Childhood Trauma Is Associated With Severe Clinical Characteristics of Bipolar Disorders
Childhood Trauma Is Associated With Severe Clinical Characteristics of Bipolar Disorders
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DOI：
10.4088/jcp.13m08353
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发表时间：
2013-10-01
影响因子：
5.3
通讯作者：
Henry, Chantal
中科院分区：
文献类型：
--
作者：
Etain, Bruno;Aas, Monica;Henry, Chantal
目的：除了遗传风险变异之外，双相情感障碍的病理生理学可能部分由环境易感因素决定。我们的研究是第一个在大量特征明确的双相情感障碍患者中调查临床表现与儿童创伤亚型（包括忽视和虐待项目）之间关联的研究之一。方法：分别于 1996-2008 年和 2007-2012 年期间从法国和挪威招募了 587 名 D.SM-W 定义的双相情感障碍患者。使用童年创伤问卷获得童年创伤史。通过 DSM-IV Axis I 疾病结构化临床访谈（挪威样本）或遗传研究诊断访谈（法国样本）评估临床变量。结果：双相情感障碍发病年龄较早、自杀未遂、快速循环和抑郁发作次数增加均与至少 1 种童年创伤亚型（情感虐待、性虐待和情感忽视）有显着关联。001)。一起调查创伤变量的多变量分析表明，情感虐待和性虐待都是较低发病年龄（各自 P=.002）和自杀未遂史（OR= 1.60 [95% Cl，1.07 至 2.39]，P=.023；OR= 1.80 [95% Cl，1.14 至 2.86]，P=.012）的独立预测因素，而性虐待是最强的。快速循环的预测因子（OR= 2.04 [95% Cl，1.21 至 3.42]，P=.007）。与男性相比，女性总体上报告了更高的童年创伤频率以及与临床表现的更大关联（P 值
Objective: Beyond genetic risk variants, the pathophysiology of bipolar disorders is likely to be partly determined by environmental susceptibility factors. Our study is one of the first to investigate, in a large sample of well-characterized bipolar patients, associations between clinical presentations and childhood trauma subtypes, including neglect and abuse items.Method: 587 patients with D.SM-W defined bipolar disorder were recruited from France and Norway between 1996-2008 and 2007-2012, respectively. History of childhood trauma was obtained using the Childhood Trauma Questionnaire. Clinical variables were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (Norwegian sample) or the Diagnostic Interview for Genetic Studies (French sample).Results: Earlier age at onset of bipolar illness, suicide attempts, rapid cycling, and an increased number of depressive episodes each had significant associations.001) with at least 1 subtype of childhood trauma (emotional abuse, sexual abuse, and emotional neglect). Multivariate analyses investigating trauma variables together showed that both emotional and sexual abuse were independent predictors of lower age at onset (P=.002 for each) and history of suicide attempts (OR= 1.60 [95% Cl, 1.07 to 2.39], P=.023; OR= 1.80 [95% Cl, 1.14 to 2.86], P=.012, respectively), while sexual abuse was the strongest predictor of rapid cycling (OR= 2.04 [95% Cl, 1.21 to 3.42], P=.007). Females reported overall higher childhood trauma frequency and greater associations to clinical expressions than males (P values