Impact of childhood abuse on the course of bipolar disorder: A replication study in US veterans
Impact of childhood abuse on the course of bipolar disorder: A replication study in US veterans
复制标题
DOI：
10.1016/j.jad.2005.06.012
复制
发表时间：
2005-12-01
影响因子：
6.6
通讯作者：
Williford, WO
中科院分区：
文献类型：
--
作者：
Brown, GR;McBride, L;Williford, WO
背景资料：尚未在以男性或退伍军人为主的人群中对双相情感障碍成人患者的早期儿童期虐待与病程（包括精神共病）之间的相关性进行研究。作为VA合作研究430的一部分，“减少双相情感障碍的疗效-疗效差距，330名患有I型或II型双相情感障碍的退伍军人（91%为男性）参加了一项为期3年的前瞻性研究，研究人员检查了研究开始时获得的基线数据。作为基线人口统计学和临床信息的一部分，进行了一次半结构化访谈，旨在获取有关儿童期身体、性或组合虐待暴露的数据。从这个数据集的其他报告没有解决的问题，童年advertisement.Results：儿童虐待报告的主题（47.3%的男性）的48.3%。48.3%的男性受试者报告了任何虐待（AA）; 8%的男性受试者报告了无身体虐待（SA）的性虐待，20.7%的男性受试者报告了无性虐待（PA）的身体虐待，18.7%的男性受试者报告了两种类型的虐待（联合虐待，CA）。女性退伍军人报告更多的SA（27%）和PA（6.7%）较少。AA受试者更有可能患有PTSD和终身诊断的恐慌症和酒精使用障碍。CA与较低的SF-36精神评分，较高的可能性，目前的创伤后应激障碍和酒精使用障碍的终身诊断，以及更多的终身抑郁发作和较高的可能性，至少有一个自杀企图。进入研究时的年龄较小与AA和PA相关。局限性：潜在的局限性包括双相情感障碍男性退伍军人患者群体之外的普遍性以及用于引出虐待史的方法。结论：与主要针对女性非退伍军人样本的研究类似，这项研究扩展了以下发现：童年虐待史可以作为双相情感障碍男性退伍军人的病程调节因素。临床医生应定期寻求有关滥用的信息，并意识到这些患者可能比没有滥用史的双相情感障碍患者更难治疗。由爱思唯尔公司出版
Background: The association between early childhood abuse and the course of illness, including psychiatric comorbidities, in adults with bipolar disorder has not been examined in a predominantly male or veteran population.Methods: As part of the VA Cooperative Study 430, "Reducing the Efficacy-Effectiveness Gap in Bipolar Disorder," 330 veterans (91% male) with bipolar I or II disorder who were enrolled in a 3-year prospective study were examined for baseline data obtained at study entry, Diagnoses were determined by the use of the SCID. A semistructured interview designed to elicit data about exposure to childhood physical, sexual, or combined abuse was conducted as part of baseline demographic and clinical information. Other reports from this data set have not addressed the issues of childhood adversity.Results: Childhood abuse was reported by 48.3% of the subjects (47.3% of men). Any abuse (AA) was reported by 48.3%; sexual abuse without physical abuse (SA) was reported by 8%, physical abuse without sexual abuse (PA) by 20.7%, and both types of abuse (combined abuse, CA) by 18.7% of the male subjects. Female veterans reported more SA (27%) and less PA (6.7%). AA subjects were more likely to have current PTSD and lifetime diagnoses of panic disorder and alcohol use disorders. CA was associated with lower SF-36 Mental scores, higher likelihood of current PTSD and lifetime diagnoses of alcohol use disorders, as well as more lifetime episodes of major depression and higher likelihood of at least one suicide attempt. Younger age at study entry was associated with AA and PA.Limitations: Potential limitations include generalizability beyond the male, veteran population of patients with bipolar disorder and the methodology used to elicit abuse histories.Conclusions: Similar to studies of predominantly female nonveteran samples, this study extends the finding that a history of childhood abuse acts as a disease course modifier in male veterans with bipolar disorder. Clinicians should routinely seek information regarding abuse and be aware that these patients may be more difficult to treat than bipolar patients who have no abuse histories. Published by Elsevier B.V.