Childhood Trauma Is Associated With Severe Clinical Characteristics of Bipolar Disorders
Abstract
Objective Beyond genetic risk variants, the pathophysiology of bipolar disorders is likely to be partly determined by environmental susceptibility factors. Our study is one of the first to investigate, in a large sample of well-characterized bipolar patients, associations between clinical presentations and childhood trauma subtypes, including neglect and abuse items. Method 587 patients with DSM-IV-defined bipolar disorder were recruited from France and Norway between 1996-2008 and 2007-2012, respectively. History of childhood trauma was obtained using the Childhood Trauma Questionnaire. Clinical variables were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders (Norwegian sample) or the Diagnostic Interview for Genetic Studies (French sample). Results Earlier age at onset of bipolar illness, suicide attempts, rapid cycling, and an increased number of depressive episodes each had significant associations (P ≤ .001) with at least 1 subtype of childhood trauma (emotional abuse, sexual abuse, and emotional neglect). Multivariate analyses investigating trauma variables together showed that both emotional and sexual abuse were independent predictors of lower age at onset (P = .002 for each) and history of suicide attempts (OR = 1.60 [95% CI, 1.07 to 2.39], P = .023; OR = 1.80 [95% CI, 1.14 to 2.86], P = .012, respectively), while sexual abuse was the strongest predictor of rapid cycling (OR = 2.04 [95% CI, 1.21 to 3.42], P = .007). Females reported overall…
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Sexual trauma may lead to more persistent mood dysregulation and heightened impulsivity, thus increasing suicide vulnerability.
“This observation builds on a smaller-scale study [67], suggesting that sexual trauma may lead to more persistent mood dysregulation and heightened impulsivity, thus increasing suicide vulnerability.”
From Association between adverse childhood experiences and suicidal behavior in affective disorders: A systematic review and meta-analysis (2025) · cites this paper as [67]
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Risk of childhood trauma exposure and severity of bipolar disorder in Colombia
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Genetic association between a ‘standing’ variant of NOD2 and bipolar disorder
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Self-citationThe association between childhood trauma and the age of onset in drug-free bipolar depression
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Self-citationThe Pervasive and Persistent Neurobiological and Clinical Aftermath of Child Abuse and Neglect
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- Authors
- Etain, B., Aas, M., Andreassen, O. A., Lorentzen, S., Dieset, I., Gard, S., Kahn, J.-P., Bellivier, F., Leboyer, M., Melle, I., & Henry, C.
- Affiliations
- Inserm (FR)
- Corresponding author
- Aas, Monica
- ORCID
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2013-10-15
- Volume
- 74
- Issue
- 10
- Pages
- 991-998
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2005920624
- Cited by
- 223
- References
- 0
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 15 · 2023: 27 · 2022: 14 · 2021: 14 · 2020: 21 · 2019: 15 · 2018: 13 · 2017: 17 · 2016: 24 · 2015: 20 · 2014: 17 · 2013: 2
- FWCI
- 14.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- 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, emotional abuse, sexual abuse, emotional neglect, age of onset, suicide attempts, rapid cycling, depressive episodes, sex differences, environmental risk factors, Childhood Trauma Questionnaire
- MeSH terms
- Adult, Bipolar Disorder, Child, Child Abuse, Female, France, Humans, Male, Middle Aged, Norway, Psychiatric Status Rating Scales, Surveys and Questionnaires, Statistics as Topic, Suicide, Attempted, Age of Onset, Diagnostic and Statistical Manual of Mental Disorders, Adult Survivors of Child Abuse
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