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Dempsey RC, Dodd AL, Gooding PA, Jones SH. The Types of Psychosocial Factors Associated with Suicidality Outcomes for People Living with Bipolar Disorder: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:525. [PMID: 38791740 PMCID: PMC11120682 DOI: 10.3390/ijerph21050525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024]
Abstract
Bipolar Disorder is associated with high rates of suicidal thoughts, behaviors, and outcomes, yet the lived experience of suicidality and Bipolar Disorder is not particularly well understood. Understanding the role of psychosocial aetiologies in suicidality outcomes for those living with Bipolar Disorder is key for developing appropriately targeted interventions focusing on factors that are amenable to change. In line with PRISMA guidance, we conducted a scoping review to identify the types of psychosocial factors studied in relation to the experience of suicidality for people living with Bipolar Disorder diagnoses. Systematic literature searches identified a sample of 166 articles from which key study data were extracted and charted. A narrative synthesis of the reviewed literature is presented ordered by the factors investigated across studies, a frequency count of the types of psychological/social aetiologies studied, and a brief overview of the key findings for each aetiology. Most of the identified literature took the form of quantitative cross-sectional studies, with only one qualitative study and 18 quantitative prospective studies. The most studied aetiologies were trauma (specifically early adverse experiences and childhood traumas) and stressful life events, impulsivity (primarily subjective self-reported trait impulsivity), social support and functioning, and personality/temperament factors. Only six studies in the final sample reported basing their research questions and/or hypotheses on an explicit theoretical model of suicide. The literature was primarily focused on using self-report measurements of key aetiologies and on factors which lead to worsened suicidality rather than focusing on potentially protective or buffering factors. Future research needs to better justify the aetiologies investigated in relation to suicidality outcomes for people living with Bipolar Disorder, including a firmer basis in theory and hypothesis testing, more prospective designs, and the use of alternative assessments of psychosocial aetiologies in addition to self-report questionnaires.
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Affiliation(s)
- Robert C. Dempsey
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Alyson L. Dodd
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Patricia A. Gooding
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Steven H. Jones
- Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
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2
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Brewerton TD, Gavidia I, Suro G, Perlman MM. Associations between major depressive and bipolar disorders and eating disorder, PTSD, and comorbid symptom severity in eating disorder patients. EUROPEAN EATING DISORDERS REVIEW 2024; 32:188-200. [PMID: 37788327 DOI: 10.1002/erv.3035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 09/05/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVE Major depressive disorder (MDD) and bipolar disorder (BD) are commonly comorbid with eating disorders (EDs). However, there is limited data about the clinical features of such patients, especially their association with traumatic histories and PTSD, which occur commonly in patients admitted to residential treatment. METHODS Adults (≥18 years, 91% female, n = 2155) admitted to residential ED treatment were evaluated upon admission for DSM-5 defined MDD and BD. Patients were divided into three groups based on an admission diagnosis of no mood disorder (NMD), MDD, and BD (types I and II) and compared on a number of demographic variables, clinical features and assessments. RESULTS Mood disorders occurred in 76.4% of participants. There were statistically significant differences across groups in most measures with the BD group showing higher rates and doses of traumatic events; higher current PTSD; higher BMIs; higher severity of ED, depression and state-trait anxiety symptoms; worse quality of life; and higher rates of substance use disorders. Similarly, the MDD group had higher rates than the NMD group on most measures. CONCLUSIONS These findings have important implications for prevention, treatment and long-term follow-up and highlight the need for early trauma-focused treatment of ED patients with comorbid mood disorders and PTSD.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Timothy D. Brewerton, MD, LLC, Mt. Pleasant, South Carolina, USA
- Monte Nido and Affiliates, Miami, Florida, USA
| | | | - Giulia Suro
- Monte Nido and Affiliates, Miami, Florida, USA
| | - Molly M Perlman
- Monte Nido and Affiliates, Miami, Florida, USA
