Childhood trauma and treatment outcomes during mood-stabilising treatment with lithium or quetiapine among outpatients with bipolar disorder.
Childhood trauma and treatment outcomes during mood-stabilising treatment with lithium or quetiapine among outpatients with bipolar disorder.
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DOI：
10.1111/acps.13420
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发表时间：
2022-06
影响因子：
6.7
通讯作者：
Nierenberg, Andrew A.
中科院分区：
文献类型：
--
作者：
Wrobel, Anna L.;Koehler-Forsberg, Ole;Sylvia, Louisa G.;Russell, Samantha E.;Dean, Olivia M.;Cotton, Sue M.;Thase, Michael;Calabrese, Joseph R.;Deckersbach, Thilo;Tohen, Mauricio;Bowden, Charles L.;McInnis, Melvin G.;Kocsis, James H.;Friedman, Edward S.;Ketter, Terence A.;Shelton, Richard C.;Ostacher, Michael J.;Iosifescu, Dan, V;Berk, Michael;Turner, Alyna;Nierenberg, Andrew A.
童年创伤影响情绪障碍的进程。研究人员现在认为童年创伤是治疗情绪障碍的一个影响因素。然而，童年创伤在双相情感障碍治疗中的作用仍然没有得到充分研究。通过临床医生评估，在双相情感障碍（双相选择）比较有效性的临床和健康结局倡议研究中，在随机接受锂或奎替利治疗的参与者中评估了儿童创伤对治疗结局的影响。使用混合效应线性回归模型分析症状严重程度（使用双相症状量表和双相情感障碍临床总体印象量表评估）和功能损害（使用纵向间隔随访评价-功能损害范围工具评估）的改善率。52.7%的样本（N = 476）报告了任何童年创伤史。尽管有任何儿童创伤史的参与者在大多数研究访视时表现出更严重的症状和功能障碍，但有和没有任何儿童创伤史的参与者在24周的治疗中表现出症状严重程度和功能障碍的改善率相似。这是第一项在随机试验的背景下探索锂或奎替利治疗期间儿童创伤与治疗结果之间关系的研究。在双相选择中，儿童期创伤史并不抑制症状严重程度或功能障碍的改善。然而，这些研究结果需要在不同的环境中推广。
Childhood trauma affects the course of mood disorders. Researchers are now considering childhood trauma as an influential factor in the treatment of mood disorders. However, the role of childhood trauma in the treatment of bipolar disorder remains understudied. The effect of childhood trauma on treatment outcomes was evaluated among participants randomised to treatment with lithium or quetiapine in the Clinical and Health Outcomes Initiatives in Comparative Effectiveness for Bipolar Disorder (Bipolar CHOICE) study by clinician assessment. Mixed effects linear regression models were used to analyse rates of improvement in symptom severity (assessed with the Bipolar Inventory of Symptoms Scale and the Clinical Global Impression Scale for Bipolar Disorder) and functional impairment (assessed with the Longitudinal Interval Follow‐up Evaluation‐Range of Impaired Functioning Tool). A history of any childhood trauma was reported by 52.7% of the sample (N = 476). Although participants with a history of any childhood trauma presented with greater symptom severity and functional impairment at most study visits, participants with and without a history of any childhood trauma showed similar rates of improvement in symptom severity and functional impairment over the 24 weeks of treatment. This is the first study to explore the association between childhood trauma and treatment outcomes during treatment with lithium or quetiapine in the context of a randomised trial. In Bipolar CHOICE, a history of childhood trauma did not inhibit improvement in symptom severity or functional impairment. Nevertheless, these findings need replication across different settings.
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