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Childhood Trauma in Bipolar Disorders

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Childhood Trauma in Mental Disorders

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Abstract

Among environmental stressors, childhood trauma has emerged as one of the most important factors associated with bipolar disorders (BD). It is particularly relevant in the genesis and the progression of the illness, and it has been linked to specific psychopathological dimensions and cognitive profiles of patients. Early adverse events can also influence neural mechanisms underlying psychiatric disorders, and recent studies have been directed towards developing biologically informed constructs of childhood trauma in BD.

This chapter aimed at providing an exhaustive review of the current evidence on childhood trauma in BD, in order to better characterize the specific subgroup of patients that present early adverse events in addition to BD diagnosis. In this perspective, we specifically investigated the relationship between BD and different subtypes of childhood trauma and clinical, psychopathological and neurobiological implications of this relationship.

Findings suggested that among the different subtypes of childhood trauma, emotional abuse is the most important in BD. Accordingly, childhood trauma in patients with BD is associated with emotional dysregulation and alterations in the brain circuits related to emotion processing, such as the limbic structures. Our review confirmed the relevant effect of childhood trauma on the clinical course of BD. Specifically, the most consistent finding is the association with early onset of the disease and increased suicidal risk. The challenge for the next years will be to personalize the interventions in the subgroup of patients with BD which report childhood trauma.

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References

  1. Kraepelin E. Manic depressive insanity and paranoia. Edinburgh: E. and S. Livingstone; 1921.

    Book  Google Scholar 

  2. Lex C, Bäzner E, Meyer TD. Does stress play a significant role in bipolar disorder? A meta-analysis. J Affect Disord. 2017;208(October 2016):298–308. https://doi.org/10.1016/j.jad.2016.08.057.

    Article  PubMed  Google Scholar 

  3. M’bailara K, Demotes-Mainard J, Swendsen J, Mathieu F, Leboyer M, Henry C. Emotional hyper-reactivity in normothymic bipolar patients. Bipolar Disord. 2009;11(1):63–9.

    Article  Google Scholar 

  4. Palmier-Claus JE, Berry K, Bucci S, Mansell W, Varese F. Relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis. Br J Psychiatry. 2016;209:454–9. http://bjp.rcpsych.org/cgi/doi/10.1192/bjp.bp.115.179655

  5. Daruy-Filho L, Brietzke E, Lafer B. Grassi-Oliveira R. Childhood maltreatment and clinical outcomes of bipolar disorder. Acta Psychiatr Scand. 2011;124:427–34. http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.2011.01756.x/full

  6. Aas M, Henry C, Bellivier F, Lajnef M, Gard S, Kahn JP, et al. Affective lability mediates the association between childhood trauma and suicide attempts, mixed episodes and co-morbid anxiety disorders in bipolar disorders. Psychol Med. 2017;47(5):902–12.

    Article  CAS  Google Scholar 

  7. Bücker J, Kozicky J, Torres IJ, Kauer-Sant’Anna M, Silveira LE, Bond DJ, et al. The impact of childhood trauma on cognitive functioning in patients recently recovered from a first manic episode: data from the systematic treatment optimization program for early mania (STOP-EM). J Affect Disord. 2013;148(2–3):424–30.

    Article  Google Scholar 

  8. Janiri D, Sani G, Rossi P De, Piras F, Iorio M, Banaj N, et al. Amygdala and hippocampus volumes are differently affected by childhood trauma in patients with bipolar disorders and healthy controls. Bipolar Disord. 2017;19:353–62.

    Google Scholar 

  9. Souza-Queiroz J, Boisgontier J, Etain B, Poupon C, Duclap D, D’Albis MA, et al. Childhood trauma and the limbic network: a multimodal MRI study in patients with bipolar disorder and controls. J Affect Disord. 2016;200:159–64.

    Article  Google Scholar 

  10. Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, et al. Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry. 1994;151(8):1132–6. https://doi.org/10.1176/ajp.151.8.1132.

    Article  CAS  PubMed  Google Scholar 

  11. Garno JL, Goldberg JF, Ramirez PM, Ritzler BA. Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry. 2005;186:121–5. http://bjp.rcpsych.org/content/186/2/121.short

  12. Janiri D, Sani G, Danese E, Simonetti A, Ambrosi E, Angeletti G, Erbuto D, Caltagirone C, Girardi P, Spalletta G. Childhood traumatic experiences of patients with bipolar disorder type I and type II. J Affect Disord. 2015;175:92–7.

    Google Scholar 

  13. Aas M, Henry C, Andreassen OA, Bellivier F, Melle I, Etain B. The role of childhood trauma in bipolar disorders. Int J Bipolar Disord. 2016;4(1):2. http://www.journalbipolardisorders.com/content/4/1/2

  14. Leverich GS, McElroy SL, Suppes T, Keck PE, Denicoff KD, Nolen WA, et al. Early physical and sexual abuse associated with an adverse course of bipolar illness. Biol Psychiatry. 2002;51:288–97.

