Delfina Janiri1, Gabriele Sani1, Emanuela Danese2, Alessio Simonetti1, Elisa Ambrosi2, Gloria Angeletti1, Denise Erbuto3, Carlo Caltagirone4, Paolo Girardi1, Gianfranco Spalletta5. 1. IRCCS Santa Lucia Foundation, Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, Rome, Italy; NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant׳Andrea Hospital, Rome, Italy; Centro Lucio Bini, Rome, Italy. 2. IRCCS Santa Lucia Foundation, Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, Rome, Italy; NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant׳Andrea Hospital, Rome, Italy. 3. NESMOS Department (Neurosciences, Mental Health, and Sensory Organs), Sapienza University of Rome, School of Medicine and Psychology, Sant׳Andrea Hospital, Rome, Italy. 4. IRCCS Santa Lucia Foundation, Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, Rome, Italy; Department of Medicine of Systems, Tor Vergata University of Rome, Italy. 5. IRCCS Santa Lucia Foundation, Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, Rome, Italy. Electronic address: g.spalletta@hsantalucia.it.
Abstract
BACKGROUND: Childhood trauma is an important environmental stressor associated with bipolar disorders (BD). It is still not clear if it is differently distributed between BD I and BD II. Therefore, the aim of this research was to investigate the distribution patterns of childhood trauma in BD I and BD II. In this perspective, we also studied the relationship between childhood trauma and suicidality. METHODS: We assessed 104 outpatients diagnosed with BD I (n=58) or BD II (n=46) according to DSM-IV-TR criteria and 103 healthy controls (HC) matched for age, sex and education level. History of childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ). RESULTS: All patients with BD had had more severe traumatic childhood experiences than HC. Both BD I and BD II patients differed significantly from HC for trauma summary score and emotional abuse. BD I patients differed significantly from HC for sexual abuse, and BD II differed from HC for emotional neglect. BD I and BD II did not significantly differ for any type of trauma. Suicide attempts were linked to both emotional and sexual abuse in BD I and only to emotional abuse in BD II. Emotional abuse was an independent predictor of lifetime suicide attempts in BD patients. LIMITATIONS: The reliability of the retrospective assessment of childhood trauma experiences with the CTQ during adulthood may be influenced by uncontrolled recall bias. CONCLUSIONS: The assessment of childhood trauma, which has great clinical importance because of its strong link with suicidality, can unveil slight differences between BD subtypes and HC.
BACKGROUND: Childhood trauma is an important environmental stressor associated with bipolar disorders (BD). It is still not clear if it is differently distributed between BD I and BD II. Therefore, the aim of this research was to investigate the distribution patterns of childhood trauma in BD I and BD II. In this perspective, we also studied the relationship between childhood trauma and suicidality. METHODS: We assessed 104 outpatients diagnosed with BD I (n=58) or BD II (n=46) according to DSM-IV-TR criteria and 103 healthy controls (HC) matched for age, sex and education level. History of childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ). RESULTS: All patients with BD had had more severe traumatic childhood experiences than HC. Both BD I and BD II patients differed significantly from HC for trauma summary score and emotional abuse. BD I patients differed significantly from HC for sexual abuse, and BD II differed from HC for emotional neglect. BD I and BD II did not significantly differ for any type of trauma. Suicide attempts were linked to both emotional and sexual abuse in BD I and only to emotional abuse in BD II. Emotional abuse was an independent predictor of lifetime suicide attempts in BD patients. LIMITATIONS: The reliability of the retrospective assessment of childhood trauma experiences with the CTQ during adulthood may be influenced by uncontrolled recall bias. CONCLUSIONS: The assessment of childhood trauma, which has great clinical importance because of its strong link with suicidality, can unveil slight differences between BD subtypes and HC.
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