- Department of Psychiatry and Behavioral Health, Florida International University Herbert Wertheim College of Medicine, Miami, Florida, USA
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Rowe AL, Perich T, Meade T. Bipolar disorder and cumulative trauma: A systematic review of prevalence and illness outcomes. J Clin Psychol 2024; 80:692-713. [PMID: 38277425 DOI: 10.1002/jclp.23650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/24/2023] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND The experience of cumulative trauma may be common in bipolar disorder (BD). However, it is not frequently reported as most studies focus on childhood trauma without examining differences in the amount of trauma experienced. This systematic review aimed to determine the prevalence of lifetime cumulative trauma in BD as well as explore associated illness outcomes. METHODS A systematic review was completed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Both the prevalence and outcomes of cumulative trauma in BD were assessed. Five electronic databases were searched (Embase, MEDLINE, PsycINFO, Web of Science, and PTSD Pubs) for records from January 2010 until December 2022. RESULTS A total of 20 studies, with 9304 participants were included in the narrative synthesis. At least one-third of BD participants had experienced cumulative trauma, with a prevalence range from 29% to 82%. The main outcomes associated with a history of cumulative trauma were earlier age of onset, longer episode duration, more lifetime mood episodes, greater likelihood of experiencing psychotic features, and higher likelihood of past suicide attempts. LIMITATIONS This review has been limited by the lack of studies directly assessing cumulative trauma in BD. CONCLUSIONS Cumulative trauma is prevalent in BD. Preliminary evidence indicates an association with a range of adverse outcomes, emphasizing the need for clinicians to obtain a detailed trauma history and to consider these risks in the management of the disorder. Future studies should report on the prevalence of cumulative trauma, particularly in adulthood as this area remains unexplored.
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Affiliation(s)
- Amy-Leigh Rowe
- School of Psychology, Western Sydney University, Penrith, Australia
| | - Tania Perich
- School of Psychology, Western Sydney University, Penrith, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - Tanya Meade
- School of Psychology, Western Sydney University, Penrith, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, Australia
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Gong J, Zhou L, Zhao L, Zhang S, Chen Z, Liu J. Epidemiology of Childhood Witnessing Domestic Violence and Exploration of Its Relationships With Affective Lability and Suicide Attempts in Chinese Young Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP22834-NP22863. [PMID: 35229677 DOI: 10.1177/08862605211072221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Childhood witnessing domestic violence (CWDV) exerts short- and long-term negative impacts on emotional and behavioral health. The present study investigated the epidemiological features of CWDV, and its negative impact on psychological outcomes in a sample of Chinese college students. The mediating role of emotion regulation strategies on CWDV associations with psychological outcomes and gender differences in these relationships were examined. A total of 3,126 respondents (1,034 males; 2,086 females; 6 missing data in gender) completed the study questionnaire, which included demographic characteristics, CWDV, and suicide attempt history items as well as the Emotion Regulation Questionnaire (ERQ) and Affect Lability Scale-18 (ALS-18). Overall, 43.03% of the respondents reported CWDV, including 44.87% of males and 42.09% of females. Higher frequencies of CWDV were found to be related to the following factors: unstable marital status of parents; not being an only child; being a left-behind child, family financial difficulties, consumption of alcohol in the past year, and being in relatively poor physical condition. Among males, ERQ suppression scores were significantly higher for those men who experienced "often or every day" CWDV than for men who indicated that they did not have any history of CWDV (Bonferroni-corrected p = 0.047). More frequent CWDV was associated with higher ALS-18 scores and increased risk of suicide attempts in males and females (p < 0.05), and emotion regulation (suppression) was found to mediate the association between CWDV and affective lability among males. This study revealed high rates of CWDV, and serious impacts of CWDV on mental health in male and female Chinese college students. In males, but not females, emotion regulation strategy use, use of suppression, was found to act as a mediator in the association of CWDV with affective lability. Our findings suggest that interventions for individuals with CWDV should focus on the emotional regulation, which may help them improve mental health, especially in males.
