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

IntroductionChildhood trauma (CT) is a relevant environmental stressor for bipolar disorder (BP). Amygdala and hippocampus are key areas involved both in the pathophysiology of BP and in mediating the biological response to stress.ObjectivesStructural neuroimaging studies help clarifying neural correlates of the relationship between BP diagnosis and CT.AimsTo verify the impact of CT on amygdala and hippocampus and hippocampal subfields volumes in BP patients and healthy control (HC).MethodsWe assessed 105 outpatients, diagnosed with BPI or BPII according to DSM-IV-TR criteria, and 113 HC subjects. History of CT was obtained using the childhood trauma questionnaire (CTQ). High-resolution magnetic resonance imaging was performed on all subjects and volumes of amygdala, hippocampus, nucleus accumbens, caudate, pallidum, putamen, thalamus and hippocampal subfields were measured through FreeSurfer.ResultsAll deep gray matter structures were smaller in BP than HC. CT modulated the impact of the diagnosis on bilateral amygdala and hippocampus, in particular on subiculum, presubiculum and cornu ammonis CA1. It was associated with bilateral decreased volumes in HC and increased volumes in patients with BP.ConclusionsChildhood trauma impacts on the amygdala and hippocampus, brain areas involved in response to stress and emotion processing, and specifically on the hippocampal subfields most implicated in learning trough positive/negative reinforcement.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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475. Gender Differences in the Impact of Childhood Trauma on Impulsive Behaviors and Suicide Attempts in Pediatric Bipolar Disorder

Biological Psychiatry ◽

10.1016/j.biopsych.2017.02.959 ◽

2017 ◽

Vol 81 (10) ◽

pp. S193-S194

Author(s):

Jair Soares ◽

Fadwa Cazala ◽

Isabelle E. Bauer ◽

Danielle Spiker ◽

Giovana Zunta-Soares

Keyword(s):

Gender Differences ◽

Bipolar Disorder ◽

Childhood Trauma ◽

Suicide Attempts ◽

Pediatric Bipolar Disorder ◽

The Impact

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The association between childhood trauma, parental bonding and depressive symptoms and interpersonal functioning in depression and bipolar disorder

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2016.43 ◽

2017 ◽

Vol 35 (1) ◽

pp. 23-32 ◽

Cited By ~ 4

Author(s):

M. Marshall ◽

C. Shannon ◽

C. Meenagh ◽

N. Mc Corry ◽

C. Mulholland

Keyword(s):

Bipolar Disorder ◽

Childhood Trauma ◽

Clinical Care ◽

Parental Bonding ◽

Outpatient Service ◽

Depressive Mood ◽

Interpersonal Functioning ◽

Regression Analyses ◽

Cross Sectional ◽

The Impact

ObjectivesThis study explores rates of a history of childhood trauma in adult patients with bipolar disorder and depression and the impact of such trauma and parental bonding patterns on depressive mood and interpersonal functioning at the time of assessment.MethodsA cross-sectional design was used and a sample of 49 participants was recruited from a mental health outpatient service in Northern Ireland. Data were subject to correlations, one-way analysis of variance and hierarchal regression analyses. A cut-off point of r=±0.25 was used to select variables for inclusion in the hierarchal regression analyses.ResultsHigh rates of childhood trauma were present in both samples: 74% in bipolar disorder and 82% in depression. Childhood trauma and poor parental bonding (with mother) were significant predictors of higher rates of current inter-episode depressive mood and interpersonal difficulties.ConclusionsThis finding adds to the evidence that routine assessment of early childhood experience is likely to prove helpful in clinical care.

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Neuropsychological status of bipolar I disorder: impact of psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.bp.108.052001 ◽

2009 ◽

Vol 194 (3) ◽

pp. 243-251 ◽

Cited By ~ 46

Author(s):

Jonathan Savitz ◽

Lize van der Merwe ◽

Dan J. Stein ◽

Mark Solms ◽

Rajkumar Ramesar

Keyword(s):

Bipolar Disorder ◽

Personality Traits ◽

Childhood Trauma ◽

Declarative Memory ◽

Type I ◽

Schizotypal Personality ◽

Neuropsychological Status ◽

History Of ◽

Psychotic Features ◽

The Impact

BackgroundThe presence of schizotypal personality traits in some people with bipolar disorder, together with reports of greater cognitive dysfunction in patients with a history of psychotic features compared with patients without such a history, raises questions about the nosological relationship between bipolar disorder with psychotic features and bipolar disorder without psychotic features.AimsTo test the impact of a history of DSM–IV-defined psychosis on the neuropsychological status of participants with bipolar disorder while statistically controlling for confounding factors such as mood, medication, alcohol misuse/dependence and childhood abuse, and to evaluate the impact of schizotypal personality traits (and thus potential vulnerability to psychotic illness) on the cognitive performance of people with bipolar disorder and their healthy relatives.MethodNeuropsychological data were obtained for 25 participants with type I bipolar disorder and a history of psychosis, 24 with type I bipolar disorder but no history of psychosis and 61 unaffected relatives. Schizotypal traits were measured with the Schizotypal Personality Scale (STA). Childhood trauma was measured with the Childhood Trauma Questionnaire.ResultsThe group with a history of psychosis performed significantly worse than the healthy relatives on measures of verbal working memory, cognitive flexibility and declarative memory. Nevertheless, the two bipolar disorder groups did not differ significantly from each other on any cognitive measure. Scores on the STA were negatively associated with verbal working and declarative memory, but positively associated with visual recall memory.Conclusions‘Psychotic’ and ‘non-psychotic’ subtypes of bipolar disorder may lie on a nosological continuum that is most clearly defined by verbal memory impairment.

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Impact of childhood abuse on the clinical course of bipolar disorder

The British Journal of Psychiatry ◽

10.1192/bjp.186.2.121 ◽

2005 ◽

Vol 186 (2) ◽

pp. 121-125 ◽

Cited By ~ 244

Author(s):

Jessica L. Garno ◽

Joseph F. Goldberg ◽

Paul Michael Ramirez ◽

Barry A. Ritzler

Keyword(s):

Bipolar Disorder ◽

Childhood Abuse ◽

Childhood Trauma ◽

Emotional Abuse ◽

Substance Misuse ◽

Suicide Attempts ◽

Clinical Course ◽

Rapid Cycling ◽

Illness Onset ◽

The Impact

BackgroundFew investigations have examined the impact of childhood trauma, and domains of childhood abuse, on outcome in bipolar disorder.AimsTo evaluate the prevalence and subtypes of childhood abuse reported by adult patients with bipolar disorder and relationshipto clinical outcome.MethodPrevalence rates of childhood abuse were retrospectively assessed and examined relative to illness complexity in a sample of 100 patients at an academic specialty centre for the treatment of bipolar disorder.ResultsHistories of severe childhood abuse were identified in about half of the sample and were associated with early age at illness onset. Abuse subcategories were strongly inter-related. Severe emotional abuse was significantly associated with lifetime substance misuse comorbidity and past-year rapid cycling. Logistic regression indicated a significant association between lifetime suicide attempts and severe childhood sexual abuse. Multiple forms of abuse showed a graded increase in risk for both suicide attempts and rapid cycling.ConclusionsSevere childhood trauma appears to have occurred in about half of patients with bipolar disorder, and may lead to more complex psychopathological manifestations.

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