Abstract
Background: There is growing awareness of the association between physical and sexual
abuse and subsequent development of psychopathology, but little is known, however,
about their relationship to the longitudinal course of bipolar disorder.
Methods: We evaluated 631 outpatients with bipolar I or II disorder for general demographics,
a history of physical or sexual abuse as a child or adolescent, course of illness
variables, and prior suicide attempts, as well as SCID-derived Axis I and patient
endorsed Axis II comorbidity.
Results: Those who endorsed a history of child or adolescent physical or sexual abuse,
compared with those who did not, had a history of an earlier onset of bipolar illness,
an increased number of Axis I, II, and III comorbid disorders, including drug and
alcohol abuse, faster cycling frequencies, a higher rate of suicide attempts, and
more psychosocial stressors occurring before the first and most recent affective episode.
The retrospectively reported associations of early abuse with a more severe course
of illness were validated prospectively.
Conclusions: Greater appreciation of the association of early traumatic experiences
and an adverse course of bipolar illness should lead to preventive and early intervention
approaches that may lessen the associated risk of a poor outcome.
Keywords
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Article info
Publication history
Accepted:
June 14,
2001
Received in revised form:
May 31,
2001
Received:
February 20,
2001
Identification
Copyright
© 2002 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