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Affiliation(s)
- Jingbo Gong
- Shanghai Changning Mental Health Center, Shanghai 200335, China
- Department of Applied Psychology, Hunan University of Chinese Medicine118393, Changsha, Hunan, China
| | - Lihua Zhou
- College of Education Science, Hengyang Normal University12573, Hengyang, Hunan, China
| | - Lishun Zhao
- Department of Applied Psychology, Hunan University of Chinese Medicine118393, Changsha, Hunan, China
| | - Shujun Zhang
- Department of Applied Psychology, Hunan University of Chinese Medicine118393, Changsha, Hunan, China
| | - Ziyi Chen
- Department of Applied Psychology, Hunan University of Chinese Medicine118393, Changsha, Hunan, China
| | - Jianbo Liu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, School of mental health, Shenzhen University504010, Shenzhen, China
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Social and environmental variables as predictors of mania: a review of longitudinal research findings. DISCOVER MENTAL HEALTH 2022; 2:7. [PMID: 35310132 PMCID: PMC8918447 DOI: 10.1007/s44192-022-00010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/07/2022] [Indexed: 10/31/2022]
Abstract
AbstractConsiderable evidence suggests that psychosocial variables can shape the course of bipolar disorder. Here, though, we focus on the more specific idea that the social environment can predict the course of mania. We systematically review evidence from longitudinal studies concerning how social support, family interactions, traumatic life events, and recent life events relate to the age of onset, the frequency of episode recurrence, and the severity of manic symptoms. Although we find some evidence that the course of mania can be worsened by social environmental factors, the links are specific. Among social variables, some studies indicate that conflict and hostility are predictive, but more general social relationship qualities have not been found to predict mania. Some research indicates that childhood trauma, and recent life events involving goal attainment or sleep disruption can predict mania. Taken together, the profile of variables involving recent exposure that are most predictive include those that are activating, reward-related, or sleep-disrupting, which fits with general psychological hypotheses of behavioral activation and sleep disruption as important for mania. We discuss gaps in the literature, and we note future directions for research, including the need for more integrative, longitudinal research on a fuller range of social and biological risk variables.
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White Matter Correlates of Early-Onset Bipolar Illness and Predictors of One-Year Recurrence of Depression in Adults with Bipolar Disorder. J Clin Med 2022; 11:jcm11123432. [PMID: 35743502 PMCID: PMC9225103 DOI: 10.3390/jcm11123432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022] Open
Abstract
Diffusion Magnetic Resonance Imaging (dMRI) studies have reported abnormalities in emotion regulation circuits in BD; however, no study has examined the contribution of previous illness on these mechanisms. Using global probabilistic tractography, we aimed to identify neural correlates of previous BD illness and the extent to which these can help predict one-year recurrence of depressive episodes. dMRI data were collected in 70 adults with early-onset BD who were clinically followed for up to 18 years and 39 healthy controls. Higher number of depressive episodes during childhood/adolescence and higher percentage of time with syndromic depression during longitudinal follow-up was associated with lower fractional anisotropy (FA) in focal regions of the forceps minor (left, F = 4.4, p = 0.003; right, F = 3.1, p = 0.021) and anterior cingulum bundle (left, F = 4.7, p = 0.002; right, F = 7.0, p < 0.001). Lower FA in these regions was also associated with higher depressive and anxiety symptoms at scan. Remarkably, those having higher FA in the right cluster of the forceps minor (AOR = 0.43, p = 0.017) and in a cluster of the posterior cingulum bundle (right, AOR = 0.50, p = 0.032) were protected against the recurrence of depressive episodes. Previous depressive symptomatology may cause neurodegenerative effects in the forceps minor that are associated with worsening of BD symptomatology in subsequent years. Abnormalities in the posterior cingulum may also play a role.
