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

Abstract

Childhood trauma (CT) has been repeatedly linked to earlier onset and greater severity of bipolar disorder (BD) in adulthood. However, such knowledge is mostly based on retrospective and cross-sectional studies in adults with BD. The first objective of this selective review is to characterize the short-term effects of CT in the development of BD by focusing on studies in young people. The second objective is to describe the longer-term consequences of CT by considering studies with adult participants. This review first outlines the most prominent hypotheses linking CT exposure and the onset of BD. Then, it summarizes the psychological and biological risk factors implicated in the development of BD, followed by a discussion of original studies that investigated the role of CT in young people with early-onset BD, youths at increased risk of developing BD, or young people with BD with a focus on subclinical and clinical outcome measures. The review considers additional biological and psychological factors associated with a negative impact of CT on the long-term course of BD in later adulthood. Finally, we discuss how the integration of information of CT can improve ongoing early identification of BD and mitigate severe clinical expression in later adulthood.

Childhood trauma in bipolar disorder: new targets for future interventions

“… 4 The underlying biological mechanisms by which childhood trauma, and particularly emotional abuse, lead to an increased risk of developing bipolar disorder and a worsened bipolar disorder prognosis are far from resolved. Exposure to childhood trauma is associated with long-term changes in the hypothalamic-pituitary-adrenal axis response, 5 such as increased cortisol reactivity. Thus, individuals exposed to childhood trauma may have heightened responses to subsequent life stressors, rendering them vulnerable to developing mood disorders such as bipolar disorder.…”

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

“…Bipolar disorders (BD) are very frequently associated with other psychiatric conditions, including anxiety disorders, substance use disorders, and eating disorders, and also frequently associated with suicidal attempts, which is not considered as a "comorbidity" per se, but rather an indicator of the severity of the illness [1,2]. Several meta-analyses have reported associations between BD and comorbid psychiatric conditions in large pooled samples.…”

The impact of lifetime interpersonal and intentional trauma on cognition and vulnerability to psychosis in bipolar disorder

“…This is in line with the broader literature suggesting that ACEs are a risk factor for poorer health outcomes, 47 as well as onset of bipolar disorder. 48 Lifetime trauma is certainly not the only factor affecting clinical course in bipolar disorder; however, our results indicate the significant impact that lifetime trauma may have on psychotic features and cognitive dysfunction in bipolar disorder. These findings also support a role for trauma inquiry in risk stratification and treatment planning for patients with bipolar disorder.…”