Effects of childhood trauma and clinical features on determining quality of life in patients with bipolar I disorder

Abstract

Background: We explored how childhood trauma (CHT) affects the clinical expression of disorder and quality of life in patients with bipolar I (BP-I) disorder. MethodsEuthymic patients (n=116) who subsequently received a diagnosis of BP-I disorder were consecutively included and were interviewed using the following sociodemographic and clinical data forms; Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Childhood Abuse and Neglect Questionnaire (CANQ) and the 36-item Medical Outcome Study Short Form Health Survey (SF-36). The quality of life of BP-I patients with and without a history of CHT were examined. ResultsThe percentage of trauma was 61.2%. Patients who had CHT had higher frequencies of depressive episodes (t=−2.38, p=0.019), total episodes (t=−2.25, p=0.026), attempted suicide more often (χ2=18.12, p=0.003) and had lower scores on the pain subscale of the SF-36 (z=−2.817, p=0.005). In patients with mixed or rapid-cycling episodes, SF-36 subscale scores except general health and pain were found to be lower. LimitationsOur sample may fail to reflect the general BD population; the patients were included consecutively and consisted of a majority of female patients. ConclusionsCHT plays an important role in the clinical expression of BP-I disorder and having mixed/rapid-cycling episodes negatively affects both physical and mental components, as measured by the SF-36. While both males and females reported experiencing sexual abuse, female BP-I patients complained about pain more often. It is suggested that treatment of BP-I patients with a history of CHT should differ from that provided for patients with no CHT history.