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The Effect of Traumatic Events on the Longitudinal Course and Outcomes of Youth with Bipolar Disorder.

Authors
  • Andreu Pascual, Maria1
  • Levenson, Jessica C2
  • Merranko, John2
  • Gill, Mary Kay2
  • Hower, Heather3
  • Yen, Shirley4
  • Strober, Michael5
  • Goldstein, Tina R2
  • Goldstein, Benjamin I6
  • Ryan, Neal D2
  • Weinstock, Lauren M7
  • Keller, Martin B7
  • Axelson, David8
  • Birmaher, Boris2
  • 1 Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA, 15213, USA. Electronic address: [email protected]
  • 2 Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3811 O'Hara St., Pittsburgh, PA, 15213, USA.
  • 3 Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA; Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA; Department of Psychiatry, School of Medicine, University of California at San Diego, 4510 Executive Drive, Suite 315, San Diego, CA, 92121, USA.
  • 4 Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA; Massachusetts Mental Health Center and the Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, 02115, USA. , (Israel)
  • 5 Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, 760 Westwood Plaza, Mail Code 175919, Los Angeles, CA, 90095, USA.
  • 6 Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto Faculty of Medicine, 2075 Bayview Ave., FG-53, Toronto, ON, M4N-3M5, Canada. , (Canada)
  • 7 Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI, 02912, USA; Butler Hospital, 700 Butler Drive, Providence, RI, 02906, USA.
  • 8 Department of Psychiatry, Nationwide Children's Hospital and The Ohio State College of Medicine, 1670 Upham Dr., Columbus, OH, 43210, USA.
Type
Published Article
Journal
Journal of affective disorders
Publication Date
Sep 01, 2020
Volume
274
Pages
126–135
Identifiers
DOI: 10.1016/j.jad.2020.05.131
PMID: 32469795
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Exposure to severe Traumatic Events (TEs) has been associated with poor course and outcomes among individuals with Bipolar Disorder (BD). However, there is limited research on TEs among youth with BD, and few studies are longitudinal. This study prospectively followed a large sample of BD youth, examining the associations of lifetime TEs with their mood and functioning. BD participants (n=375; mean age=17; range 8-25y) were assessed, on average, every 7 months for a median 8.7 years. Psychopathology and lifetime trauma history were prospectively evaluated using the Longitudinal Interval Follow-Up Evaluation, and a traumatic events screening. Accounting for covariates, participants with one or more lifetime TEs (84%) showed earlier BD onset, poorer psychosocial functioning, worse mood symptoms, and more suicidal ideation, comorbidities, and family psychopathology than those without TEs. TEs during recovery periods increased recurrence risk (p<0.02). More TEs were associated with poorer mood course, particularly among victims of violence/abuse (p<0.02). Abused participants (34% physical; 17% sexual) showed earlier onset of substance use disorders, more suicidality and comorbidities compared to those without abuse. Comparisons of mood course before and after abuse occurred, and with participants without abuse, showed worsening mood symptoms after, specifically hypo/mania (p<0.03). Prospective data was gathered longitudinally but assessed retrospectively at every follow-up; given approximate dates causality cannot be inferred; TEs severity was not assessed. Severe TEs, particularly abuse, were associated with poorer course and outcomes among BD youth. Prompt screening of trauma and early intervention may be warranted to minimize TEs impact. Copyright © 2020 Elsevier B.V. All rights reserved.

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