Bipolar Disorder Linked with Childhood Neglect and Abuse

Adults diagnosed with bipolar disorder are much more likely than the general population to have suffered emotional, physical, or sexual abuse as children.

Researchers from the University of Manchester in England suggest that childhood adversity appears to be associated with bipolar disorder, which has implications for the treatment of this patient population. Published in the October 2016 issue of the British Journal of Psychiatry, the study found that people with bipolar disorder were 2.63 times (95% CI 2.00—3.47) more likely to have suffered emotional, physical, or sexual abuse as children than counterparts in the general population.

A meta-analysis approach was applied in the study for the first time in relation to bipolar disorder and childhood adversity and, as a result, the findings represent a much larger pool of data than has been previously available.

For the study, the investigators entered search terms relating to childhood adversity and bipolar disorder into Medline, EMBASE, PsycINFO, and Web of Science. Eligible studies included a sample diagnosed with bipolar disorder, a comparison sample, and a quantitative measure of childhood adversity. From the hundreds published between 1980 and 2014, they identified 19 that gathered data from millions of patient records, interviews, and assessments. Childhood adversity was defined as experiencing neglect, abuse, bullying, or the loss of a parent before age 19 years. The research team applied rigorous statistical analysis to the data in order to compare the likelihood of people with and without bipolar disorder having adverse childhood experiences.

Their findings revealed a strong link between such events and a future diagnosis of bipolar disorder. A particularly strong link was observed between emotional abuse, which was four times more likely to occur in patients with bipolar disorder. Conversely, the loss of a parent was not associated with significantly increased risk of developing the disorder.

With bipolar disorder characterized by extreme depressive and manic states that impair quality of life and increase suicide risk, the study findings help address an urgent need exists in this field for a better understanding of any risk factors that can be used to improve detection and treatment.

“Much research into bipolar has focused on bio-genetics, but following previous work on schizophrenia, we felt that a similar effect could be found in bipolar,” said senior author Filippo Varese, PhD, a clinical lecturer in psychology in the Division of Psychology and Mental Health at the University of Manchester. “The link between experiencing a troubled childhood and subsequently being diagnosed with this serious condition is extremely strong.”

Adding to Varese’s sentiments, lead author Jasper Palmier-Claus, PhD, ClinPsyD, a clinical psychologist at the Psychosis Research Unit in West Manchester, said “Handled sensitively, enquiries about a person’s childhood experiences can make a significant difference to how treatment proceeds and the types of support that can be put into place.”

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