    Article  Google Scholar 

  15. Post RM, Altshuler LL, Kupka R, Mcelroy SL, Frye MA, Rowe M, et al. Verbal abuse, like physical and sexual abuse, in childhood is associated with an earlier onset and more difficult course of bipolar disorder. Bipolar Disord. 2015;17(3):323–30.

    Article  Google Scholar 

  16. Li X, Bin LJT, Zhu XZ, Zhang L, Tang YL, Wang CY. Childhood trauma associates with clinical features of bipolar disorder in a sample of Chinese patients. J Affect Disord. 2014;168:58–63.

    Article  Google Scholar 

  17. Etain B, Aas M, Andreassen OA, Lorentzen S, Dieset I, Gard S, et al. Childhood trauma is associated with severe clinical characteristics of bipolar disorders. J Clin Psychiatry. 2013;74:991–8. http://www.ncbi.nlm.nih.gov/pubmed/24229750

    Article  Google Scholar 

  18. Dienes KA, Hammen C, Henry RM, Cohen AN, Daley SE. The stress sensitization hypothesis: understanding the course of bipolar disorder. J Affect Disord. 2006;95(1–3):43–9.

    Article  Google Scholar 

  19. Koukopoulos A, Sani G, Koukopoulos AE, Minnai GP, Girardi P, Pani L, et al. Duration and stability of the rapid-cycling course: a long-term personal follow-up of 109 patients. J Affect Disord. 2003;73:75–85.

    Article  CAS  Google Scholar 

  20. Janssen I, Krabbendam L, Bak M, Hanssen M, Vollebergh W, De Graaf R, et al. Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatr Scand. 2004;109:38–45.

    Article  CAS  Google Scholar 

  21. Romero S, Birmaher B, Axelson D, Goldstein T, Goldstein BI, Gill MK, et al. Prevalence and correlates of physical and sexual abuse in children and adolescents with bipolar disorder. J Affect Disord. 2009;112:144–50.

    Article  Google Scholar 

  22. Bebbington P, Jonas S, Kuipers E, King M, Cooper C, Brugha T, et al. Childhood sexual abuse and psychosis: data from a cross-sectional national psychiatric survey in England. Br J Psychiatry. 2011;199(1):29–37. http://www.ncbi.nlm.nih.gov/pubmed/21508437

    Article  Google Scholar 

  23. Upthegrove R, Chard C, Jones L, Gordon-Smith K, Forty L, Jones I, et al. Adverse childhood events and psychosis in bipolar affective disorder. Br J Psychiatry. 2015;206(3):191–7.

    Article  Google Scholar 

  24. Goldstein BI, Strober MA, Birmaher B, Axelson DA, Esposito-Smythers C, Goldstein TR, et al. Substance use disorders among adolescents with bipolar spectrum disorders. Bipolar Disord. 2008;10(4):469–78.

    Article  Google Scholar 

  25. Brown GR, McBride L, Bauer MS, Williford WO, Cooperative-Studies-Program. Impact of childhood abuse on the course of bipolar disorder: a replication study in U.S. veterans. J Affect Disord. 2005;89:57–67.

    Article  Google Scholar 

  26. Aas M, Etain B, Bellivier F, Henry C, Lagerberg T, Ringen A, et al. Additive effects of childhood abuse and cannabis abuse on clinical expressions of bipolar disorders. Psychol Med. 2014;44(8):1653–62.

    Article  CAS  Google Scholar 

  27. Janiri D, De Rossi P, Kotzalidis GD, Girardi P, Koukopoulos AE, Reginaldi D, et al. Psychopathological characteristics and adverse childhood events are differentially associated with suicidal ideation and suicidal acts in mood disorders. Eur Psychiatry. 2018;53:31–6. http://linkinghub.elsevier.com/retrieve/pii/S0924933818301044

    Article  Google Scholar 

  28. Aas M, Aminoff SR, Vik Lagerberg T, Etain B, Agartz I, Andreassen OA, et al. Affective lability in patients with bipolar disorders is associated with high levels of childhood trauma. Psychiatry Res. 2014;218(1–2):252–5. http://www.ncbi.nlm.nih.gov/pubmed/24803185

    Article  Google Scholar 

  29. Neacsiu AD, Fang CM, Rodriguez M, Rosenthal MZ. Suicidal behavior and problems with emotion regulation. Suicide and life-threatening behavior. 2017;

    Google Scholar 

  30. Janet P. L’Amnésie et la dissociation des souvenirs par l’émotion. J Psycologie. 1904;1:417–53.

    Google Scholar 

  31. American Psychiatric Association. DSM 5. Am J Psychiatr. 2013:991. http://ajp.psychiatryonline.org/article.aspx?articleID=158714%5Cnhttp://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:DSM-5#0

  32. Hariri AG, Gulec MY, Orengul FFC, Sumbul EA, Elbay RY, Gulec H. Dissociation in bipolar disorder: relationships between clinical variables and childhood trauma. J Affect Disord. 2015;184:104–10. https://doi.org/10.1016/j.jad.2015.05.023.

