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Trauma exposure and post-traumatic stress disorder in bipolar disorder

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Introduction

There is a lack of data about post-traumatic stress disorder (PTSD) in European bipolar patients compared to the US-population. This study was conducted to ascertain the rates and types of traumatic events and PTSD in bipolar-I disorder.

Methods

Euthymic bipolar patients were screened for lifetime diagnosis of PTSD using the Post-Traumatic Stress Diagnostic Scale and the Clinician Administered Post-traumatic Stress Disorder Scale.

Results

A total of 74 patients (m = 30, f = 44) with diagnosis of bipolar-I disorder were assessed. 37 patients (50%) reported no trauma, 22 patients (29.7%) experienced traumatic events without diagnosis of PTSD and 15 patients (20.3%) had comorbid PTSD. Bipolar PTSD patients were at higher risk to be exposed to physical violence, parental disregard, alcohol dependence of parents, sexual assault by a family member or acquaintance. The number of siblings was higher and they had higher scores on the Hamilton Depression Rating Scale and the Global Assessment of Functioning Scale.

Conclusions

Bipolar patients are more likely to experience traumatic events and PTSD is a relevant comorbid disorder. PTSD is associated with an increased illness severity of bipolar disorder.

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References

  1. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders (DSM-IV), 4th edn, APA

  2. Berkson S (1946) Limitations of the application of fourfold table analysis to hospital data. Biom Bull 2:47–53

    Article  Google Scholar 

  3. Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, Keane TM (1995) The development of a Clinician-Administered PTSD scale. J Trauma Stress 8:75–90

    Article  CAS  PubMed  Google Scholar 

  4. Bock C, Bukh JD, Vinberg M, Gether U, Kessing LV (2009) Stressful life events predict medical treatment outcome in first episode of depression? Soc Psychiatry Psychiatr Epidemiol (epub ahead of print)

  5. Brown GR, McBride L, Bauer MS, Wiliford WO (2005) Impact of childhood abuse on the course of bipolar disorder: A replication study in U.S. veterans. J Affect Disord 89:57–67

    Article  PubMed  Google Scholar 

  6. Dilsaver SC, Benazzi F, Akiskal HS, Akiskal KK (2007) Post-traumatic stress disorder among adolescents with bipolar disorder and its relationship to suicidality. Bipolar Disord 9:649–655

    Article  PubMed  Google Scholar 

  7. Fichter MM, Kohlboeck G, Quadflieg N, Wyschkon A, Esser G. From childhood to adult age: 18-year longitudinal results and prediction of the course of mental disorders in the community. Soc Psychiatry Psychiat Epidemiol (epub ahead of print)

  8. Foa EB, Tolin DF (2000) Comparison of the PTSD Symptom Scale-Interview Version and the Clinician-administered PTSD scale. J Trauma Stress 13:181–191

    Article  CAS  PubMed  Google Scholar 

  9. Garno JL, Goldberg JF (2005) Impact of childhood abuse on the clinical course of bipolar disorder. Br J Psychiatry 186:121–125

    Article  PubMed  Google Scholar 

  10. Goldberg JF, Garno JL (2005) Development of PTSD in adult bipolar patients with histories of severe childhood abuse. Psychiatr Res 39:595–601

    Article  Google Scholar 

  11. Goodman LA, Thompson KM, Weinfurt K, Corl S, Acker P, Mueser KT, Rosenberg SD (1999) Reliability of reports of violent victimization and posttraumatic stress disorder among men and women with serious mental illness. J Trauma Stress 12:587–599

    Article  CAS  PubMed  Google Scholar 

  12. Griesel D, Wessa M, Flor H (2006) Psychometric qualities of the German version of the Posttraumatic Diagnostic Scale (PTDS). Psychol Assess 18:262–268

    Article  PubMed  Google Scholar 

  13. Griffin MG, Uhlmansiek MH, Resick PA, Mechanic MB (2004) Comparison of the posttraumatic stress disorder scale versus the clinician-administered posttraumatic stress disorder scale in domestic violence survivors. J Trauma Stress 17:497–503

    Article  PubMed  Google Scholar 

  14. Hall CW, Webster RE (2002) Traumatic symptomatology characteristics of adult children of alcoholics. J Drug Educ 32:195–211

    Article  PubMed  Google Scholar 

  15. Hoffmann BU, Meier TD (2006) Mood fluctuations in people putatively at risk for bipolar disorders. Br J Clin Psychol 45:105–110

    Article  Google Scholar 

  16. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 52:1048–1060

    CAS  PubMed  Google Scholar 

  17. Leverich GS, McElroy SL, Suppes T et al (2002) Early physical and sexual abuse associated with an adverse course of bipolar illness. Biol Psychiatry 51:288–297