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Lippard ETC, Nemeroff CB. Going beyond risk factor: Childhood maltreatment and associated modifiable targets to improve life-long outcomes in mood disorders. Pharmacol Biochem Behav 2022; 215:173361. [PMID: 35219755 DOI: 10.1016/j.pbb.2022.173361] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 02/17/2022] [Accepted: 02/20/2022] [Indexed: 01/26/2023]
Abstract
Childhood maltreatment increases risk for mood disorders and is associated with earlier onset-and more pernicious disease course following onset-of mood disorders. While the majority of studies to date have been cross-sectional, longitudinal studies are emerging and support the devastating role(s) childhood maltreatment has on development of, and illness course in, mood disorders. This manuscript extends prior reviews to emphasize more recent work, highlighting longitudinal data, and discusses treatment studies that provide clues to mechanisms that mediate disease risk, course, relapse, and treatment response. Evidence suggesting systemic inflammation, alterations in hypothalamic-pituitary-adrenal (HPA) axis function and corticotropin-releasing factor (CRF) neural systems, genetic and other familial factors as mechanisms that mediate risk and onset of, and illness course in, mood disorders following childhood maltreatment is discussed. Risky behaviors following maltreatment, e.g., substance use and unhealthy lifestyles, may further exacerbate alterations in the HPA axis, CRF neural systems, and systematic inflammation to contribute to a more pernicious disease course. More research on sex differences and the impact of maltreatment in vulnerable populations is needed. Future research needs to be aimed at leveraging knowledge on modifiable targets, going beyond childhood maltreatment as a risk factor, to inform prevention and treatment strategies and foster trauma-informed care.
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Affiliation(s)
- Elizabeth T C Lippard
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA; Institute of Early Life Adversity Research, Dell Medical School, University of Texas, Austin, TX, USA; Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA; Department of Psychology, University of Texas, Austin, TX, USA; Mulva Clinic for Neuroscience, Dell Medical School, University of Texas, Austin, TX, USA.
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas, Austin, TX, USA; Institute of Early Life Adversity Research, Dell Medical School, University of Texas, Austin, TX, USA; Waggoner Center for Alcohol and Addiction Research, University of Texas, Austin, TX, USA; Mulva Clinic for Neuroscience, Dell Medical School, University of Texas, Austin, TX, USA
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8
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Andreu-Pascual M, Merranko J, Gill MK, Levenson JC, Hafeman D, Hower H, Yen S, Strober M, Goldstein BI, Diler R, Ryan ND, Weinstock LM, Keller MB, Axelson D, Birmaher B, Goldstein TR. Risk factors preceding new onset abuse among youth with bipolar disorder: A longitudinal prospective analysis. J Affect Disord 2022; 300:296-304. [PMID: 34990625 PMCID: PMC10601969 DOI: 10.1016/j.jad.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/01/2021] [Accepted: 01/01/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Childhood abuse negatively impacts the course of Bipolar Disorder (BD). Yet, no study has examined risk factors associated with prospectively evaluated physical/sexual abuse, specifically, those preceding first abuse among BD youth. We investigate past/intake/follow-up factors preceding first physical/sexual abuse among BD youth. METHODS Childhood-onset BD participants (n = 279 youth, mean age at intake = 12, mean length of follow-up = 12 years) enrolled in the Course and Outcome of Bipolar Youth (COBY) study. Demographic, clinical and family history variables were assessed every 7 months on average using Longitudinal Interval Follow-up Evaluation and Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). Abuse was evaluated at intake using the K-SADS-PL, over follow-up with a Traumatic Events Screen. Family psychopathology was assessed using Family History Screen/Structured Clinical Interview for Diagnostic Statistical Manual-IV. RESULTS Fifteen-percent of youth reported new-onset abuse during follow-up (62% physical, 26% sexual; 12% both). Intake predictors included more severe depressive symptoms (HR = 1.29), low socioeconomic-status (SES) in families with substance abuse (HR = 0.84) (physical abuse), and female sex (HR = 2.41) (sexual abuse). Follow-up predictors preceding physical abuse included: older age (HR = 1.42), disruptive disorders (HR = 1.39), and the interaction between low SES and family substance abuse (HR = 0.86). For sexual abuse, female sex (HR = 4.33) and a non-biologically related father presence in the household (HR = 2.76). Good relationships with friends (prospectively evaluated) protected against physical/sexual abuse (HR = 0.72/0.70, respectively). LIMITATIONS Prospective data was gathered longitudinally but assessed retrospectively at every follow-up; perpetrator information and abuse severity were not available. CONCLUSIONS Identifying factors temporally preceding new onset physical/sexual abuse may hold promise for identifying high-risk youth with BD.
