, with aggregated effect sizes in the small-to-moderate range. Conclusion: These findings support calls for the routine assessment of traumatic experiences in clients with SMIs presenting with dissociative symptoms and the provision of adequate therapeutic support (e.g. trauma-focused therapies) to manage and resolve these difficulties. Summations• Small-to-moderate relationship between childhood trauma and dissociation across SMIs. • Medium relationship between childhood trauma and dissociation in schizophrenia-spectrum disorders.• All forms of childhood traumatic experiences (e.g. sexual abuse, physical abuse, emotional abuse, emotional neglect, physical neglect) were found to be associated with dissociation in people diagnosed with SMI. Considerations• Only three studies were found eligible for the bipolar sample (i.e. low power); therefore, no strong conclusions can be drawn regarding the association between childhood trauma and dissociative experiences in bipolar disorder.• The relationship between childhood trauma and dissociation in SMI requires further corroboration using longitudinal designs to determine causality and directionality.• No firm conclusions can be drawn regarding which specific traumatic experience is most strongly associated with dissociation, as the studies included in the analysis were not independent (i.e. effects for sexual abuse and physical abuse estimated from the same sample of participants). 509Acta Psychiatr Scand 2018: 138: 509-525

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“…Previous studies have consistently shown greater alexithymia for BD and SZ patients, compared to HCs (Herold et al, 2017;Yilmaz et al, 2016;Cedro et al, 2001;van't Wout et al, 2007). Also, studies comparing psychotic versus non-psychotic disorders revealed no difference in alexithymia (Heshmati et al, 2010;Karayağiz et al, 2016;Picardi et al, 2012).…”

Section: Discussionmentioning

confidence: 95%

“…Given this inability to recognize self-referential cognitive states, alexithymia has been theorized to partially represent deficits in metacognition (Dimaggio et al, 2009), with certain metacognitive strategies correlating with aspects of alexithymia (Babei et al, 2016). Studies in BD have generally shown that BD patients present with higher alexithymia scores, particularly difficulty in identifying and describing feelings, compared to healthy controls (HCs) (Herold et al, 2017;Yilmaz et al, 2016). Interestingly, studies comparing psychotic versus nonpsychotic axis I disorders (as well as one study comparing BD to major depressive disorder) revealed no difference in alexithymia between the diagnostic groups (Heshmati et al, 2010;Karayağiz et al, 2016;Picardi et al, 2012), suggesting that alexithymia may not reliably differentiate between mood and psychotic disorders and may in fact be a characteristic of major psychiatric illnesses in general.…”

Section: Introductionmentioning

confidence: 99%

Alexithymia predicts poorer social and everyday functioning in schizophrenia and bipolar disorder

Ospina

Shanahan

Perez‐Rodriguez

et al. 2019

Psychiatry Research

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Alexithymia, or the inability to identify and describe one's emotions, is significantly higher in bipolar disorder (BD) and schizophrenia (SZ), compared to healthy controls (HC). Alexithymia has also been observed to predict psychosocial functioning in SZ. We investigated whether alexithymia predicted social and everyday functioning in BD, as well as transdiagnostically in HC, BD, and SZ patients. 56 BD, 45 SZ, and 50 HC were administered and compared on tests measuring neurocognition, social cognition, functioning and alexithymia. We conducted linear regressions assessing whether alexithymia predicted functional outcomes in BD. Next, we conducted hierarchical stepwise linear regressions investigating the predictive ability of neurocognition, social cognition and alexithymia on everyday and social functioning in our overall sample. BD and SZ patients were comparable on most demographics and demonstrated higher alexithymia compared to HCs. In BD, alexithymia predicted social functioning only. In the overall sample, difficulty identifying and describing feelings predicted everyday functioning; difficulty describing feelings predicted social functioning. Results suggest that aspects of alexithymia significantly predict functioning among these psychiatric groups, above and beyond the contributions of previously identified factors such as neurocognition and social cognition. Results may aid in developing proper interventions aimed at improving patients' ability to articulate their feelings.

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Childhood traumas in patients with bipolar disorder: association with alexithymia and dissociative experiences

Cited by 13 publications

References 0 publications

Dissociative Symptoms and Disorders in Patients With Bipolar Disorders: A Scoping Review

Dissociative Symptoms and Disorders in Patients With Bipolar Disorders: A Scoping Review

The relationship between childhood adversities and dissociation in severe mental illness: a meta‐analytic review

Alexithymia predicts poorer social and everyday functioning in schizophrenia and bipolar disorder

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