    Article  PubMed  Google Scholar 

  33. Raust A, Sportiche S, Geoffroy PA, Aouizerate B, Desage A, Olie E, et al. Childhood trauma, dimensions of psychopathology and the clinical expression of bipolar disorders: a pathway analysis. J Psychiatr Res. 2017;95:37–45.

    Article  Google Scholar 

  34. Garno JL, Gunawardane N, Goldberg JF. Predictors of trait aggression in bipolar disorder. Bipolar Disord. 2008;10(2):285–92.

    Article  Google Scholar 

  35. Herman JL, Perry JC, van der Kolk B. a. Childhood trauma in borderline personality disorder. Am J Psychiatry. 1989;146(4):490–5.

    Article  CAS  Google Scholar 

  36. Agius M, Lee J, Gardner J, Wotherspoon D. Bipolar II disorder and borderline personality disorder - co-morbidity or spectrum? In: Psychiatria Danubina; 2012. p. 197–201.

    Google Scholar 

  37. Minkoswski E. La schizophrénie: Psychopathologie des schizoïdes et des schizophrènes. Paris: Payot; 1927.

    Google Scholar 

  38. Aas M, Kauppi K, Brandt CL, Tesli M, Kaufmann T, Steen NE, et al. Childhood trauma is associated with increased brain responses to emotionally negative as compared with positive faces in patients with psychotic disorders. Psychol Med. 2017;47(4):669–79.

    Article  CAS  Google Scholar 

  39. Torres IJ, Boudreau VG, Yatham LN. Neuropsychological functioning in euthymic bipolar disorder: a meta-analysis. Acta Psychiatr Scand. 2007;116(SUPPL. 434):17–26.

    Article  Google Scholar 

  40. Savitz JB, van der Merwe L, Stein DJ, Solms M, Ramesar RS. Neuropsychological task performance in bipolar spectrum illness: genetics, alcohol abuse, medication and childhood trauma. Bipolar Disord. 2008;10(4):479–94.

    Article  Google Scholar 

  41. Marshall DF, Passarotti AM, Ryan KA, Kamali M, Saunders EFH, Pester B, et al. Deficient inhibitory control as an outcome of childhood trauma. Psychiatry Res. 2016;235:7–12. https://doi.org/10.1016/j.psychres.2015.12.013.

    Article  PubMed  Google Scholar 

  42. Jiménez E, Solé B, Arias B, Mitjans M, Varo C, Reinares M, et al. Impact of childhood trauma on cognitive profile in bipolar disorder. Bipolar Disord. 2017;19(5):363–74.

    Article  Google Scholar 

  43. Miller S, Hallmayer J, Wang PW, Hill SJ, Johnson SL, Ketter TA. Brain-derived neurotrophic factor val66met genotype and early life stress effects upon bipolar course. J Psychiatr Res. 2013;47(2):252–8. https://doi.org/10.1016/j.jpsychires.2012.10.015.

    Article  PubMed  Google Scholar 

  44. Aas M, Haukvik UK, Djurovic S, Tesli M, Athanasiu L, Bjella T, et al. Interplay between childhood trauma and BDNF val66met variants on blood BDNF mRNA levels and on hippocampus subfields volumes in schizophrenia spectrum and bipolar disorders. J Psychiatr Res. 2014;59:14–21.

    Article  Google Scholar 

  45. Mandolini GM, Lazzaretti M, Pigoni A, Delvecchio G, Soares JC, Brambilla P. The impact of BDNF Val66Met polymorphism on cognition in bipolar disorder: a review. J Affect Disord. 2018;243(July 2018):552–8. https://doi.org/10.1016/j.jad.2018.07.054.

    Article  CAS  PubMed  Google Scholar 

  46. Benedetti F, Riccaboni R, Poletti S, Radaelli D, Locatelli C, Lorenzi C, et al. The serotonin transporter genotype modulates the relationship between early stress and adult suicidality in bipolar disorder. Bipolar Disord. 2014;16(8):857–66.

    Article  Google Scholar 

  47. Etain B, Lajnef M, Henrion A, Dargél AA, Stertz L, Kapczinski F, et al. Interaction between SLC6A4 promoter variants and childhood trauma on the age at onset of bipolar disorders. Sci Rep. 2015;5:1–9. https://doi.org/10.1038/srep16301.