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Affiliation(s)
- Maria Andreu-Pascual
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA; Child and Adolescent Psychiatry and Psychology Department. Hospital Sant Joan de Déu Barcelona, Spain. Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Spain.
| | - John Merranko
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Jessica C Levenson
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Danella Hafeman
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Heather Hower
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA; Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, Providence, RI 02903, USA; Department of Psychiatry, School of Medicine, University of California at San Diego, 4510 Executive Drive, Suite 315, San Diego, CA 92121, USA
| | - Shirley Yen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA; Massachusetts Mental Health Center and the Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA 02115, USA
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, 760 Westwood Plaza, Mail Code 175919, Los Angeles, CA 90095, USA
| | - Benjamin I Goldstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, 2075 Bayview Ave., FG-53, Toronto, ON M4N-3M5, Canada
| | - Rasim Diler
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Neal D Ryan
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Lauren M Weinstock
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA; Butler Hospital, 700 Butler Drive, Providence, RI 02906, USA
| | - Martin B Keller
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, USA; Butler Hospital, 700 Butler Drive, Providence, RI 02906, USA
| | - David Axelson
- Department of Psychiatry, Nationwide Children's Hospital and The Ohio State College of Medicine, 1670 Upham Dr., Columbus, OH 43210, USA
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
| | - Tina R Goldstein
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA 15213, USA
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Wrobel A, Russell SE, Dean OM, Cotton S, Berk M, Turner A. Influence of childhood trauma on the treatment outcomes of pharmacological and/or psychological interventions for adolescents and adults with bipolar disorder: protocol for a systematic review and meta-analysis. BMJ Open 2021; 11:e044569. [PMID: 33926981 PMCID: PMC8094386 DOI: 10.1136/bmjopen-2020-044569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/14/2020] [Accepted: 03/23/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Despite available pharmacological and psychological treatments, remission rates for bipolar disorder remain relatively low. Current research implicates the experience of childhood trauma as a potential moderator of poor treatment outcomes among individuals with bipolar disorder. To date, the evidence reporting the influence of childhood trauma on the treatment outcomes of pharmacological and/or psychological interventions for adolescents and adults with bipolar disorder has not been systematically reviewed. METHOD AND ANALYSIS MEDLINE Complete, Embase, PsycINFO and the Cochrane Central Register of Controlled Trials will be searched to identify randomised and nonrandomised studies of pharmacological and/or psychological interventions for bipolar disorder, which also assessed childhood trauma. To be eligible for inclusion, studies must have been conducted with adolescents or adults (≥10 years). Data will be screened and extracted by two independent reviewers. The methodological quality of the included studies will be assessed with the Cochrane Collaboration's Risk of Bias tool and the Newcastle-Ottawa Scale. If deemed viable, a meta-analysis will be conducted using a random effects model. Heterogeneity of evidence will be estimated with the I² statistics. ETHICS AND DISSEMINATION This systematic review will use only previously published data. Therefore, ethical approval is not required. The results will be written in concordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, published in peer-reviewed journals and presented at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42020201891.
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Affiliation(s)
- Anna Wrobel
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - Samantha E Russell
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Olivia M Dean
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sue Cotton
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael Berk
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
- Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Alyna Turner
- IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
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Cirone C, Secci I, Favole I, Ricci F, Amianto F, Davico C, Vitiello B. What Do We Know about the Long-Term Course of Early Onset Bipolar Disorder? A Review of the Current Evidence. Brain Sci 2021; 11:brainsci11030341. [PMID: 33800274 PMCID: PMC8001096 DOI: 10.3390/brainsci11030341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 11/29/2022] Open
Abstract
Aim: Early onset of psychopathology is often an index of a more severe clinical course and worse prognosis. This review examined the course of bipolar disorder (BD) with onset in childhood and adolescence, with a focus on persistence of symptoms, severity of illness, comorbidity, and functional impairment. Methods: The databases of PubMed, Embase, and PsycInfo were systematically searched for publications since 1990 reporting on long-term (12 months or longer) assessments of patients with early onset BD. Results: Forty-two relevant publications were identified, which reported on data derived from 15 different patient cohorts, including 7 prospective research psychopathology studies, 4 medical record reviews, 2 follow-ups of clinical trial samples, 1 managed care database, and 1 nationwide registry, for a total of 10,187 patients. The length of follow-ups ranged from 1.0 to 15 years. Diagnostic stability of BD ranged from 73% to 100% over ten years. Recovery rate from an index episode was 81.5–100% and recurrence rate was 35–67%. Suicide attempt cumulative prevalence in five years was 18–20%. Earlier age at the first episode predicted a more severe clinical course. Conclusions: Early onset BD persists over time through adolescence, with homotypic diagnostic continuity over the years, but heterogeneity in the severity of the clinical course. Whether early identification and treatment improves distal prognosis remains to be further investigated.
