Childhood trauma in bipolar disorder
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Objective: There has been little investigation of early trauma in bipolar disorder despite evidence that stress impacts on the course of this illness. We aimed to compare the rates of childhood trauma in adults with bipolar disorder to a healthy control group, and to investigate the impact of childhood trauma on the clinical course of bipolar disorder. Methods: Retrospective assessment of childhood trauma was conducted using the Childhood Trauma Questionnaire (CTQ) in 60 outpatients with bipolar disorder being treated for a depressive episode and 55 control participants across two centres in north-east England and New Zealand. Results: Significantly higher rates of childhood trauma were observed in patients with bipolar I and bipolar II disorder compared to controls. Logistic regression, controlling for age and sex, identified emotional neglect to be the only significant CTQ subscale associated with a diagnosis of bipolar disorder. Childhood history of sexual abuse was not a significant predictor. Associations with clinical severity or course were less clear. Conclusions: Childhood emotional neglect appears to be significantly associated with bipolar disorder. Limitations include the relatively small sample size, which potentially increases the risk of type II errors. Replication of this study is required, with further investigation into the neurobiological consequences of childhood trauma, particularly emotional neglect.
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Several smaller-scale cross-sectional and longitudinal studies suggest that ACEs could exacerbate clinical characteristics, increase relapse rates, and heighten the risk of suicidality in both major depressive disorder and bipolar disorder.
“Several smaller-scale cross-sectional and longitudinal studies suggest that ACEs could exacerbate clinical characteristics, increase relapse rates, and heighten the risk of suicidality in both major depressive disorder and bipolar disorder [17, 18].”
From Association between adverse childhood experiences and suicidal behavior in affective disorders: A systematic review and meta-analysis (2025) · cites this paper as [18]
The Introduction links childhood abuse in bipolar disorder to an adverse illness course, more depressive episodes, greater mania severity, and suicidal ideation; the Discussion also reports an association with prior suicide attempts. It describes childhood trauma as an indicator of poor prognosis in major depressive disorder, but does not substantiate the full set of claimed outcomes—including increased relapse rates and suicidality—for both disorders. No page numbers are available in our copy. (LLM, conf=0.85)
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Self-citation
- Authors
- Watson, S., Gallagher, P., Dougall, D., Porter, R., Moncrieff, J., Ferrier, I. N., & Young, A. H.
- Affiliations
- Newcastle University (GB)
- University College London (GB)
- University of Otago (NZ)
- King's College London (GB)
- Corresponding author
- Watson, Stuart
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2013-12-16
- Volume
- 48
- Issue
- 6
- Pages
- 564-570
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- PMC
- PMC4539529
- OpenAlex
- W2153448968
- Cited by
- 122
- References
- 48
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 7 · 2023: 10 · 2022: 15 · 2021: 11 · 2020: 9 · 2019: 13 · 2018: 9 · 2017: 12 · 2016: 13 · 2015: 8 · 2014: 5
- FWCI
- 6.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Australian & New Zealand Journal of Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity) (cc-by)
- Funders
- National Institute for Health and Care Research (NF-SI-0510-10065)
- Medical Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- childhood trauma, bipolar disorder, bipolar I disorder, bipolar II disorder, emotional neglect, child sexual abuse, Childhood Trauma Questionnaire, clinical course, depressive episodes
- MeSH terms
- Bipolar Disorder, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Case-Control Studies, Adult Survivors of Child Abuse
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