Childhood maltreatment and clinical response to mood stabilizers in patients with bipolar disorder
Childhood maltreatment and clinical response to mood stabilizers in patients with bipolar disorder
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DOI：
10.1002/hup.2783
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发表时间：
2021-03-05
影响因子：
1.7
通讯作者：
Maj, Mario
中科院分区：
文献类型：
--
作者：
Cascino, Giammarco;D'Agostino, Giulia;Maj, Mario
目的双相情感障碍（BD）儿童虐待（CM）与心境稳定剂临床反应之间的关系研究甚少。因此，我们评估CM是否会影响BD患者对锂或抗惊厥药物治疗的反应。方法采用Alda量表对97例心境稳定剂的临床疗效进行回顾性评价。通过儿童创伤问卷调查CM病史。结果37例（24例有CM病史，13例无CM病史）采用稳定锂离子治疗，60例（35例有CM病史，25例无CM病史）采用稳定抗惊厥药物治疗。在整个样本以及抗惊厥药物治疗亚组中，合并CM的BD和未合并CM的BD患者对药物治疗的临床反应没有差异。在锂治疗亚组中，儿童身体虐待与临床反应呈显著负相关，CM患者的Alda评分显著降低。结论：在BD患者中，CM不影响抗惊厥情绪稳定剂的临床反应，但它与锂的不良反应有关，儿童时期的身体虐待在这种影响中起主要作用。
Objective The association between childhood maltreatment (CM) and clinical response to mood stabilizers has been scarcely investigated in bipolar disorder (BD). Therefore, we assessed whether CM affects the response to lithium or anticonvulsant treatments in BD patients.Methods A retrospective assessment of clinical response to mood stabilizers was conducted in 97 euthymic patients with BD by means of the Alda scale. History of CM was investigated through the Childhood Trauma Questionnaire.Results Thirty-seven patients (24 with a history of CM and 13 without CM) were on stable lithium treatment while sixty (35 with a history of CM and 25 without CM) were on stable anticonvulsant treatment. Clinical response to drug treatment did not differ between BD with CM and those without CM in the whole sample as well as in the anticonvulsant-treated subgroup. In the lithium-treated subgroup, a significant negative correlation emerged between childhood physical abuse and clinical response and patients with CM showed a significantly reduced Alda score.Conclusions In BD patients, CM did not influence the clinical response to anticonvulsant mood stabilizers whereas it was associated with a poorer response to lithium with childhood physical abuse playing a major role in this effect.