    Article  PubMed  Google Scholar 

  18. Leverich GS, Post RM (2006) Course of bipolar illness after history of childhood trauma. Lancet 367:1040–1042

    Article  PubMed  Google Scholar 

  19. Maercker A, Michel T, Fehm L, Becker E, Margraf J (2004) Age of traumatisation as a predictor of posttraumatic stress disorder or major depression in young women. Br J Psychiatry 184:482–487

    Article  PubMed  Google Scholar 

  20. Michels R, Siebel U, Freyberger HJ, Stieglitz RD, Schaub RT, Dilling H (1996) The multiaxial system of ICD-10: evaluation of a preliminary draft in a multicentric field trial. Psychopathology 29:347–356

    Article  CAS  PubMed  Google Scholar 

  21. Mueser KT, Goodman LB, Trumbetta SL et al (1998) Trauma and Posttraumatic Stress Disorder in severe mental illness. J Consult Clinic Psychol 66:493–499

    Article  CAS  Google Scholar 

  22. Neria Y, Gross R, Olfson M et al (2006) Posttraumatic stress disorder in primary care one year after the 9/11 attacks. Gen Hosp Psychiatry 28:213–222

    Article  PubMed  Google Scholar 

  23. Nutt DJ, Malizia DL (2004) Structural and functional brain changes in posttraumatic stress disorder. J Clin Psychiatry 65(Suppl 1):11–17

    PubMed  Google Scholar 

  24. Otto M, Simon N, Wisniewski S et al (2006) Prospective 12-month course of bipolar disorder in out-patients with and without comorbid anxiety disorders. Br J Psychiatry 189:20–25

    Article  CAS  PubMed  Google Scholar 

  25. Otto MW, Perlman CA, Wernicke R, Reese HE, Bauer MS, Pollack MH (2004) Posttraumatic stress disorder in patients with bipolar disorder: a review of prevalence, correlates, and treatment strategies. Bipolar Dis 6:470–479

    Article  Google Scholar 

  26. Perkonigg A, Kessler R, Storz S, Wittchen H (2000) Traumatic events and posttraumatic stress disorder in the community: prevalence, risk factors and Comorbidity. Acta Psychiatr Scand 101:46–59

    Article  CAS  PubMed  Google Scholar 

  27. Pollack M, Simon N, Fagiolini A et al (2006) Persistent posttraumatic stress disorder following September 11 in patients with bipolar disorder. J Clin Psychiatry 67:394–399

    Article  PubMed  Google Scholar 

  28. Read J, van Os J, Morrison AP, Ross CA (2005) Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatr Scand 112:330–350

    Article  CAS  PubMed  Google Scholar 

  29. Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK (1990) Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiological Catchment Area (ECA) Study. JAMA 264:2511–2518

    Article  CAS  PubMed  Google Scholar 

  30. Schnyder U, Moergeli H (2002) German version of Clinician-Administered PTSD Scale. J Trauma Stress 15:487–492

    Article  PubMed  Google Scholar 

  31. Shalev AY, Freedman S, Peri T, Brandes D, Sahar T, Orr SP, Pitman RK (1998) Prospective study of posttraumatic stress disorder and depression following trauma. Am J Psychiatry 155:630–637

    CAS  PubMed  Google Scholar 

  32. Sheehan DV, Lecubrier Y, Sheehan KH, et al. (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD 10. J Clin Psychiatry 59(Suppl 20):22–23

    Google Scholar 

  33. Simon NM, Otto MW, Wisniewski SR et al (2004) Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry 161:2222–2229

    Article  PubMed  Google Scholar 

  34. Spearing MK, Post RM, Leverich GS, Brandt D, Nolen W (1997) Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): the CGI-BP. Psychiatry Res 73:159–171

    Article  CAS  PubMed  Google Scholar 

  35. Thomson SJ, Maccio EM, Desselle SK, Zittel-Palamara K (2007) Predictors of posttraumatic stress symptoms among runaway youth utilizing two service sectors. J Trauma Stress 20:553–563

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, LWL-Hospital, Ruhr-University Bochum, Alexandrinenstr. 1, 44791, Bochum, Germany

    Hans-Jörg Assion, Nils Brune, Nadja Schmidt, Marc-Andreas Edel, Miriam Basilowski & Georg Juckel

  2. Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, LWL-Hospital Dortmund, Dortmund, Germany

    Thomas Aubel

  3. Department of Psychiatry and Psychotherapy, MediClin, Klinik an der Lindenhöhe, Offenburg, Germany

    Ulrich Frommberger

Authors
  1. Hans-Jörg Assion
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  2. Nils Brune
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  4. Thomas Aubel
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  5. Marc-Andreas Edel
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  6. Miriam Basilowski
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Correspondence to Hans-Jörg Assion.

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Assion, HJ., Brune, N., Schmidt, N. et al. Trauma exposure and post-traumatic stress disorder in bipolar disorder. Soc Psychiat Epidemiol 44, 1041–1049 (2009). https://doi.org/10.1007/s00127-009-0029-1

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  • DOI: https://doi.org/10.1007/s00127-009-0029-1

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