    Article  CAS  Google Scholar 

  48. Benedetti F, Riccaboni R, Dallaspezia S, Locatelli C, Smeraldi E, Colombo C. Effects of CLOCK gene variants and early stress on hopelessness and suicide in bipolar depression. Chronobiol Int. 2015;32(8):1156–61.

    Article  Google Scholar 

  49. Aubert E, Jaussent I, Olié E, Ducasse D, Azorin JM, Bellivier F, et al. Effect of early trauma on the sleep quality of euthymic bipolar patients. J Affect Disord. 2016;206:261–7. https://doi.org/10.1016/j.jad.2016.07.045.

    Article  CAS  PubMed  Google Scholar 

  50. Leclerc E, Mansur RB, Grassi-Oliveira R, Cordeiro Q, Kapczinski F, McIntyre RS, et al. The differential association between history of childhood sexual abuse and body mass index in early and late stages of bipolar disorder. J Affect Disord. 2017;227:214–8. https://doi.org/10.1016/j.jad.2017.10.031.

    Article  PubMed  Google Scholar 

  51. Hibar DP, Westlye LT, van Erp TGM, Rasmussen J, Leonardo CD, Faskowitz J, et al. Subcortical volumetric abnormalities in bipolar disorder. Mol Psychiatry. 2016:1–7. http://www.ncbi.nlm.nih.gov/pubmed/26857596

  52. Doucet GE, Bassett DS, Yao N, Glahn DC, Frangou S. The role of intrinsic brain functional connectivity in vulnerability and resilience to bipolar disorder. Am J Psychiatry. 2017;174(12):1214–22.

    Article  Google Scholar 

  53. Duarte DGG, Neves MDCL, Albuquerque MR, De Souza-Duran FL, Busatto G, Corrêa H. Gray matter brain volumes in childhood-maltreated patients with bipolar disorder type I: a voxel-based morphometric study. J Affect Disord. 2016;197:74–80. https://doi.org/10.1016/j.jad.2016.02.068.

    Article  PubMed  Google Scholar 

  54. Bücker J, Muralidharan K, Torres IJ, Su W, Kozicky J, Silveira LE, et al. Childhood maltreatment and corpus callosum volume in recently diagnosed patients with bipolar I disorder: data from the systematic treatment optimization program for early mania (STOP-EM). J Psychiatr Res. 2014;48(1):65–72. http://www.ncbi.nlm.nih.gov/pubmed/24183241

    Article  Google Scholar 

  55. Stevelink R, Abramovic L, Verkooijen S, Begemann MJH, Sommer IEC, Boks MP, et al. Childhood abuse and white matter integrity in bipolar disorder patients and healthy controls. Eur Neuropsychopharmacol. 2018;28(7):807–17. https://doi.org/10.1016/j.euroneuro.2018.05.003.

    Article  CAS  PubMed  Google Scholar 

  56. Etain B, Lajnef M, Brichant-Petitjean C, Geoffroy PA, Henry C, Gard S, et al. Childhood trauma and mixed episodes are associated with poor response to lithium in bipolar disorders. Acta Psychiatr Scand. 2016:1–9. http://www.ncbi.nlm.nih.gov/pubmed/27987204

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Authors and Affiliations

  1. Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy

    Delfina Janiri

  2. Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy

    Delfina Janiri & Gabriele Sani

  3. Centro Lucio Bini, Rome, Italy

    Delfina Janiri & Gabriele Sani

  4. Laboratory of Neuropsychiatry, IRCCS Fondazione Santa Lucia, Rome, Italy

    Gianfranco Spalletta

  5. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA

    Gianfranco Spalletta

  6. Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy

    Gabriele Sani

Authors
  1. Delfina Janiri
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  2. Gianfranco Spalletta
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  3. Gabriele Sani
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Correspondence to Delfina Janiri .

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Editors and Affiliations

  1. Laboratory of Neuropsychiatry, IRCCS Fondazione Santa Lucia, Rome, Italy

    Gianfranco Spalletta

  2. Department of Psychiatry and Neurology, Sapienza University of Rome, Rome, Italy

    Delfina Janiri

  3. Laboratory of Neuropsychiatry, IRCCS Fondazione Santa Lucia, Rome, Italy

    Federica Piras

  4. Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy

    Gabriele Sani

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Janiri, D., Spalletta, G., Sani, G. (2020). Childhood Trauma in Bipolar Disorders. In: Spalletta, G., Janiri, D., Piras, F., Sani, G. (eds) Childhood Trauma in Mental Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-49414-8_8

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  • DOI: https://doi.org/10.1007/978-3-030-49414-8_8

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