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Affiliation(s)
- Carlotta Cirone
- Child and Adolescent Neuropsychiatry—Department of Public Health and Pediatric Sciences, Universita’ degli Studi di Torino, 10126 Turin, Italy; (C.C.); (I.S.); (I.F.); (F.R.); (B.V.)
| | - Ilaria Secci
- Child and Adolescent Neuropsychiatry—Department of Public Health and Pediatric Sciences, Universita’ degli Studi di Torino, 10126 Turin, Italy; (C.C.); (I.S.); (I.F.); (F.R.); (B.V.)
| | - Irene Favole
- Child and Adolescent Neuropsychiatry—Department of Public Health and Pediatric Sciences, Universita’ degli Studi di Torino, 10126 Turin, Italy; (C.C.); (I.S.); (I.F.); (F.R.); (B.V.)
| | - Federica Ricci
- Child and Adolescent Neuropsychiatry—Department of Public Health and Pediatric Sciences, Universita’ degli Studi di Torino, 10126 Turin, Italy; (C.C.); (I.S.); (I.F.); (F.R.); (B.V.)
| | - Federico Amianto
- Child and Adolescent Neuropsychiatry—Department of Neurosciences, Universita’ degli Studi di Torino, 10126 Turin, Italy;
| | - Chiara Davico
- Child and Adolescent Neuropsychiatry—Department of Public Health and Pediatric Sciences, Universita’ degli Studi di Torino, 10126 Turin, Italy; (C.C.); (I.S.); (I.F.); (F.R.); (B.V.)
- Correspondence:
| | - Benedetto Vitiello
- Child and Adolescent Neuropsychiatry—Department of Public Health and Pediatric Sciences, Universita’ degli Studi di Torino, 10126 Turin, Italy; (C.C.); (I.S.); (I.F.); (F.R.); (B.V.)
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Vaughn-Coaxum RA, Merranko J, Birmaher B, Dickstein DP, Hafeman D, Levenson JC, Liao F, Gill MK, Hower H, Goldstein BI, Strober M, Ryan ND, Diler R, Keller MB, Yen S, Weinstock L, Axelson D, Goldstein TR. Longitudinal course of depressive symptom severity among youths with bipolar disorders: Moderating influences of sustained attention and history of child maltreatment. J Affect Disord 2021; 282:261-271. [PMID: 33418377 PMCID: PMC8073228 DOI: 10.1016/j.jad.2020.12.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 12/10/2020] [Accepted: 12/21/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pediatric bipolar disorders are often characterized by disruptions in cognitive functioning, and exposure to child maltreatment (e.g., physical and sexual abuse) is associated with a significantly poorer course of illness. Although clinical and developmental research has shown maltreatment to be robustly associated with poorer cognitive functioning, it is unclear whether maltreatment and cognitive function jointly influence the clinical course of bipolar symptoms. METHODS This secondary analysis examined moderating effects of lifetime childhood physical and sexual abuse, and cognitive disruptions (sustained attention, affective information processing), on longitudinal ratings of depression symptom severity in youths from the Course and Outcome of Bipolar Youth (COBY) study, examined from intake (M = 12.24 years) through age 22 (N = 198; 43.9% female; Mean age of bipolar onset = 8.85 years). RESULTS A significant moderating effect was detected for sustained attention and maltreatment history. In the context of lower sustained attention, maltreatment exposure was associated with higher depression symptom severity during childhood, but not late adolescence. There was no association between maltreatment and symptom severity in the context of higher sustained attention, and no association between attention and depression symptom severity for non-maltreated youths. LIMITATIONS Depression symptom ratings at each assessment were subject to retrospective recall bias despite the longitudinal design. Cognitive assessments were administered at different ages across youths. CONCLUSIONS Depressive symptoms in pediatric bipolar may be jointly moderated by impairments in attention and exposure to maltreatment. Assessment of these risks, particularly in childhood, may be beneficial for considering risk of recurrence or chronicity of depressive symptoms.
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Affiliation(s)
| | | | | | - Daniel P. Dickstein
- McLean Hospital, Harvard Medical School,Brown University, Warren Alpert Medical School
| | | | | | - Fangzi Liao
- University of Pittsburgh, School of Medicine
| | | | - Heather Hower
- Brown University, Warren Alpert Medical School,University of California at San Diego, School of Medicine
| | | | - Michael Strober
- University of California at Los Angeles, David Geffen School of Medicine
| | | | - Rasim Diler
- University of Pittsburgh, School of Medicine
| | | | - Shirley Yen
- Brown University, Warren Alpert Medical School,Harvard Medical School, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center
| | | | - David Axelson
- Ohio State University, Nationwide Children’s Hospital
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12
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Quidé Y, Tozzi L, Corcoran M, Cannon DM, Dauvermann MR. The Impact of Childhood Trauma on Developing Bipolar Disorder: Current Understanding and Ensuring Continued Progress. Neuropsychiatr Dis Treat 2020; 16:3095-3115. [PMID: 33364762 PMCID: PMC7751794 DOI: 10.2147/ndt.s285540] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/18/2020] [Indexed: 12/12/2022] Open
Abstract
Childhood trauma (CT) has been repeatedly linked to earlier onset and greater severity of bipolar disorder (BD) in adulthood. However, such knowledge is mostly based on retrospective and cross-sectional studies in adults with BD. The first objective of this selective review is to characterize the short-term effects of CT in the development of BD by focusing on studies in young people. The second objective is to describe the longer-term consequences of CT by considering studies with adult participants. This review first outlines the most prominent hypotheses linking CT exposure and the onset of BD. Then, it summarizes the psychological and biological risk factors implicated in the development of BD, followed by a discussion of original studies that investigated the role of CT in young people with early-onset BD, youths at increased risk of developing BD, or young people with BD with a focus on subclinical and clinical outcome measures. The review considers additional biological and psychological factors associated with a negative impact of CT on the long-term course of BD in later adulthood. Finally, we discuss how the integration of information of CT can improve ongoing early identification of BD and mitigate severe clinical expression in later adulthood.
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Affiliation(s)
- Yann Quidé
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Leonardo Tozzi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Mark Corcoran
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Dara M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Maria R Dauvermann
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
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Can Physical and/or Sexual Abuse Play a Role in the Female Choice of a Partner? A Cross-Sectional, Correlational Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186902. [PMID: 32967290 PMCID: PMC7558269 DOI: 10.3390/ijerph17186902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 02/08/2023]
Abstract
The present study aims to evaluate the relationship in women between a history of physical/sexual abuse and the preferences regarding the choice of a partner for a short/long-term relationship in terms of male facial dimorphism, and to assess their sexual functioning. We enrolled 48 abused women and 60 non-abused women. Facial preferences were evaluated with the Morphing test. Sexual functioning was measured with the Female Sexual Function Index (FSFI). Regarding the choice for a short-term partner, abused and non-abused women did not show any differences, and both groups chose a less masculine male face. On the other hand, regarding the choice for a long-term partner, abused women showed a preference for an average male face, whilst non-abused women preferred a less masculine face. The sexual functioning of abused women was found significantly dysfunctional in all domains of the FSFI. These data, generated from a small but highly selected cohort, demonstrated that physical/sexual abuse may be associated with a more rational and conscious choice of a male partner for a long-term relationship, but not with an instinctive one, as the choice of an occasional partner. In addition, the sexual functioning of abused women appears to be compromised by the traumatic experience.
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